San Francisco counted 34 fatal drug overdoses in July, its lowest monthly tally since the city began tracking them in 2020. Officials framed it as proof their programs are working. The harder truth is that the decline started before most of those programs did — and it is happening almost everywhere.

The July count, released Aug. 14, is a real improvement: down roughly a third from a year earlier, with 296 deaths so far in 2026 against 412 over the same stretch of 2025. Public health director Daniel Tsai credited a run of initiatives the city has stood up since early 2025. But San Francisco already hit a "record low" in July 2024, before those programs opened, and federal data show overdose deaths dropping across the country for a third straight year. How much of the local win the city can actually claim is the open question the celebration skipped.

Start with the good news, because it is good news. In July, 34 San Franciscans died of accidental overdoses — the fewest in any month since the medical examiner began publishing monthly counts in 2020. Compared with the same month last year, the drop is somewhere between 27% and 35% depending on which measure you use, and the running 2026 total of 296 is down nearly 30% year over year. SFGATE first surfaced the numbers; the San Francisco Examiner detailed the Aug. 14 briefing, where Tsai called himself optimistic while cautioning that the city still faces a behavioral-health emergency.

He credited a specific list: an involuntary sobering center in SoMa, a crisis-stabilization center in the Tenderloin, the merging of the city's street outreach teams under his department, and a bigger push on medication-assisted treatment. Most of those launched in 2025 under Mayor Daniel Lurie.

Here is the wrinkle. The city announced a "record low" once before — in July 2024, when the medical examiner logged 39 accidental overdose deaths, the first month under 40 since early 2020 and a 50% fall from the July prior, according to KQED's reporting at the time. That happened under a different mayor and a different health director, and before the sobering center, the stabilization center or the RESET diversion program existed.

The city's own officials have been more candid about the causes than the press releases suggest. Reporting on June's figures, DPH deputy director Dr. Naveena Bobba told ABC7 the improvement owed to a mix of national trends and local effort — not local effort alone. Two years ago, Stanford addiction-policy researcher Keith Humphreys made a similar point to KQED, tying the slide to national forces such as a shrinking heroin supply and the receding pandemic.

The national data track with that. In May, the CDC's National Center for Health Statistics reported↗ (external source, opens in a new tab) that U.S. overdose deaths fell for a third year running in 2025, down about 14% to an estimated 69,973, with fentanyl-class deaths off 22%. The declines reached nearly every state. San Francisco's improvement sits inside that national one.

That context takes nothing from the people living the change. Beverly Lee, who grew up in Bayview-Hunters Point, said Code Tenderloin outreach workers coaxed her into treatment at a Sixth Street triage site, where she began monthly buprenorphine injections. A year on, she told the briefing, she has a home, a job and a relationship.

Two footnotes belong under the headline. The 34 figure is preliminary and can climb as toxicology closes out, the same way earlier monthly counts have. And even at a record low, San Francisco still ranks among the deadliest counties in the nation for overdoses — a distinction ABC7 pegged at second. The number falling is not in dispute. What City Hall owes residents is an honest account of why — and a plan for the month the national tide stops doing half the work.