JT Farrell, 32 rest near a warm sewer grate on Larkin Street on Thursday, Jan. 13, 2022 in San Francisco, California.
An unhoused person smokes on Jones Street on Wednesday, Jan. 12, 2022 in San Francisco, California. In San Francisco, roughly 1,310 people died from drug overdoses in 2020 and 2021, almost twice the toll of the COVID-19 pandemic. Nearly three-quarters of the victims were found to have fentanyl in their systems. The toll would be higher if not for Narcan, the antidote now used more than 500 times a month to yank people back from the brink of death. Many of the city’s dead have been found within blocks of each other in the Tenderloin and South of Market, which have long shouldered San Francisco’s most pressing problems. The Tenderloin, full of vulnerable people and low-income families, endures a constant open-air drug market that city leaders would never tolerate in wealthier neighborhoods.
Jessica Didia watches as an EMT responds to David Larson who overdosed on drugs at the corner of Eddy and Larkin Streets as people look on on Monday, Feb. 28, 2022 in San Francisco, California. David survived the overdose.
A homeless (left) man walks past the body of Charles Edward Banks, 61, originally from Texas, who lays dead on the sidewalk after a fentanyl drug overdose on Ellis Street in San Francisco, Calif., on Monday, June 12, 2023. Medical personnel tried for over thirty minutes to bring him back to life using an automated chest compression machine but he was unable to be revived. His body was being attended to by San Francisco police as they waited for the medical examiner to arrive. Charles' wife, who is also a drug user, was pregnant at the time of his death but later lost the baby. The opioid epidemic has hit San Francisco particularly hard as authorities have been unable to control the open air drug markets. 2023 has been the deadliest for opioid overdoses on record despite local efforts.
A homeless man sits with his umbrella on Powell Street in San Francisco, Calif., on Monday, Jan. 8, 2018.
EMT's respond to David Thomas Larson, 49, who overdosed on drugs at the corner of Eddy and Larkin Streets on Monday, Feb. 28, 2022 in San Francisco, California. David had been sitting at a bus stop before his eyes glazed over and he hit the ground. Pedestrians called for an ambulance and tried to perform CPR. He was not revived at the scene but he did survive and gave consent to his image after recovering.
A man who goes by Groundstrike sits hunched over after doing drugs outside the window of 6-year-old Lapats Charoensuk’s (not pictured) apartment on Eddy Street on Tuesday, Jan. 18, 2022 in San Francisco, California. He suffers from mental illness and his drug use has left him crippled.
Floyd, (left) and Lulu, 27, (second from right) sit on the ground in Willow Alley as they use drugs in San Francisco on Wednesday, March 13, 2024.
Syringes are seen on the street outside a tent encampment on Harrison Street in San Francisco, Calif., on Wednesday, January 11th, 2017.
A drug deal is made on Eddy and Hyde Streets in the Tenderloin on Friday, Jan. 14, 2022 in San Francisco, California. Dealers have said they can make over $350,000 a year in drug sales. Law enforcement efforts can feel futile: The supply of fentanyl has grown exponentially and the Tenderloin, full of vulnerable people and low-income families, endures a constant open air drug market that city leaders would never tolerate in wealthier neighborhoods. The seeds for the crisis began with the crackdown on the rampant overuse of prescription opioids in the early 2000s sent people addicted to opioids to the illicit heroin market. Then came a surge in overdoses and a squeeze on the heroin supply. But the demand was still there, so dealers cut their product with fentanyl, which is stronger, readily available, and much more deadly.
Lloyd Brown, who is homeless, set up his tent on Alameda Street in San Francisco in February 2016.
Twitch Napier, a homeless transgender woman, sits with her dog Shiva next to a tent encampment under the freeway on Division Street in San Francisco, California on Thursday, February 25, 2016.
Homeless man Kevin Christopher Highfield, 39, sits for a portrait on Larkin Street in San Francisco, California, on Tuesday, June 18, 2019. Kevin said he has been homeless since he was 18 years old after getting kicked out of the house by his mother.
Four homeless men including Larry Gaspar, 66 (center, with shoe heels shown) sleep on Larkin Street in San Francisco, California, on Tuesday, June 18, 2019. Photo taken on the corner of Larkin Street and McAllister Street at 10:14pm.
J.D. Spurgeon uses fentanyl in his tent in his parents back yard in Grants Pass, Oregon on Thursday, April 11, 2024.
Esmeralda Carachure, 45, drags her belongings to the front of the Poverello house shelter for safe keeping during a police sweep in Fresno, Calif., on Wednesday, Sept. 18, 2024. Each morning, homeless people who live outside the shelter have to pack up their belongings while the police and cleaning crew come by. The belongings must be moved by 7am or the police throw them in the trash.
A police officer surveys the front of the Poverello house shelter during a police sweep of a homeless encampment in Fresno, Calif., on Wednesday, Sept. 18, 2024. Each morning, homeless people who live outside the shelter have to pack up their belongings while the police and cleaning crew come by. The belongings must be moved by 7am or the police throw them in the trash.
Arturo Castro- Ochoa and friend Kimmy Smith, 25 rest on a mattress at their tent encampment along the railroad tracks in Fresno, Calif., on Tuesday, Sept. 17, 2024.
A woman lays passed out on the sidewalk in the Tenderloin in San Francisco in September, California. She was later tended to by medics.
Ollie Harris, 69, and partner Debbie Lang, 63, rest in their tent at an encampment on East 12th Street in Oakland, California, on Wednesday, July 24, 2019. Debbie and her partner Ollie are currently homeless. They went through Oakland's Tuff Shed program where they resided before getting permanent housing in Stockton. After spending a month in an apartment in Stockton the couple moved back to an encampment in Oakland because they claimed the apartment was infested with rats and cockroaches.
Leslie and Richard Burton (right) embrace one another as they stand by their belongings during a police sweep of a homeless encampment in Fresno, Calif., on Wednesday, Sept. 18, 2024. Each morning, homeless people who live outside the shelter have to pack up their belongings while the police and cleaning crew come by. The belongings must be moved by 7am or the police throw them in the trash.
A man who survived a drug overdose is carried away by medical personnel on Mission Street near 7th Street near the Federal Building in San Francisco on Tuesday, Sept. 19, 2023. He was revived by an unhoused drug user because Federal Marshall’s said they were untrained to intervene.
A man chats on his cell phone as he walks past a tent encampment on Harrison Street in San Francisco, Calif., on Wednesday, January 11th, 2017.
Shawn attempts to inject Molly with heroin in her neck on Larkin Street in San Francisco, Calif., on Thursday, Oct. 26, 2017.
A man (declined name) from SF Recology throws out the remaining belongings of a homeless couple who were shot to death on Sunday night on 16th Street, in San Francisco, Calif., on Monday, Dec. 19, 2016.
Angela Flax, a homeless woman, originally from Missouri, does her makeup in her tent, before going out to meet a friend on Division Street in San Francisco, California. She has been in San Francisco for ten-weeks.
Princess Surak, 27, holds a needle in her mouth as she prepares to inject heroin at OnPoint NYC, a supervised drug injection site in Washington Heights on Wednesday, March 23, 2022 in New York, New York.
Joolie Coombes sits outside her friends tent as she watches the commotion between the homeless and the police, on Division Street, in San Francisco, California, on Tuesday, March 2, 2016.
(l-r) Homeless couple Papa Smurf and his girlfriend Dawn Perry look out of their tent in the Design District in San Francisco, California, on Thursday, March 23, 2017.
Homeless man Timothy Robbins, 26, sweeps up around the area where his tent was pitched on Division Street in San Francisco, California.
Department of Public Works employees haul an abandoned tent on Division Street in San Francisco, California, on Tuesday, March 1, 2016.