San Francisco Department of Public Health Director Dr. Grant Colfax joined other medical directors at a press conference this week to call on legislators to pass a bill that would ease restrictions on opioid addiction medicines.
In July in San Francisco, 39 people died of accidental drug overdoses, according to the monthly DPH report.
“That is an over 50% drop in overdose deaths that we’re seeing in San Francisco in July 2024 compared to July of 2023, when there were 79 overdose deaths,” Colfax said during Wednesday conference.
He considered it a sign that the department’s efforts to expand treatment are working.
“Fentanyl remains our focus, because fentanyl remains the primary driver of the overdose deaths that we continue to report,” he said.
Colfax said that medications such as methadone and buprenorphine are the most effective treatments for opioid use disorder and reduce the risk of death in some cases by as much as half.
According to a research study published in July by the National Institutes of Health, medications like buprenorphine and methadone are highly effective but remain underused. The study said methadone should be made more accessible, as it may hold clinical advantages in the age of fentanyl.
Methadone and buprenorphine reduce the cravings and withdrawal symptoms that can delay recovery.
“We applaud the federal government for recently relaxing regulations earlier this year, but California needs to make more regulatory changes around methadone access in order to make a greater impact locally.”
SFDPH Director Dr. Grant Colfax
“We often don’t talk about methadone as much as buprenorphine, but we want to emphasize that methadone is as effective as buprenorphine. But it has been restricted by excessive regulations at the state and federal level,” said Colfax.
“We applaud the federal government for recently relaxing regulations earlier this year, but California needs to make more regulatory changes around methadone access in order to make a greater impact locally,” he said.
Federal changes allow a broader number of medical professionals, including nurse practitioners and physician assistants, working at licensed narcotic treatment programs to administer drugs like methadone. New federal rules also allow methadone treatment to be initiated via telehealth.
Overhauling methadone access
Assembly bill 2115, presented in February by Assemblymember Matt Haney, D-San Francisco, would make changes to the state pharmacy law to bring it in line with new federal rules.
“It is true that methadone is the most regulated medication in the United States,” said Dr. Hillary Kunins, Director of Behavioral Health in San Francisco.
“Can you imagine requiring a person who has heart disease to be physically present at a special cardiac clinic every day to take their medication? That’s what new methadone patients need to do to get their daily medication,” said Kunins.
Currently in California, methadone can only be dispensed from a licensed opioid treatment program, also called a methadone clinic. Under new federal laws, new methadone patients can get up to 72 hours’ worth of methadone from a hospital or other health clinic, said Kunins. This allows them to start methadone treatment immediately outside the operating hours of a methadone clinic.
Other changes in Haney’s bill would prohibit a narcotic treatment program from denying treatment to a patient based on the length of time they have been addicted. A program could not deny medication if a patient refuses counseling. And the decision to dispense take-home doses would be made by the medical practitioner, based on new criteria to prevent harm to the patient or others.
San Francisco DPH currently has more than 2500 people receiving methadone, said Colfax. Total accidental overdose deaths in 2024 are 374 to date, according to DPH reporting, with fentanyl accounting for 268. Area codes with the highest overdose deaths were 94102 and 94103, which span the Tenderloin to South of Market areas.
International Overdose Awareness Day is Aug. 31. To learn more about treatment options, San Francisco’s Behavioral Health Access Center can be reached 24/7 at 888-246-3333, and is open daily at 1380 Howard St., San Francisco.
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