Drug overdose deaths in San Francisco are snowballing, and the city still hasn’t ruled out its strategy of enabling users.

San Francisco saw 806 people die from accidental drug overdoses in 2023, the most on record and a sharp increase after a brief decline. The previous record was 726 in 2020, during the pandemic lockdowns. That dropped to 642 in 2021 and ticked up slightly to 649 in 2022 before the surge in overdose deaths last year.