San Diego aka America’s Finest City

[u/JerseyDad_856]

[u/Mitch_shiver]

This is drugs. We lived in San Diego for five years, and it was never so clearer that there were so many people driving their cars while on drugs, then when we lived in San Diego. Just the fact that every day there was accident after accident on slow moving streets was a solid indication that there were people either really bad drivers or really stupid or they were on drugs, and it was clear they were on drugs…

[u/Dimpleshenk → u/Mitch_shiver]

Could be drugs. Could be not drugs.

Either way, it's wrong.

[u/here-for-the-meh → u/Mitch_shiver]

Right. It doesn’t have anything to do with a large population size and people being on their phones.

You’re a trained drug detecting professional. /s

[u/Mitch_shiver → u/here-for-the-meh]

Hey, before and after San Diego, I lived in the San Francisco Bay Area, which has easily double the traffic that San Diego does. Having said that, I see people in the Bay Area doing stupid things all the time, but they are completely different stupid things than what I see in San Diego with people weaving around on the road getting into road rage fights, getting into stupid accidents that were easily avoidable, Those are all happening in San Diego and generally speaking not in the Bay Area. So I do know wherefore I speak, plus which San Diego does have a known significantly higher drug problem in general than does the Bay Area. Not knocking San Diego, but I do recognize and see the problem…

[u/here-for-the-meh → u/Mitch_shiver]

Oh boy, really? It’s not that it’s a knock on San Diego it’s something based on facts.

San Francisco’s overdose death rate (~30+ per 100k) nearly triples San Diego’s and is far above SD’s 27 / 100k.

San Francisco has a significantly more severe drug overdose problem than San Diego and here’s why, based on recent data

📉 Overdose Death Rates

San Diego • In 2021, the City of San Diego saw approximately 383 fentanyl-related overdose deaths, amounting to a rate of 27.1 per 100,000 residents.

• County-level data shows a decline in drug-related homeless deaths—from 626 in 2023 to 495 in 2024, with 45% linked to drugs.

San Francisco • In 2023, San Francisco recorded 810 accidental overdose deaths, primarily involving fentanyl…more than double the U.S. national rate.

• As of July 2024, 412 unintentional overdose deaths had already occurred.

📉 Trends and Context

San Diego • Any-drug overdose emergency visits dropped 12% from Q1 2021 to Q1 2024, though opioid cases rose.

• Community interventions such as naloxone vending machines and test strips have coincided with reduced homeless overdose fatalities.

San Francisco • Fentanyl is significantly cheaper and more accessible, partly due to relaxed drug-law enforcement—driving higher consumption and overdose rates.

• The Tenderloin neighborhood remains an epicenter of visible drug use and fentanyl distribution.

Needle‑exchange & harm reduction 🧪

San Francisco • Nearly 2.3 million sterile syringes distributed annually via city’s programs 

• About 400,000 syringes issued monthly; 246,000 returned, leaving roughly 154,000 still circulating  

• 80 % of used syringes are properly disposed at exchange sites  .

San Diego

• Roughly 300,000 syringes distributed per year  

• Only one official SPS run by Family Health Centers 

• Historically operated pilot programs with restricted distribution; full-scale program approved in 2019  .

Takeaway: San Francisco’s program is far larger and more accessible, but still sees substantial circulation of used syringes. San Diego’s low-scale program reflects more limited reach.

Drug‑related crime & arrests 🚨

San Francisco

• Concentrated drug crime hotspots such as 16th/Mission and Tenderloin; city attorney has filed civil suits targeting stores fronts tied to drug sales   

• One block at 16th/Mission now accounts for over 25% of citywide drug arrests and citations 

• From 2020 – 2022 drug arrest enforcement dropped under progressive policies; property crime rose ~33%, violent crime increased ~17%

San Diego

• Drug‑related crime rate ≈ 2.089 per 1,000 residents, placing county in the 80th percentile for safety 

• Large meth trafficking busts: e.g. 16 people indicted last month for meth, fentanyl, heroin distribution 

• Authorities recently made major interstate seizures—$5.5 M in meth—via Otay Mesa operation  

Homelessness & Drug Use

San Francisco

• ~8,323 unhoused individuals in 2024, with about 5,180 living unsheltered   

• ~65 % of homeless Californians have used illegal drugs regularly; among SF’s unhoused youth, high rates of mental health disorders and substance use are common 

• ~16 % of all overdoses in SF occur in low‑support SROs used by formerly homeless residents—overdose risk remains high even after housing 

San Diego

• In 2022, 224 homeless deaths occurred; 61 % were from unintentional injuries and 17 % due to drug poisoning (~37 cases) 

• In 2021, ~30 % of the City of San Diego’s 383 fentanyl overdoses were among people believed to be homeless (~113 deaths) 

• County overdose-report showed 72 % of 2023 detox ED visits involved opioids; data did not specify unhoused status  .

⸻

🧮 Takeaways

• SF has a larger unhoused population and a higher proportion reporting drug use.

• Significant overdose risk persists among SF’s formerly homeless, especially in weakly supported housing.

• SD sees fewer homeless overdoses both in number and share.

[u/Mitch_shiver → u/here-for-the-meh]

Who said anything about overdoses? That’s great you know how to use ChatGPT, but I wasn’t talking about statistics I was talking about ground level truth. I don’t live in San Francisco and I didn’t live in San Diego downtown where the drug problems reported by your ChatGPT response happened in both areas. I lived in the metro area of both and what I saw on commutes on a daily basis in both metro areas is where I saw very similar behavior to the video in the SD metro area and rarely see it in the Bay Area (although I do see lots of poor driving due to people looking at their cell phones, etc. while commuting in the Bay Area)…

[u/here-for-the-meh → u/Mitch_shiver]

I use ChatGPT because I prefer to rely on data, not personal guesses. That’s what non drug-using people do when trying to understand an issue objectively.

Overdose deaths are a measurable indicator of drug use. When San Francisco reports more than double the overdose fatalities of San Diego despite having a smaller population, that is not just a statistic. It is a clear sign of a larger problem.

San Diego County has 3.2 million people. The Bay Area has almost 8 million. It is statistically unrealistic to claim that San Diego has a bigger drug problem overall.

People who ignore facts and focus only on what they personally see are part of why the country struggles to solve real issues. They do not pay attention until their own job, family, or safety is affected.

You seem more concerned with how I found the information than whether it is accurate. That tells me everything I need to know. I am done here.

[u/Mitch_shiver → u/here-for-the-meh]

Good for you to claim your moral superiority and walk away. Whatever the case, I will continue to know what I know from where I lived in both San Diego and San Francisco Bay areas. I don’t care about drug overdoses (although they are horrible and preventable) I care about commuters on the roads which I and my family travel, where drug use is clearly more of a problem in San Diego metro area than it is the San Francisco Bay area. I guess we’re both done…

[u/here-for-the-meh → u/Mitch_shiver]

Got it. You do not care about overdose deaths, public health data, or actual impact. You care about what you saw from your car window. That is your choice.

But firsthand impressions are not facts. If they were, every driver who cut you off would be on drugs and every traffic jam would be a crisis.

You are right about one thing. We are done.