Understanding the overdose crisis through the eyes of workers trying to save lives

More than 750 people died from drug overdoses in San Francisco in 2023, a record high. 

Drug use and overdose deaths have gotten plenty of attention in the city. Residents post images of people using drugs and overdosing. Journalists from local and national publications have covered the push for tougher penalties and calls from activists for safe consumption sites where people can use drugs under supervision. 

For my project for the Center for Health Journalism 2023 California Health Equity Fellowship, I knew I needed to take on this topic from a unique angle to be useful. I thought about my past reporting on workers reversing overdoses at Hotel Whitcomb in San Francisco. Workers at the hotel, which opened for unhoused people during the pandemic, provide life-saving treatment for low pay while dealing with their own trauma. Many also had direct experiences with substance use.

I decided to pitch a series focusing on frontline workers, and ultimately produced four radio stories on KALW radio in a series called “In Harm’s Way: Workers Battle the Overdose Crisis.” 

I hope some of the lessons I learned can provide insight for people wanting to take on a big topic and add to an important conversation. 

1. Don’t be afraid to focus on people.

This fellowship helped me return to documentary-style radio stories that focus on people and characters. My goal was to produce four stories, portraits of workers’ lives and the clients they’re trying to help. Because I work multiple jobs, I knew I needed a medium and an approach that would save time. 

As I listened to my tape and drafted my scripts, I began to understand the power of personal anecdotes, especially when people are given the space to share their insights. For example, in the first episode, “Street Outreach in San Francisco,” a woman named Jennifer Hernandez, who had only recently found housing, gives her take on calls to arrest more people living on the streets.

“Something happened along the line that made us feel that this is where we belong,” she says. “It gets to a point where we’re sick of being walked over and ignored like we’re not human anymore.” 

To me, hearing her voice speak to this issue adds an important perspective to the necessary conversation around drug use and addiction. 

2. Follow sources to work.

This project reminded me that following sources to work and shadowing them can sometimes be all you need to tell a story successfully. I shadowed several workers during street outreach for this series. In one case, I watched as a worker approached a former client on the street. The client had previously found support at the Tenderloin Center, a one-stop shop for receiving basic services that had closed. Now the client was struggling on the streets alone, and he cried out in despair. The moment was powerful and raw, and I was there to record. 

My hope was to capture some of the emotion and frustration of workers seeing services disappear, and following that worker during a day on the job allowed me to do so. I could not have demonstrated the fallout from closing the Tenderloin Center through phone calls, a reminder of how important it is to show up in person and report. 

3. Pay attention to themes.  

If you don’t know exactly what the story is, listen closely to what sources say, paying careful attention to themes or trends. Harm reduction groups throughout California all have histories and stories to tell. 

For example, one theme that came out in my reporting was of older generations of workers feeling burned out on the job. Meanwhile, newer staff sign up for jobs they know will be difficult, especially in the age of fentanyl. When I shadowed the group Punks with Lunch, I met a woman who had worked with harm reduction programs since the 1990s and was preparing to move, and another worker deeply passionate about saving lives and learning to set personal boundaries. Similarly, my third story captured a substance use counselor speaking to a client who aspired to work in treatment herself one day. 

4. If a story falls through, let one story become two.

Before the fellowship began, I had carefully planned out my four stories. But then my ideas to cover efforts to unionize at a nonprofit fell through. Luckily, while my editor was going through one of my drafts, she had the idea of turning what had started as one story into two. The story, which focused on high turnover for substance use counselors, had mentioned that many workers got their start at City College of San Francisco. My editor suggested producing one story focusing on how community colleges have been a pathway for those looking to enter the field. That became the final episode in the series, “Bringing Lived Experience with Addiction to Class.” 

If you feel you don’t have enough material but are working against a deadline, try creating a story anyway. Pay attention to the gaps that remain, and you may have done more reporting than you realize. 

5. Find ways to keep reporting.

For International Overdose Awareness Day in August 2023, activists set up their own temporary safe consumption site in San Francisco. Almost every main character in my KALW series for this fellowship was there, a rare chance for me to hear directly from sources how they felt about my reporting. These workers are still out there doing this work, and people are still fatally overdosing in terrifying numbers. 

I feel I have so much more reporting left to do on this topic, and people I met in the reporting process whom I want to hear from again. It’s hard to finish a big project and then stop, but it’s also difficult to keep going without the kind of support the USC Annenberg Center for Health Journalism provided. My advice for myself, or anyone working on reporting they care about, is to try to find ways to keep going. That can mean making a note to follow up with sources when the time is right, getting creative about the medium, or slowly but surely chipping away on big projects.