This research paper focuses on the alarming rates of opioid abuse, particularly linked to fentanyl, within San Francisco's homeless population. The study aims to investigate the specific challenges posed by fentanyl and identify effective measures to address them. Recognizing the need for larger-scale interventions, the paper discusses the shift from punitive to harm reduction strategies, such as needle exchange programs and the distribution of Narcan. However, a literature gap exists regarding the comparative effectiveness of these interventions, prompting the proposal of an observational case study. The study plans to explore the impact of different interventions on the lives of the homeless population and associated costs, utilizing a robust data collection approach through key search terms and reputable databases.