Practically a decade into California’s fentanyl disaster, public well being consultants are discovering trigger for each optimism and fear.
Deadly opioid overdoses within the state have lastly receded from report highs, with round 6,700 deaths recorded within the first half of 2024 — a roughly 16% drop from 2023’s peak.
However docs, researchers and a few L.A. County officers warn that many key measures credited with turning the tide are in jeopardy. President Trump has slashed federal funding for dependancy remedy applications, with some providers in L.A. County on the chopping block.
Preliminary L.A. County information present round 1,300 deadly overdoses brought on by fentanyl and different opioids by mid-2024, round 300 fewer deaths in comparison with an analogous time in 2023.
A number of consultants stated an emphasis on hurt discount, together with elevated availability of the overdose reversal drug naloxone and fentanyl testing kits, was behind the development.
However cash earmarked to help such efforts is now drying up.
An L.A. County Public Well being Division spokesperson stated the federal cuts included rescinding greater than $45 million in hurt discount grants. Some funding for substance abuse prevention was additionally terminated mid-contract because of the federal price range adjustments, the spokesperson stated.
“Simply as we’re making progress on overdose numbers, now shouldn’t be the time to divest,” the Public Well being Division’s assertion stated.
On the identical time, native authorities are re-embracing a extra conventional strategy to preventing crime, which incorporates pursuing longer jail sentences towards some drug offenders.
Californians voted to cross Proposition 36 over the past election cycle, imposing stricter penalties for repeat theft and crimes involving fentanyl.
L.A. County Dist. Atty. Nathan Hochman campaigned final 12 months on the drug disaster, pledging to carry “fentanyl poisoners/murderers absolutely accountable for his or her actions of spreading this poison all through our communities.”
“Each fentanyl supplier can be warned of the extreme repercussions to their liberty in the event that they kill an individual with their poison,” Hochman’s marketing campaign web site stated.
Hurt discount employees in Santa Ana distribute the overdose reversal drug naloxone and syringes to shoppers who use opioids.
(Gary Coronado / Los Angeles Occasions)
Ricardo Garcia, L.A. County’s public defender, stated the renewed emphasis on punishment for drug crimes looks like a flashback to when prolonged sentences for crack fueled mass incarceration.
“It’s one thing that we’ve seen earlier than that rises in a short time and infrequently has a devastating impact on poor communities, Black and brown communities, and fairly frankly, taxpayers, as the price of coping with this over-policing,” Garcia stated.
The parallels to the crack period are troubling to many engaged on the entrance strains of at this time’s disaster, from dehumanizing rhetoric — describing fentanyl customers as “zombies” — to punitive sentencing insurance policies.
Shoshanna Scholar, director of hurt discount for L.A. County, stated the important thing to saving lives is evident: Ramp up naloxone distribution and overdose prevention efforts in high-risk communities.
“Over the past 25 years, there’s been an actual reckoning with substance use and seeing it as a continual situation, versus dangerous conduct that requires punishment in an effort to change it,” Scholar stated. “We all know there’s one other path and it really works to cut back the variety of useless individuals.”
Since 2023, California Gov. Gavin Newsom has invested over $1 billion in grants for naloxone distribution, fentanyl take a look at strips and different anti-overdose initiatives. Naloxone — also referred to as Narcan — is now accessible for buy for all California residents by the CalRx initiative for $24.
At this 12 months’s Coachella Valley Music and Arts Pageant, Finish Overdose, a Burbank-based group, had a sales space close to the pageant’s EDM levels providing naloxone coaching, free doses and quite a lot of swag.
On the stall, two twentysomething festivalgoers, Mimi and Lily — who requested to be recognized solely by their first names to debate drug use — stated they’d been taking each attainable precaution for worry they could possibly be bought one thing laced with fentanyl.
“Truthfully, we study probably the most from Reddit and from our mother and father. They’re at all times telling me to watch out about fentanyl,” stated Mimi. “It jogs my memory a whole lot of when individuals promote abstinence in the case of secure intercourse, after they actually ought to be speaking about condoms and contraception. As a result of, both manner, persons are going to do medication, so it’s important to be sure you are doing it safely.”
Dr. Brian Hurley, the county’s medical director who oversees dependancy remedy initiatives, stated implementing harsher penalties on drug customers can enhance the danger of overdose, as persons are extra possible to make use of alone and in secret.
“It turns into tougher to interact individuals in an open, trustworthy, impartial dialog about if they’re able to cease utilizing, if they’re able to strive interim housing or take a shelter mattress. All of these items get individuals off the road in a manner that advances what I believe most individuals really need,” Hurley stated.
He and others famous that even with the tough-on-crime insurance policies of the Eighties and ’90s, crack cocaine use has by no means gone away. And regardless of native authorities saying for years that arrests and prosecutions alone are usually not the answer, consultants stated it’s nonetheless troublesome for these in want of remedy to search out assist.
Devon O’Malley, left, a hurt discount case supervisor with the Venice Household Clinic, fingers out Narcan nasal spray to Ken Newark, 63, at Tongva Park in Santa Monica.
(Mel Melcon / Los Angeles Occasions)
“Individuals are pushing extra extreme penalties and extra arrests, nevertheless it’s simply that’s not the way you cease individuals from utilizing a drug you don’t need them to make use of,” stated Dr. Ricky Bluthenthal, a public well being professor at USC. “Usually talking, incarceration isn’t a spot the place individuals get higher.”
That message, nevertheless, runs opposite to the hard-line strategy now being pushed by the White Home. Trump has cited fentanyl deaths as a purpose for tariffs towards China, a supply of chemical substances utilized in clandestine labs, and steered drone strikes on Mexican drug cartels. Trump has additionally declared fentanyl a weapon of mass destruction and referred to as for giving drug sellers the loss of life penalty
For Dr. Daniel Ciccarone, a UC San Francisco professor who researches public well being and drug use, it’s onerous to not see historical past repeating itself.
The professor, who just lately printed a paper about “ethical panics” surrounding drug use, stated elected officers have lengthy been extra involved with optics and approval rankings than addressing the underlying causes of dependancy.
“We’re afraid of this drug, and we’re afraid of people that use the drug,” Ciccarone stated. “After we get fearful, the pure human response is to search for safety. Who could make us really feel safer? The police and courts.”
The current development in overdose deaths at the very least presents a glimmer of hope, he added, even when nobody can agree on one of the best path ahead.
“I acknowledge that as a human impulse of worry, urgency and panic, that we should do one thing,” he stated. “I’ve heard this from the police saying, ‘Now we have to be seen as doing one thing,’ and I say, ‘OK, however don’t make the issue worse.’”
