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In almost a decade or so of California’s fentanyl crisis, public health experts have found the causes of both optimism and worry.
The state’s fatal opioid overdoses have finally settled from a record high, down about 16% from its 2023 peak, marking around 6,700 deaths in the first half of 2024.
However, doctors, researchers and some LA county officials have warned that many important measures believed to turn the tide are at risk. President Trump has significantly cut federal funding for addiction treatment programs, with some services in LA County located in the Chopping Block.
Preliminary LA County data show about 1,300 fatal overdoses caused by fentanyl and other opioids through mid-2024, showing that around 300 deaths are fewer than a similar time in 2023.
Several experts said the focus is on reducing harm, including increasing availability of overdose reversal drugs naloxone and fentanyl testing kits.
But the money allocated to support such efforts is now drained.
A spokesperson for the LA County Department of Public Health said federal cuts include withdrawing more than $45 million in harm reduction grants. Several funds to prevent substance abuse have also ended in the mid-term contract due to changes in the federal budget, a spokesperson said.
“Like we’re making progress on overdose numbers, it’s not time for sale,” a statement from the Department of Public Health said.
At the same time, local governments are re-enveloping more traditional approaches to combating crime.
The Californian voted to pass Proposition 36 during the final election cycle, imposing harsher penalties for repeated theft and crimes involving fentanyl.
LA County Dist. Atty. Nathan Hochman campaigned about the drug crisis last year, saying, “We pledged to pledge that fentanyl addicts/killers will be fully responsible for their actions spreading this poison throughout our community.
“All fentanyl dealers are warned of serious consequences on freedom when they kill people with poison,” says Hochman’s campaign website.
Santa Ana Harm Reduction Workers distribute overdose inverted drug naloxone and syringes to clients using opioids.
(Gary Coronado/Los Angeles Times)
Ricardo Garcia, public defense attorney for LA County, said the new emphasis on punishment for drug crimes feels like a flashback when the long sentences for refueling cracks burn.
“We’ve seen it before it rose very quickly, but the cost of dealing with this excess of politics is often devastatingly impacting poor communities, black and brown communities, and frankly taxpayers,” Garcia said.
The similarities in the Crack Age are bothering many who are at the forefront of today’s crisis, from the rhetoric of inhumanity that describes fentanyl users as “zombies” to punitive sentencing policies.
Shoshanna Scholar, LA County’s Director of Hazard Reduction, said the key to saving lives is clear. It is increasing the distribution of naloxone and overdose efforts in high-risk communities.
“In the last 25 years, we have seen it as a chronic condition, in contrast to bad behaviors that require punishment to change it,” the scholar said. “We know there is another path and work to reduce the number of people who actually died.”
Since 2023, California Gov. Gavin Newsom has invested more than $1 billion in grants in the naloxone distribution, fentanyl test strips and other anti-overdose initiatives. Naloxone (also known as Narcan) is now available for purchase by all California residents through the CalRX initiative for $24.
At this year’s Coachella Valley Music and Arts Festival, Burbank-based organization End End Overdose had a booth offering naloxone training, free doses and a variety of swags near the festival’s EDM stage.
At the food stall, two 20 festival participants, Mimi and Lily, asked to be identified by the first name alone to discuss drug use – said they had taken all possible precautions due to the fear that they could sell a mixture of fentanyl.
“To be honest, we learn the most from Reddit and our parents. They always tell me to be careful of fentanyl,” Mimi said. “When it comes to safe sex, when we should talk about condoms and birth control, when people promote abstinence, it reminds me a lot.
Dr. Brian Hurley, the county medical director who oversees addiction treatment initiatives, said implementing strict penalties on drug users could increase the risk of overdose.
“It’s difficult to get people into open, honest, neutral conversations about whether they’re ready to stop using it or whether they’re ready to get on a shelter bed. All of this will get people off the streets like they think most people really want,” Harley said.
He and others pointed out that even with the strict criminal policies of the 1980s and ’90s, crack cocaine use never stopped. And despite years of saying that arrests and prosecutions alone aren’t the solution, experts said it’s still difficult for people in need of treatment to find help.
Devon O’Malley, harm reduction case manager at the Venice Family Clinic, gives 63-year-old Ken Newark a Narcan Nair spray at Tonva Park, Santa Monica.
(Melmercon/Los Angeles Times)
“People are pushing for more serious penalties and more arrests, but that’s not a way to stop people from using drugs they don’t want to use.” “Generally speaking, incarceration isn’t where people get better.”
But that message runs counter to the hardline approach currently being pushed into by the White House. Trump cites fentanyl death as a reason for tariffs on China, the source of chemical constituents used in secret labs, and proposes a drone strike at Mexican drug cartels. Trump also called for Fentanyl to declare weapons of mass destruction and to grant the death penalty to drug dealers
For Dr. Daniel Chickaron, a professor at UC San Francisco who studies public health and drug use, it’s hard to see history repeat itself.
A professor who recently published a paper on “moral panic” surrounding drug use said elected officials have long been interested in assessing optics and approval rather than addressing the underlying causes of addiction.
“We are afraid of this drug and we are afraid of those who use it,” Ciccarone said. “When we are afraid, the natural human response is to look for security. Who can feel safer? Police and the courts.”
The recent trend in overdose deaths provides at least a faint glow of hope, he added.
“I recognize that we have to do something as a human impulse of fear, urgency, panic,” he said. “I’ve heard the police say, ‘We have to be seen as doing something.’ “OK, but don’t make the problem worse.” ”
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