Overdose: Fentanyl deaths have skyrocketed in Los Angeles County. SMDP Image

The State of California, County of Los Angeles and City of Santa Monica are all in the midst of an overdose crisis caused largely by the surging prevalence of fentanyl in recreational drugs in recent years.

Fentanyl has reemerged in local headlines following a spate of overdoses in Hollywood but the drug is causing deaths locally, regionally and throughout the state at an alarming rate.

Fentanyl is a synthetic opioid that, according to the CDC, is up to 50 times as potent as heroin and 80 to 100 times more powerful than morphine. It’s a major contributor to fatal and non-fatal overdoses across the nation. It is colorless and odorless and can be deadly in quantities as small as a few grains of sand. Many people who overdose on fentanyl unknowingly ingest it laced in pills or powders.

According to a recent study of CDC data by online pharmacy company NiceRx, fentanyl overdose deaths have been spiking nationwide for years. Between 2013 and 2016, fentanyl deaths increased 855.45% nationwide making it the fastest growing source of drug-related deaths. Fentanyl was responsible for a total of 32,728 deaths over three years and while that’s less than the total number attributed to heroin (48,579) the rate of increase in fentanyl is so far beyond anything else (cocaine 112.75%, methamphetamine 111.71%, heroin 89.6%) that it’s the largest concern for health officials.

According to the CDC data, California reported the most overdose deaths in the country between 2013 and 2020 at 39,156. The annual number of deaths has doubled in that time from 4,452 in 2013 to 8,908 in 2020. About 9% of the state’s population is reported to have an addiction to drugs or alcohol.

The numbers are just as shocking in Los Angeles where the Coroner’s office has reported total opioid deaths more than tripled between 2016 and 2020. According to the Prescription Drug Abuse Coalition of Los Angeles County, the number of fentanyl overdose deaths in the county increased every year since routine testing of fentanyl began in 2016. In 2020, fentanyl-related overdose deaths increased to 1,125, a 982% jump from 2016, and a 144% increase from the previous year.

According to the County Department of Public Health, in 2021, fentanyl was identified in about 77% of adolescent overdose deaths nationally, and over 80% of drug overdose deaths among adolescents aged 15 – 19 in 2015 were unintentional. Fentanyl and methamphetamine-related overdose deaths have increased in Los Angeles County even prior to the pandemic and continue to rise at an alarming rate.

City by city, the trend is the same. Four high school students overdosed on fentanyl laced pills in Hollywood last week and one of those, a 15-year old girl, died. The tragic death is just the latest in an ongoing crisis that has hit Santa Monica as recently as this year.

Three female students, who were all enrolled in the Santa Monica-Malibu Unified School District, were transported to the hospital from a Santa Monica apartment in May after reportedly overdosing on fentanyl-laced drugs. Santa Monica teenager Sammy Berman Chapman died in February 2021 after ingesting a fentanyl-laced pill he purchased from a dealer on Snapchat and mistakenly believed to be Xanax.

In Santa Monica specifically, overdose calls increased 33 percent in 2021 and depending on trends this year, will increase by an additional 10-25 percent.

While every overdose isn’t necessarily fentanyl, local officials said their paramedics are easily able to identify an opioid overdose compared to another class of drug and the wealth of data at every level supports the conclusion that fentanyl is making rapid inroads locally.

The County Department of Public Health said recently that part of the crisis is being driven by counterfeit pills contaminated with fentanyl and other life-threatening substances and Fire Chief Danny Alvarez said fentanyl is particularly insidious as it is being inserted into other kinds of drugs, often without the knowledge of the buyer.

“What’s most concerning for me is those cases where we have individuals that believe they are taking something else when it’s actually fentanyl or laced with fentanyl which was the case with the teenagers. Unfortunately, that scenario is happening more frequently,” he said. 

While youth overdoses have made headlines, SMFD’s EMS Coordinator, Catherine Borman, said the problem cuts across ages, social classes and  income levels

“It’s not just students or just homeless individuals, it’s everyone,” she said. “It’s a broad cross section, it’s not just street drugs, it’s also prescription drugs that people overdose on. It’s a general problem.”

To try to address the crisis, the local fire department is participating in a Naloxone Distribution Program that allows them to leave doses of the lifesaving medication with individuals who may encounter someone overdosing.

Naloxone is carried by many first responders as a nasal spray. The medication attaches to opioid receptors blocking the effects of other drugs and potentially reversing some overdose symptoms. While paramedics or EMTS can administer it when they arrive on scene, the new program allows them to leave doses behind. Officials said leaving the drug is not automatic and it requires a responsible individual to be able to follow the directions but by providing the opportunity to use it, they hope to prevent deaths.

“We leave two doses of four milligrams. A typical dose is two to four milligrams, so it’s two doses of four milligrams,” said Borman. “We educate them and we leave the medication with them so that if their loved one experiences an overdose they can administer it, call 911 and hopefully save their life.”

She said calling 911 is imperitive, even with naloxone, because the effects are temporary and depending on the quantity of drugs in the patient’s system, they could still overdose and die when naloxone wears off without additional medical care.

The program has been operating for a couple of months and officials have left it with individuals three times so far. Overall, the statewide project had distributed more than 1,300,000 units of naloxone by July of this year and reversed more than 86,000 opioid overdoses.

County officials recently said naloxone is available to patients who are at an increased risk of opioid overdose or who have household members, including children, who are at risk for accidental ingestion or opioid overdose. Residents can ask their primary healthcare provider about being prescribed naloxone if not automatically co-prescribed to you. Naloxone is also available without a prescription ast some pharmacies (https://drugpolicy.org/pharmacy-naloxone-access-california) or from community distribution points (https://harmreduction.org/resource-center/harm-reduction-near-you)

While naloxone is a post-overdose treatment, Chief Alvarez said he’s working on the education component to try to raise awareness as much as possible.

“We want people to start having these conversations and to understand that you can think you’re taking one thing when it’s actually something different. From our perspective, this education is critical and awareness of the dangers of fentanyl have the potential to save lives,” he said.