California could get some relief for its rising overdose deaths as the Biden administration moves to better control the opioid epidemic.
More than 100,000 Americans died of overdoses in the year between April 2020 and 2021, according to the National Center for Health Statistics — the highest year on record and a jump of almost 30% from the prior year.
Synthetic opioids — primarily fentanyl — caused two-thirds of those deaths.
In California, San Francisco, Nevada, Lake, Mendocino and Kern counties had the highest opioid overdose death rates in 2020, according to the California Department of Public Health. Counties across the state belong to a federal program that supports local law enforcement to dismantle drug trafficking organizations and track overdoses.
Fentanyl will claim the lives of more Sacramento County residents than gun violence this year, a Sacramento Bee analysis found. Counterfeit pills make up a majority of the market in Sacramento County, according to the district attorney.
Many people do not realize they are taking fentanyl at all, since it comes laced with or disguised as other drugs.
“We need to address this overdose crisis head on, and that involves raising awareness about how fentanyl is circulating in Sacramento County and getting life-saving tools into the hands of people who need it most,” said Rep. Doris Matsui, D-Sacramento. Matsui has long pushed for expanding addiction care services and telemedicine options.
The coronavirus pandemic has heightened use, National Institute on Drug Abuse Director Dr. Nora Volkow said in a call with reporters on Wednesday. At the same time, pandemic closures and social distancing protocols forced community networks to roll back prevention, treatment and recovery services, she said.
Fentanyl is typically used by doctors to treat severe pain, such as advanced stages of cancer. It is cheaper to produce than its plant-based counterparts, like heroin and cocaine, and a lot stronger. The powerful narcotic is up to 100 times stronger than morphine, according to the Centers for Disease Control and Prevention, and is 50 times more potent than heroin. It’s an economical, but deadly, concoction.
Emergency treatment for opioid overdoses
On Wednesday, the White House Office of National Drug Control Policy offered a road map for states to expand access to naloxone, a drug which can reverse opioid overdoses.
The model suggests states eliminate measures that allow prosecution against people who administer naloxone, require having health insurance coverage for it and increase access to it in correctional facilities and schools. California’s Good Samaritan Law already protects people offering emergency care from civil damages.
Wednesday’s announcement follows on the heels of several administrative changes that seek to increase access to treatment and prevention strategies.
This year, the administration released a new overdose prevention strategy and reduced barriers for many health care providers to prescribe medicine for opioid addiction. And it allowed treatment programs to travel, which would let providers to go help people in rural and underserved areas.
The $2 trillion American Rescue Plan, passed this spring, gave almost $4 billion to the Substance Abuse and Mental Health Services Administration, with $30 million of it for harm reduction services like syringe disposal and interventions.
The CDC said federal funding offered to programs that treat addiction could be used for fentanyl test strips, which allow people who use drugs to see whether the synthetic is laced in the drugs they are using.
Now, the 2022 Biden-proposed budget calls for $41 billion for public health interventions and illicit opioid supply reduction.
More oversight on fentanyl
The administration is also moving to get tighter oversight on types of fentanyl by changing their federal classification, known as their schedule.
Fentanyl is a Schedule II drug, with morphine and oxycodone. The federal government temporarily reclassified the narcotic’s look-a-likes, or analogues, as Schedule I — the most restricted classification, which includes heroin and ecstasy — for research until Jan. 28, 2022.
Analogues mimic the drug they resemble and can be more powerful. Carfentanil is 100 times more potent than standard fentanyl.
Schedule I drugs are those that the government says can be abused and have no medical value.
The Biden administration has recommended that Congress up fentanyl-related substances’ classification permanently. A stricter scheduling allows the DEA higher regulation on its supply and use. For the most part, it would exempt the sale of different forms of fentanyl from mandatory minimum penalties that come with sales of higher-scheduled drugs.
In the process, the administration also wants to ease access for research on Schedule I drugs.
Human rights organizations have said reclassifying drugs does little to curb use, but rather raises criminal penalties on people who are battling addiction. In a letter addressed to Congress and Biden administration leaders in October, almost 100 health, drug and human rights policy organizations wrote that Biden’s plan would not limit negative public health effects, but it would reinforce racial disparities in addressing substance abuse.
Drug trafficking crackdown
Eleven California Republicans — including Reps. Kevin McCarthy, David Valadao and Devin Nunes — penned a letter to Biden in May to ask for tighter restrictions at the border with Mexico to prevent illicit fentanyl from entering the U.S. They blamed the Mexican government for allowing drug trafficking to continue across the border.
“It appears that for the time being, our nation’s law enforcement will be on its own in addressing this crisis,” they wrote.
The typical route for fentanyl is from China to Canada, Mexico or the U.S., where it is processed into pills, powders or other forms. Most of the fentanyl in the U.S. has passed through Mexico, per the DEA.
Enough fentanyl exists in the U.S. to give everyone “a lethal amount,” DEA Administrator Anne Milgram said during the Wednesday announcement.
Fentanyl and its copycats have become the targets of several bipartisan bills in Congress to crack down on its use, surveil its spread and curtail assistance to countries that produce and ship synthetic opioids illicitly, among other efforts.
Many California representatives told The Bee that one of the primary pushes is for local education about the prevalence of fentanyl.
“Drugs, narcotics dropped off of public information,” California Democratic Sen. Dianne Feinstein said of people who are not living with the impacts of addiction. “You read about it. You don’t see what it does.”
If you or someone you know is suffering from fentanyl or opioid addiction, you can reach out to the Substance Abuse and Mental Health Service Administration’s National Helpline at 1-800-662-4357.
McClatchyDC’s Bryan Lowry contributed to this report.
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