Trump cuts overdose prevention efforts alert experts

Public health experts are looking for reasons for optimism and concern during the fentanyl crisis in California.

The state's deadly opioid overdose has finally withdrawn from a record high, recording about 6,700 deaths in the first half of 2024, down about 16% from its peak in 2023.

But doctors, researchers and some Los Angeles County officials warn that many key measures that are highly affected by tides are at risk. President Trump cut funding for federal funding for addiction treatment programs, with some services in Los Angeles County in the chopping neighborhood.

Preliminary data from LA County shows that by mid-2024, about 1,300 fatal overdoses caused by fentanyl and other opioids have decreased by 300 deaths compared to a similar time in 2023.

Several experts say the focus is on reducing injuries, including increasing the availability of overdose reversal drugs naloxone and fentanyl test kits.

But funds specifically supporting this effort are now drying up.

A Los Angeles County Department of Public Health spokesman said federal cuts include withdrawing more than $45 million in damage reduction grants. Some funds to prevent substance abuse have also been terminated due to changes in the federal budget.

“Just as we have made progress on overdose numbers, now is not the time to divest,” the public health department statement said.

Meanwhile, local authorities are reconsidering a more traditional approach to combating crime, which includes longer imprisonment for certain drug offenders.

Californians voted to pass Proposition 36 in the last election cycle, imposing strict penalties for repeated thefts and crimes involving fentanyl.

Los Angeles County. Atti. Nathan Hochman ran for the drug crisis last year, promising to put “fentanyl poisoners/killers entirely responsible for their actions to spread the poison in our community.”

“If every fentanyl dealer kills a poison person, they will be warned of having a serious impact on their freedom,” Hochman's campaign website said.

Ricardo Garcia, a public defense lawyer in Los Angeles County, said the focus was on the punishment for drug crimes, which felt like a flashback, when a long sentence was fueled by mass incarceration.

“This is something we've seen before very quickly and often has a devastating impact on poor neighborhoods, black and brown neighborhoods and frankly taxpayers, which is the cost of dealing with this excessive benefit,” Garcia said.

Similarities to the age of the cracks have disturbingly made many work on the frontlines of today’s crisis, from dehumanizing rhetoric (describe fentanyl users as “zombies”) to punitive judgment policies.

The key to saving lives is obvious: Strengthening naloxone distribution and preventing overdose in high-risk communities, says Shoshanna Scholar, director of injury reduction at Los Angeles County.

“In the past 25 years, there has been a real substance use and viewing it as a chronic disease, rather than a need for punishment to change its bad behavior,” Scholar said. “We know there is another way that actually it can reduce the number of deaths.”

Since 2023, California Gov. Gavin Newsom has invested more than $1 billion in grants for naloxone distribution, fentanyl test belts and other anti-surplus agent initiatives. Naloxone (also known as Narcan) is now available for purchases for all California residents for $24 through the CALRX initiative.

At this year's Coachella Valley Music and Arts Festival, Burbank-based organization Enn Everdose has a booth near the festival's EDM stage, offering naloxone training, free doses and a variety of swags.

At the stall, there are two festival spectators in their twenties (who only use names to identify their drug use), who say they have been taking every possible precaution for fear that they will be sold to fentanyl.

“To be honest, we learned the most from Reddit and our parents. They always told me to be careful with fentanyl,” Mimi said. “It reminds me of when people promote abstinence in terms of safety, when they really should talk about condoms and birth control. Because either way, people go to drugs, so you have to make sure you are doing it safe.”

Brian Hurley, the county’s medical director, who runs the addict’s medical director, said that imposing tougher penalties on drug users could increase the risk of overdoses, as people are more likely to use them alone and secretly.

“Hold people to engage in open, honest, neutral conversations about whether they are ready to stop using it, whether they are ready to try temporary housing or ride in shelter beds. All of these things are getting people off the streets in the way I think most people really want,” Hurley said.

He and others point out that even with crime policies in the 1980s and 1990s, cocaine use never disappeared. Although arrests and prosecutions alone are not the solution for many years, experts say it is still difficult for people in need of treatment to seek help.

Devon O'Malley left, hazard reduction case manager at the Venice family clinic, sent Narcan Nasal Sprays to Ken Newark, 63, of Tongva Park, Santa Monica.

(Mel Melcon/Los Angeles Times)

“People are pushing for tougher penalties and more arrests, but that’s not the way you stop people from using drugs they don’t want them to use,” said Dr. Ricky Bluthenthal, a professor of public health at the University of Southern California. “Incarceration is not a place for people to get better.”

However, that information is contrary to the hard-line approach now pushed by the White House. Trump believes the death of fentanyl is the cause of tariffs on China, a source of chemical ingredients used in secret laboratories and recommended a drone strike on Mexican drug cartels. Trump also declared fentanyl a weapon of mass destruction and called for death sentences to drug dealers

For Dr. Daniel Ciccarone, a professor at the University of California, San Francisco, who studies public health and drug use, it is hard not to see a repeat of history.

The professor recently published a paper on the “moral panic” of drug use, and he said elected officials have long been more concerned with optics and approval ratings than addressing the root causes of addiction.

“We are afraid of this drug, we are afraid of people who use it,” Ciccarone said. “When we feel fear, the natural human response is to find safety. Who can make us feel safer? Police and the court.”

He added that the latest trend to overdose deaths gave at least a glimmer of hope, even if no one can agree to the best way forward.

“I realized that it was human fear, urgency and panic impulse to do something,” he said. “I heard this from the police and said ‘We have to be seen as doing something’ and I said, ‘Okay, but don’t make the problem worse.”