[BOT] Why fatal drug overdoses are finally declining in SF -- and elsewhere

Bot

search:

fast-breaking news analysis about drug policy and illegal drugs

Your Enslavement in the Matrix (video)
Prison for Profit
The Rise of the Prison Industrial Complex
Prison Profiteers (2013)

Here

Mapinc

This newsbot site, while automated (true!) has always depended on the generosity of volunteers and visitors to keep it up and running. If this site has helped you, and you can afford to help us, then we ask you to give generously. And to those who have been helping to keep us running, a heartfelt THANK YOU! Donate online: click here and help us out!

Why fatal drug overdoses are finally declining in SF -- and elsewhere

Found: Fri Nov 22 14:01:28 2024 PST Webpage: http://www.sfchronicle.com/health/article/... [translate] Author: Catherine Ho, Health Care ReporterNov, cho@sfchronicle.c Newshawk: http://drugpolicycentral.com/bot/

topical analysis prison was NOT mentioned
propaganda analysis

Why fatal drug overdoses are finally declining in SF -- and elsewhere Why fatal drug overdoses are finally declining in SF -- and elsewhere

San Francisco Chronicle LogoHearst Newspapers Logo

Bay Area

* Newsroom News

* Terms of Use

* Privacy Notice

* Your Privacy Choices (Opt Out of Sale/Targeted Ads)

* Advertise With Us

* Audio Tours

* Obituaries

New parking law

Bay Area//Health

Why fatal drug overdoses are finally declining in S.F. -- and elsewhere

By Catherine Ho, Health Care ReporterNov 22, 2024

A man who survived a drug overdose is carried away by medical personnel on Mission Street near Seventh Street in San Francisco.Gabrielle Lurie/The Chronicle

San Francisco this past week reported the lowest number of monthly drug overdose deaths in four years, continuing a sustained trend with 2024's running total of fatalities down nearly a quarter compared with the same period last year.

The trend -- which local health officials called "remarkable" -- echoes similarly promising national data, released by the U.S. Centers for Disease Control and Prevention this month, that show fatal overdoses are down almost 15% compared with 2023. Overdose deaths in California are down about 10%, according to the CDC data. The figures are provisional and compare the 12 months ending June 2024 with the 12 months ending June 2023.

Both nationally and locally, it marks the first time in years there has been an apparent sustained reversal of the steep climb in deadly overdoses -- mostly driven by fentanyl -- that have devastated families and frustrated public health leaders.

Article continues below this ad

Mayor London Breed this past week attributed the decline in part to efforts by local, state and federal law enforcement agencies to arrest dealers and take fentanyl off the streets. Public health experts say it's unclear whether those crackdowns are having an effect on overdoses.

Doctors and researchers don't yet have clear answers on what's driving the decline, but are looking into several factors they believe may be contributing.

The decline of the COVID pandemic

Before the start of the pandemic in early 2020, overdose deaths were rising but at a more modest rate. But the trend took a turn for the worse during the early months of COVID, when deaths spiked sharply. Researchers attribute this in part to people using substances more during an exceptionally stressful time. Because of stay-at-home restrictions, people were often using alone rather than with peers, which put them at higher risk of overdosing. Overdose deaths continued to soar in 2021 and 2022.

"COVID pushed overdoses off the historical growth pattern dramatically, by as much as 30% in a single year in a lot of cities, which we'd never seen before," said Keith Humphreys, a professor of psychiatry and addiction researcher at Stanford University. "COVID created isolation, which made drug use dangerous. It also caused understandable fear, upset, anxiety, lack of structure, all incentives to use drugs more. All that is gone now."

Article continues below this ad

More Narcan and treatment

Health officials in many parts of the country, including California, have made the distribution of overdose reversal spray Narcan -- also known by its generic name naloxone -- a key part of their response.

During the first nine months of 2024, the San Francisco Department of Public Health distributed about 155,000 units of naloxone to community-based programs, which then gave out the product to individuals. That's up from about 107,000 units during the same period of 2023, according to city data.

"Perhaps we hit a tipping point or saturation point where there is enough access to naloxone among the population in need," said Dr. Dan Ciccarone, a UCSF professor of family and community medicine who researches addiction.

Statewide, the Naloxone Distribution Project, the primary mechanism for the state to distribute naloxone, has distributed 1.9 million units of naloxone this year -- up 27% compared with 2023, according to the California Department of Health Care Services, which runs the project.

Article continues below this ad

The naloxone goes to first responders, law enforcement, community organizations including libraries, harm reduction groups, schools, county health agencies, substance use recovery facilities, hospitals and community clinics.

But naloxone is only part of the equation. Overdose deaths are falling in communities with a lot of low-cost naloxone distribution such as St. Louis, but they're also falling in areas with limited naloxone distribution including Mississippi and Arkansas, said Nabarun Dasgupta, a senior scientist at the University of North Carolina who studies street drugs. That suggests other factors are at play.

Still, he encouraged local officials and community groups to continue efforts to make naloxone, treatment, housing and shelter available.

"If you see something that's working, if you know there's a scientific reason it should be working, just keep doing it," Dasgupta said. "If you're working directly with people who use drugs and you see their lives getting better because of the care you're providing, you're doing something right, regardless of what the numbers say."

In San Francisco, health officials attribute much of the progress to the expansion of addiction treatment options, including methadone and a type of behavioral therapy called contingency management, residential treatment and on-demand telehealth access to buprenorphine. Methadone and buprenorphine are prescription medications that help manage opioid addiction.

Article continues below this ad

"As we expand access, we're seeing higher rates of people starting life-saving medications," said Dr. Grant Colfax, director of the San Francisco Department of Public Health.

During the first nine months of 2024, 776 people in San Francisco were admitted to residential treatment for substance use disorder -- up 21% compared with the same period last year, according to city data. The figures are for people on Medi-Cal, the government insurance program for low-income residents, who enter a treatment program that has been certified by Medi-Cal.

Changes in the drug supply

Perhaps counterintuitively, the introduction of xylazine, the veterinary tranquilizer that was first detected in San Francisco's illicit drug supply in 2022, may actually be helping to reduce the severity of opioid overdoses. This is because when fentanyl and xylazine are used together, which is common among drug users, xylazine appears to protect against some of the most acute effects of fentanyl.

Article continues below this ad

"Overdoses with both xylazine and fentanyl are less clinically severe than overdoses with just fentanyl," Dasgupta said. "Xylazine has a protective effect on the severity of an opioid overdose. That may be preventing some of the overdoses."

In recent field studies in areas where xylazine is more prevalent, including Pittsburgh and Grand Rapids, Mich., drug users said they were using fentanyl less often, Dasgupta said. Among the reasons they cited were because xylazine appears to prevent withdrawal longer than fentanyl and because xylazine causes skin wounds that force people to moderate how much fentanyl they can use.

The group at highest risk of overdosing may be shrinking

There is some evidence that fentanyl users in San Francisco are getting older, and little evidence that new or younger people are coming in, said Ciccarone of UCSF.

And within the cohort at highest risk of fatally overdosing, so many have died already that the cohort is getting smaller, experts said. Those still in it may be changing their behavior as they witness others around them dying, or as they learn about how to use fentanyl more safely -- like in groups, or with naloxone nearby.

"As there's more death and destruction, people are losing people they know, seeing this incredible damage," said Humphreys, the Stanford professor. "It lowers people's willingness to initiate drug use. Over time, that shrinks the vulnerable population."

Reach Catherine Ho: cho@sfchronicle.com

Nov 22, 2024

Catherine Ho

Health Care Reporter

Catherine Ho covers health care at The San Francisco Chronicle. Before joining the paper in 2017, she worked at The Washington Post, the Los Angeles Times and the Daily Journal, writing about business, politics, lobbying and legal affairs. She's a Bay Area native and alum of UC Berkeley and the Daily Californian.

analysis of article text

prohibitionist	prohibition_agency	drugwar_propaganda	legalization	drug_reformer
reform_referenda	cannabis	stimulant	narcotic	hallucinogen

incarceration/prison mentioned? NO - the issue of prison or incarceration was NOT mentioned in this article .

propaganda analysis

EXP - explicit prohibition propaganda (explicit_propaganda)	GRP - hated group (propaganda_theme1)	MAD - madness, violence, illness (propaganda_theme2)
SOC - survival of society (propaganda_theme3)	USE - gateway, use is abuse (propaganda_theme4)	KID - children (propaganda_theme5)
WAR - demonize, war, epidemic (propaganda_theme6)	TOT - total prohibition (propaganda_theme7)	DIS - dissent opposed (propaganda_theme8)

text of article used for CRITICAL ANALYSIS, under FAIR USE provisions of the Copyright Act of 1976, 17 U.S.C. § 107, et al.

media charts

Bot's analysis of: "The Dangers and Consequences of Marijuana Abuse" the U.S. Department of Justice Drug Enforcement Administration (DEA) Demand Reduction Section, May 2014
more >>

Newsbot crossword puzzles!

Drug War
Propaganda

A review and analysis of modern prohibition rhetoric

Amazon Kindle

html (free)

pdf (free)

Wonder Drug Cover-Up: Yes, it's true: pot fights cancer. more

As Bad For Your Lungs As Smoking 20 Normal Cigarettes? 20 times more likely to cause cancer than tobacco? Why does the US Government make cannabis researchers use only Government-issued marijuana?

Observer's Propaganda Picks
dripping with drug-war propaganda!

Prohibition-era cartoons
Anti-prohibition political cartoons from Prohibition I.

Support Mapinc & Drugsense

Donate to drugsense please give generously!

article tags

analysis of article text

incarceration/prison mentioned? NO - the issue of prison or incarceration was NOT mentioned in this article .

propaganda analysis

Drug WarPropaganda

Drug War
Propaganda