 | It has been suggested that Fentanyl crisis in San Francisco be merged into this article. (Discuss) Proposed since April 2024. |
Since 2017, the number of fatalities in California attributable to synthetic opioids has increased by 1,027%. Fentanyl has been to blame for 20% of deaths among California's teenagers and young adults. California is taking legal efforts to tackle the opioid issue, including patrols, assistance grants, and education.
Over 80,000 Americans may have fatally overdosed on opioids in 2021, with more than 11,200 of those fatalities occurring in California, as reported by the U.S. Centers for Disease Control and Prevention. [2] Fentanyl is responsible for the death of 20% of teens and young adults in California (15 - 24). According to California Health Policy Strategies statistics, drug overdoses are now two to three times more fatal than state car accidents. The number of California state fatalities linked to synthetic opioids has climbed by 1,027% since 2017. [3]
San Francisco has the highest per capita fatal OD rate compared to four neighboring counties. Of the 1,510 overdose deaths occurring in the region, 57% belong to San Francisco. [4] According to a preliminary estimate from the San Francisco Medical Examiner office, there were 346 unintentional overdose fatalities in San Francisco throughout the initial five months of 2023, a rise of more than 40% over the identical period in 2018. According to the data, fentanyl is responsible for roughly 80% of all unintentional fatal overdoses in the city. [5] In the first four months of 2023, 268 people died from unintentional overdoses in San Francisco, according to an investigation by the medical examiner. All of the fentanyl was discovered in the Tenderloin region of San Francisco. [3]
Senate Bill 10, also known as "Melanie’s Law," was a bill heard by the California Senate in 2023. The bill was named after 15 years old Melanie Ramos, a student at Hollywood's Helen Bernstein High School who passed away at school in September 2022 from what was thought to be a fentanyl overdose. Her body was discovered in one of the campus bathrooms by her friend's stepfather after she had been reported missing for eight hours, according to a lawsuit filed by her family. By expanding resources, the bill attempts to prevent fentanyl overdoses on campuses across the state. [7] [8] As part of a school safety plan, the legislation would compel schools to devise an action plan for student opioid overdoses. This can entail educating staff on how to give medicines like Narcan to alleviate the symptoms of an opioid overdose. [8]
From the beginning of May through the middle of June, California highway patrol (CHP) officers seized in San Francisco as much fentanyl as it could be the direct cause of more than 2 million fatal overdoses. The governor's office stated that the quantity, being over 4 kilograms, was sufficient to kill the population of San Francisco three times over. The seizure was conducted as a part of Gavin Newsom's plan, which combats the spread of fentanyl and bright and tries to enhance the public health and safety in San Francisco. [3] [9]
Attorney General Rob Bonta stated on 9 June 2023 that Walgreens, CVS, and two pharmaceutical companies would have to pay a total of $17.3 billion to the state of California as part of a settlement for their involvement in the opioid crisis. [2] Despite the drug issues in the San Francisco city, community-led harm-reduction initiatives have been stopped by Newsom and some local officials. Tenderloin Center, which was designed as a temporary harm-reduction measure, was planned to be replaced by 12 smaller “wellness hubs” located around the city. These hubs were designed to offer "health and shelter services", besides allowing "supervised drug use" so that overdose deaths are prevented. [3]
Legislation that would have permitted controlled drug-use facilities in three Californian cities, including San Francisco, was vetoed by Newsom in 2022 summer. Consequently, the plan for the wellness centers became a standstill after San Francisco's city attorney objected that the city would end up being held heavily liable, a decision which made the non-profits seeking for a means to finance the overdose preventive components of their activities without receiving financing from the city. [3]
Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic. It is 20 to 40 times more potent than heroin and 100 times more potent than morphine; its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose. Fentanyl works by activating μ-opioid receptors. Fentanyl is sold under the brand names Actiq, Duragesic and Sublimaze, among others.
A drug overdose is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Typically it is used for cases when a risk to health will potentially result. An overdose may result in a toxic state or death.
Walgreens is an American company that operates the second-largest pharmacy store chain in the United States, behind CVS Health. It specializes in filling prescriptions, health and wellness products, health information, and photo services. It was founded in Chicago in 1901, and is headquartered in the Chicago suburb of Deerfield, Illinois. On December 31, 2014, Walgreens and Switzerland-based Alliance Boots merged to form a new holding company, Walgreens Boots Alliance. Walgreens became a subsidiary of the new company, which retained its Deerfield headquarters and trades on the Nasdaq under the symbol WBA. In 2021 the company was found by a federal jury to have substantially contributed to the opioid crisis.
Speedball, powerball, or over and under is the polydrug mixture of a stimulant with a depressant, usually an opioid. The most well-known mixture used for recreational drug use is that of cocaine and heroin; however, amphetamines can also be mixed with morphine and/or fentanyl. A speedball may be taken intravenously or by nasal insufflation.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Carfentanil or carfentanyl, sold under the brand name Wildnil, is an extremely potent opioid analgesic used in veterinary medicine to anesthetize large animals such as elephants and rhinoceroses. It is typically administered in this context by tranquilizer dart. Carfentanil has also been used in humans to image opioid receptors. It has additionally been used as a recreational drug, typically by injection, insufflation, or inhalation. Deaths have been reported in association with carfentanil.
Kolokol-1 is a synthetic opioid developed for use as an aerosolizable incapacitating agent. The exact chemical structure has not yet been revealed by the Russian government. It was originally thought by some sources to be a derivative of the potent opioid fentanyl, most probably 3-methylfentanyl dissolved in an inhalational anaesthetic as an organic solvent. However, independent analysis of residues on the Moscow theater hostage crisis hostages' clothing or in one hostage's urine found no fentanyl or 3-methylfentanyl. Two much more potent and shorter-acting agents, carfentanil and remifentanil, were found in the samples. They concluded that the agent used in the Moscow theater hostage crisis contained two fentanyl derivatives much stronger than fentanyl itself, sprayed in an aerosol mist.
Xylazine is a structural analog of clonidine and an alpha-2 adrenergic receptor agonist, sold under many trade names worldwide, most notably the Bayer brand name Rompun, as well as Anased, Sedazine and Chanazine.
CVS Health Corporation is an American healthcare company that owns CVS Pharmacy, a retail pharmacy chain; CVS Caremark, a pharmacy benefits manager; and Aetna, a health insurance provider, among many other brands. The company is the world's largest healthcare company, and its headquarters are in Woonsocket, Rhode Island. In 2023, the company was ranked 65th in the Forbes Global 2000.
3-Methylfentanyl is an opioid analgesic that is an analog of fentanyl. 3-Methylfentanyl is one of the most potent opioids, estimated to be between 400 and 6000 times stronger than morphine, depending on which isomer is used.
An opioid overdose is toxicity due to excessive consumption of opioids, such as morphine, codeine, heroin, fentanyl, tramadol, and methadone. This preventable pathology can be fatal if it leads to respiratory depression, a lethal condition that can cause hypoxia from slow and shallow breathing. Other symptoms include small pupils and unconsciousness; however, its onset can depend on the method of ingestion, the dosage and individual risk factors. Although there were over 110,000 deaths in 2017 due to opioids, individuals who survived also faced adverse complications, including permanent brain damage.
Acetylfentanyl is an opioid analgesic drug that is an analog of fentanyl. Studies have estimated acetylfentanyl to be 15 times more potent than morphine, which would mean that despite being somewhat weaker than fentanyl, it is nevertheless still several times stronger than pure heroin. It has never been licensed for medical use and instead has only been sold on the illicit drug market. Acetylfentanyl was discovered at the same time as fentanyl itself and had only rarely been encountered on the illicit market in the late 1980s. However, in 2013, Canadian police seized 3 kilograms of acetylfentanyl. As a μ-opioid receptor agonist, acetylfentanyl may serve as a direct substitute for oxycodone, heroin or other opioids. Common side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially fatal respiratory depression. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
Harm reduction consists of a series of strategies aimed at reducing the negative impacts of drug use on users. It has been described as an alternative to the U.S.'s moral model and disease model of drug use and addiction. While the moral model treats drug use as a morally wrong action and the disease model treats it as a biological or genetic disease needing medical intervention, harm reduction takes a public health approach with a basis in pragmatism. Harm reduction provides an alternative to complete abstinence as a method for preventing and mitigating the negative consequences of drug use and addiction.
New Jersey's most recent revised policy was issued September 7, 2022 pursuant to P.L.2021, c.152 which authorized opioid antidotes to be dispensed without a prescription or fee. Its goal is to make opioid antidotes widely available, reducing mortality from overdose while decreasing morbidity in conjunction with sterile needle access, fentanyl test strips, and substance use treatment programs. A $67 million grant provided by the Department of Health and Human Services provides funding for naloxone as well as recovery services. This policy enables any person to distribute an opioid antidote to someone they deem at risk of an opioid overdose, alongside information regarding: opioid overdose prevention and recognition, the administration of naloxone, circumstances that warrant calling 911 for assistance with an opioid overdose, and contraindications of naloxone. Instructions on how to perform resuscitation and the appropriate care of an overdose victim after the administration of an opioid antidote should also be included. Community first aid squads, professional organizations, police departments, and emergency departments are required to "leave-behind" naloxone and information with every person who overdosed or is at risk of overdosing.
In response to the surging opioid prescription rates by health care providers that contributed to the opioid epidemic in the United States, US states began passing legislation to stifle high-risk prescribing practices. These new laws fell primarily into one of the following four categories:
Access, Harm Reduction, Overdose Prevention and Education, commonly referred to as AHOPE Boston or AHOPE Needle Exchange, and formerly called Addicts Health Opportunity Prevention Education, is a needle exchange and public health initiative of the Boston Public Health Commission.
Synthetic opioids, most notably fentanyl and drugs laced with it have seen increasing usage in the American city of San Francisco, California since 2019. In 2023, 810 people died from accidental drug overdoses, a majority containing Fentanyl, in San Francisco, with overdoses per 100,000 people being more than double the national average. From January to April 2024, 258 people died from unintentional drug overdoses.
End Overdose, a California-based 501(c)3 nonprofit organization, seeks to confront the drug overdose epidemic by promoting evidence-based strategies and fostering inclusivity and collaboration. They have a vision for a future where everyone affected by drug use receives necessary support and a de-stigmatized conversation, they advocate for reducing overdoses, empowering communities, and informing policies. Through initiatives such as establishing a central organization, End Overdose aims to facilitate a unified effort to combat overdoses.