Tracking the fentanyl epidemic

Fentanyl overdose is now a leading cause of death for Americans ages 18-29. Many of those deaths occur among people who have overdosed at least once before.

“Experiencing a nonfatal overdose is one of the most important predictors of a future fatal overdose,” said Rahul Gupta, the administration’s drug czar.

The Biden administration recently unveiled a new tool to record and track nonfatal opioid overdoses. The surveillance dashboard relies on nationally submitted emergency medical services data to tally state and county overdoses and emergency response times.

The new system will only indicate trends. “This will not tell you about absolute numbers. This will not tell you clinical findings,” said Edward Boyer, a medical toxicologist at The Ohio State University.

By tracking nonfatal overdoses, authorities hope to pinpoint opioid hot spots and increase the availability of first responders and naloxone, a medication that reverses the effects of an opioid overdose. The data testify to a worsening epidemic and the need for holistic responses to a complicated crisis.

Opioids accounted for 75,673 of over 100,000 overdose deaths in the United States last year. The picture is cloudy for 2022—the agency cannot track overdose death data in real time. Two-thirds of those deaths were due to the synthetic opioid fentanyl, now the leading cause of death for Americans ages 18-29. In 1999, 16,849 people in the United States died of a drug overdose.

Overdose deaths spiked by 33 percent last year in San Diego, Calif. “Law enforcement did the best it could,” said David King, the executive director of a federal drug task force in San Diego. “We can only do so much. But in Washington, they have been very slow to respond to this, and now we are at the confluence of paralysis.”

As the crisis escalates, local governments are rethinking their approach. Officials in San Francisco closed the Tenderloin Center, the city’s only supervised drug consumption site in a neighborhood infamous for homelessness, drugs, and crime. Critics argued the city should not have allowed drug use and offered treatment at the same site. Supporters claimed it saved lives. Staff reversed more than 300 overdoses. But the center led to few permanent changes. Fewer than 1 percent of visits resulted in mental health or drug treatment.

Despite the center’s failure to bring about long-term change, eight San Francisco supervisors introduced legislation calling for $5.5 million to open more supervised consumption sites, or “wellness hubs.”

Government solutions can only go so far, said former addict Bryan Braddock. Drug addiction brought him to his knees on the floor of his car, hoping to find more cocaine dropped on the floor mat. “I was on my hands and knees looking for drugs. And I said a very simple prayer, ‘God, I can’t do it anymore,’” he said.

Now Braddock is a city councilman and the president of House of Hope in Florence, S.C. The homeless ministry welcomes many struggling with addiction. Men and women can join a yearlong life transformation program, where they learn financial skills, find employment, and live in transitional housing.

In October, Braddock participated in a panel about the fentanyl and overdose crisis at First Baptist Church in Georgetown County, S.C. The county of 63,921 received 82 service calls for overdoses this year. Overdoses have killed 32 residents so far.

Braddock joined school officials, the county sheriff, medical staff, and other local leaders. “They’re all addressing rules, regulations, medications,” he said. “There has to be funding available for churches and nonprofit organizations that are doing their part in providing housing, counseling care, and job training. … Jesus has got to be part of this conversation.