Synthetic opioid fentanyl is behind the growing death of the LA homeless population | National

Los Angeles — The surge in homeless deaths that began in the spring of 2020 was caused by an overdose of drugs, including fentanyl, a report released Thursday by the Los Angeles County Public Health Service concluded.

During the first seven months of 2020, 926 homeless people died in Los Angeles County. This is a 26% increase over the same period in 2019.

COVID-19 was the second leading cause of death in the entire population of Los Angeles, but remained a minor cause of homeless deaths, following heart disease, road-related accidents and murders. All of these were far behind the drug overdose.

“Although the direct impact of COVID-19 is relatively small … in the first seven months of 2020, the death toll from overdose of this population has increased tremendously,” the county’s Health Impact Assessment Center conducted. The report said. “This increase was mainly caused by the more frequent involvement of fentanyl.”

“Overdose is an absolute plague of the homeless community,” Darren Willett, director of Harm Reduction in Homeless Healthcare Los Angeles, said in a briefing in the report.

The increase in deaths seems to have leveled off slightly by the end of the year. LA County Medical Inspector-Coroner’s tentative estimate of 1,383 homeless deaths in 2020 will increase by about 9% year-on-year.

The county’s second annual report on homeless mortality found that drug overdose was responsible for just under 30% of homeless deaths in 2020, which is by far the leading cause. ..

Methamphetamine, determined to be involved in nearly two-thirds of those deaths, remained the dominant contributor. However, the presence of potent synthetic opioid fentanyl in drug mixtures commonly found in human systems has more than doubled to 41%.

The report states that more work on the streets, more temporary housing, chronic disease management, increased distribution of the antidote naloxone, a dramatic increase in residential beds to treat substance use disorders, and substance use from prisons. Recommendations for reducing fatalities, such as increased opportunities for treatment diversion, are provided.

During the briefing, service providers emphasized “harm reduction” (naloxone use, syringe replacement programs, and licensed drug use locations) as the most effective response.

“One of the main reasons people are dying from overdose is that they are using it alone,” Willett said. “They don’t have people to ask for help to get rid of the overdose.”

According to Willett, homeless skidrow residents who responded to a community needs survey said they would inject the drug, with 92% using it alone last year and 60% using it daily alone.

“Hiding in this shadow, in a tent, or in an alley is undoubtedly the result of crime and deprivation of social rights from the drug war,” he said.

Only 30% of the people surveyed said they had been to shelters. If the shelter permits the use of drugs, the proportion will probably increase, the study found.

“Change one factor — if you could use the drugs, would you access them? — 80% said so,” Willett said.

Willett disagreed with full permission to use drugs in shelters, but suggested having several shelters, especially for drug users.

The County Immigration and Re-Immigration Department’s Soshanna Scholar has issued 50,000 naloxone doses to prisoners leaving prison to deal with mortality rates up to 136% higher than the general population of those involved in the judicial system since January. Said that he gave out.

She trusted the program with 3,000 overdose reversals.

The report, which covers both 2019 and 2020, did not try to calculate last year’s mortality rate due to the lack of current information on the number of homeless people.

The authors explored the possibility that COVID-19 had an indirect effect on the increase in homeless deaths, but said there was not enough information to draw a conclusion.

According to the annual count conducted in January last year, the number of people living on the streets and shelters increased by 13% in 2019. Dramatic unemployment due to the COVID-19 pandemic could make more people homeless, but there is no way. Quantify it.

The increase in the number of homeless people last year had the counterintuitive effect of delaying the year-long rise in homeless mortality, despite a significant increase in homeless mortality.

According to the report, the overall mortality rate, the number of deaths per 100,000, increased only slightly in 2019 after a surge in the previous year.

Overall, homeless people were three times more likely to die for any reason than the entire population. Their chances of death were 36 times higher for drug or alcohol overdose, 4 times higher for heart disease, 17 times higher for traffic-related injuries, 15 times higher for homicide, and 8 times higher for suicide.

Drug overdose was not associated with adolescents. The highest rate and sharp increase in 2019 was between the ages of 55 and 61, followed by those over the age of 62.

Mortality from drug overdose was highest in whites and remained stable in 2019, but blacks increased by 45% and Latin Americans increased by 17%.

“The continued increase in mortality from overdose in 2019, especially between blacks and Latins (those experiencing homelessness), is primarily due to overdose mortality in these racial / ethnic groups. It appears to have been caused by increased involvement of fentanyl, “the report said.

The overdose rate of homeless women is slightly lower than that of men, a significant difference from the total population, where men are more than twice as likely to overdose as women.

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