Overdose deaths in San Diego County are declining

Fatal overdoses continue to occur in the region, but local data released Thursday offers hope: The number of people who have died from drug and alcohol overdoses in San Diego County has dropped. Some experts hope it’s a continuing trend.

Last year, 1,203 people in the region died from accidental overdoses — a 7.5 percent decrease from 1,300 people the year before. Fentanyl — prescribed or illegal — remained a leading cause of overdose deaths, found in 62 percent of all fatal overdoses in the region. A few years ago, the synthetic opioid accounted for just 16 percent.

Some local experts say the data may be showing a plateau, indicating the peak in fentanyl-related deaths has passed and may be entering a steady decline.

“We are starting to see a turn in the epidemic curve here,” Dr. Luke Bergmann, the region’s director of Behavioral Health Services, said Thursday.

The new data comes from an annual report from the Substance Use Overdose Prevention Task Force, a national coalition that also includes health officials and law enforcement.

Several local officials highlighted that data and the ongoing battle to address overdoses during a news conference Thursday outside the County Administration Center. Behind the speakers, 1,203 purple flags were planted in the grass, each one representing someone who died from an accidental overdose last year.

Experts and advocates say the change is due in part to easier access to naloxone, a drug that reverses the effects of an opioid overdose. They also point to better access to addiction treatment, law enforcement and prevention work. Bergmann cautioned that the only way forward is to address substance abuse, the “most prevalent chronic disease” in the community, even more than diabetes.

The number of deaths from drug and alcohol overdoses in the region has more than doubled in four years, from 645 deaths in 2019 to 1,300 in 2022.

The county coroner, Dr. Steven Campman, said overdose deaths are the “largest cause of preventable unnatural deaths in the county.”

Last year, more than three times as many men than women suffered fatal fentanyl overdoses. The highest number of deaths occurred among those aged 26 to 35. The number of deaths among teenagers dropped from 15 in 2021 to two last year.

Central San Diego, including the area from Balboa Park to Southcrest, had the highest rates of fatal fentanyl overdoses in the region, the data show. Homeless people were also hit hard: drug overdoses rose 233 percent in the past five years, largely caused by fentanyl. Last year, 419 homeless people in the county died from drug overdoses.

Brian Clark, special agent in charge of the Drug Enforcement Administration’s San Diego office, blames drug cartels for the supply of illicit fentanyl. On Thursday, he said authorities seized 11.4 million counterfeit fentanyl pills along the southwest border last year.

Fentanyl is a laboratory-made opioid used in low doses by medical professionals to treat people with severe pain, but it is also widely produced and sold on the illicit market — often cut with other drugs. It is potent — up to 50 times more potent than heroin and up to 100 times more potent than morphine.

Methamphetamine also remains a deadly scourge. Like fentanyl, meth was found in nearly two-thirds of all overdose deaths in the county last year. That’s because there’s significant overlap: A combination of the substances was the cause of 38 percent of drug deaths.

Bergmann said the county is “leaning on harm reduction” efforts as the most effective way to reach people. “People who engage in harm reduction services are five times more likely to engage in formal addiction treatment and clinical settings,” he said. “These are not opposing ideas. These are seamless ideas that will help us save lives.”

Harm reduction involves providing people with naloxone, known by the brand name Narcan. The drug comes in the form of a nasal spray and can be carried on a keychain. Naloxone is available free of charge at 16 vending machines across the county, from prisons to college campuses.

Tara Stamos of the Harm Reduction Coalition of San Diego said her organization has distributed 100,000 naloxone kits in the region. She said that when she started her work, it wasn’t considered OK to talk to people about harm reduction, but attitudes have changed.

“This is happening to someone you know,” she said. “And just because it’s not happening to you doesn’t mean it’s not happening. And we can’t get ourselves out of this by blaming ourselves. We can’t get ourselves out of this by shaming ourselves.”

Bergmann noted that historically, drug epidemics will rise, plateau and fall — think heroin and crack cocaine in the late 20th century. “And what often plays a role in those periods where the epidemic curve starts to trend downward is a change in social perception,” he said.

That includes preventive messaging, but also shifts in perception of a particular drug. “The attractiveness, socially, of doing certain types of substances is going down. We’re seeing that across generations,” Bergmann said. It’s also happening in communities that are hardest hit by any substance.

The U.S. Attorney’s Office unveiled Thursday a new effort with the San Diego District Attorney’s Office to combat fentanyl deaths: a public service announcement featuring the San Diego State University women’s soccer team. The athletes talk about the dangers of the drug, signs of an overdose and the importance of naloxone, which is available from a vending machine on campus.

“We’re working together to save lives,” said U.S. Attorney Tara McGrath. “If you’re not afraid of the fentanyl epidemic, you’re not paying attention.”

Saturday is International Overdose Awareness Day. That evening, the County Administration Building will be bathed in purple light.