Tiny purple flags, 1,303 of them, flapped in the wind outside the County Administration Center on Wednesday. Each flag represented a life lost to a drug overdose in San Diego County last year.
In years past, officials planted slightly larger markers — placards — as symbols on the grass near the county building to observe International Overdose Awareness Day.
But now there’s not enough room on the lawn. Too many people are dying.
Last year the number of local overdose deaths surged 33 percent — from 976 in 2020 to 1,303 in 2021. People suffering from drug addiction. People trying illicit drugs for the first time. People who fell asleep and never woke up.
While drugs including methamphetamine, cocaine and alcohol were responsible for some of the accidental overdose deaths, the enormous surge in the use of fentanyl, a synthetic opioid that is 50 to 100 times stronger than morphine, has fueled the spike.
At Wednesday’s event, volunteers handed out free boxes of naloxone — a medication that can reverse the effects of opioid overdoses — while speakers took turns at a lectern on the lawn to talk about steps being taken to try to reverse the trend.
“Tragically, as we stand here before you today, the drug overdose epidemic has devolved into the fentanyl nightmare,” said David King, director of the High Intensity Drug Trafficking Area program in San Diego and Imperial counties, which coordinates law enforcement efforts to address drug threats. “The 1,303 flags behind me are a stark visualization of the lives lost to accidental overdose.”
Laura Brinker-White, who lost her 17-year-old son to a fentanyl overdose, warned parents that drug dealers can get access to their children to sell drugs through Snapchat and other social media programs. Her son Connor, a student at Cathedral Catholic High School, died after taking what he thought was a prescription pill before school.
“You may be thinking that this will never happen to my family — think again. We are in a different time… Drug dealers have a direct connection to our children, and they are preying on them every day,” she said.
Brinker-White encouraged parents to have open communication with their teens and to talk with other parents about the issue. “We need to see a reduction in the number of deaths, and this is up to us,” she said.
County supervisors have declared fentanyl a public health crisis and have taken steps to make naloxone easier to obtain, including installing up to a dozen vending machines that will dispense the drug. Drug stores can sell naloxone, also known by the brand name Narcan, without a prescription. State and federal prosecutors are going after drug dealers, charging some with murder when deaths occur.
Speakers urged parents to talk to their children about the dangers of so-called “fake” pills, many which contain fentanyl, which can be lethal in small doses. Users often believe they are buying pharmaceutical-grade opioid pills but instead are getting illicit fentanyl, which officials say primarily is manufactured in Mexico, with precursors chemicals coming from China.
Addiction experts talked about how addiction is a medical problem — a brain disease — and that substance use disorder can be treated successfully. Dr. Luke Bergmann, the county’s director of behavioral health, said people need to stop stigmatizing those who use drugs.
“This is maybe the most common public illness, chronic illness, that we face in this country, very much like diabetes,” Bergmann said. “But it is talked about still as a moral liability or as a bad choice, and we have to shift our thinking… If we can embrace the reality, the commonness of this illness, we will embrace the treatment for it and treatment works.”
Francisco Platt, 20, said treatment worked for him. He said he took what he thought was a Percocet during a low period in his life in high school after he lost his father. It turns out the pill he ingested contained fentanyl — and he quickly became hooked.
Soon, he found himself taking fentanyl every day to keep from going into withdrawal.
“I never felt so alone as during that time. I was damaging myself physically, I was damaging my relationships and I was hurting my goals and aspirations,” he said.
Platt said said he decided to ask for help, and his mother took him to a hospital emergency room. That’s where he talked with a counselor about medication-assisted treatment and was referred to a program. Platt said he was prescribed buprenorphine, a medication used to treat opioid use disorder that helps with withdrawal symptoms. He eventually weaned himself off that medication, too.
“I’ve now been clean for over two years now,” he said.
Illicit fentanyl continues to hit the market, and not just in fake prescription pills like what Platt took. In a disturbing new trend, the U.S. Drug Enforcement Administration this week warned that “rainbow fentanyl” — multicolored pills sometimes stamped with M/30 to look like a legitimate oxycodone pill — has been seized in 18 states in recent weeks, including a seizure at San Ysidro border crossing.
Law enforcement officers worry the candy-colored pills are being produced as a deliberate effort to drive addiction amongst children and young adults, DEA Administrator Anne Milgram said in a statement. Some of the seized fentanyl has been in powder form or in blocks that resemble sidewalk chalk.
“The men and women of the DEA are relentlessly working to stop the trafficking of rainbow fentanyl and defeat the Mexican drug cartels that are responsible for the vast majority of the fentanyl that is being trafficked in the United States,” Milgram said.
Dr. Steven Campman, the county’s chief Medical Examiner, said just six years ago, there were hardly any accidental fentanyl overdose deaths in the county — just 33. Now the county sees that many every couple of weeks. And he warned that the trend doesn’t seem to be changing — nationally or locally. Fentanyl now is the No. 1 killer of people ages 18 to 45 in the country, Campman said.
Already in the first quarter of this year, San Diego County has had a 14 percent increase in accidental deaths compared to the same period a year ago, the medical examiner said.
“As I look over the purple flags behind us here, I know that all of those people came through the Medical Examiner’s Office — 1,303 people dead because of drug intoxication, many due to fentanyl or methamphetamine or a combination of both,” Campman said. “That number is remarkable considering we only investigated 4,403 deaths last year.”
He said people need to look for signs of overdoses and be prepared to administer naloxone to reverse the effects of a suspected opioid overdose. Snoring louder than usual and struggling to breathe are signs of an overdose, Campman said.
“Even if someone thinks they are using cocaine, or methamphetamine or Adderall or Xanax, fentanyl has been mixed in or disguised as all of those,” he said.
After all the speakers were finished, King — from the High Intensity Drug Trafficking Area program — underscored the message that overdoses don’t need to turn fatal.
“This is dire. I want to stress today that naloxone saves lives,” King said. “In San Diego County, dial 211 or 988 to get this. Every household, every business should have this on hand for individuals.
“You never know when you are going to need it.”