Fentanyl claimed the lives of more than 2,100 people living on the streets of Los Angeles County and in homeless shelters between 2014 to 2023. Last year, the county medical examiner for the first time logged more than 1,000 drug-related deaths of unhoused people, including a record-high of 728 overdoses linked to fentanyl, The Guardian reports. The figures illustrate the staggering toll as fentanyl wreaks havoc on unhoused communities in L.A., an emergency fueled by a growing housing crisis and the worst overdose epidemic in U.S. history, which in recent years has seen the powerful synthetic opioid rapidly infiltrate communities on the west coast. Los Angeles, the nation’s most populous county, is home to more than 75,000 unhoused people. The majority of those people live on the streets. More than six unhoused people die every day, and homelessness and treatment programs have failed to meet the scale of the needs.
City and county leaders have been working to expand public health services to address the fentanyl crisis, but have struggled to keep up with the demands. L.A. County’s Division of Housing for Health has mobile clinics they use to help with the issue but according to Dr Absalon Galat, the program’s medical director, there are challenges in treating addiction in the field. Some of his patients with substance use disorders enter treatment programs, but the progress often isn’t sustainable without housing and stability in other parts of their lives, he said. He also connects patients to benefits like Social Security, which can get them closer to stability. Galat must deal with political resistance, including from some municipalities in the county and businesses that don’t want mobile clinics for the unhoused in their areas. Political concerns have repeatedly blocked another harm reduction strategy that some providers and county officials say would save lives: safe consumption sites, where people can use drugs under supervision. In 2022, California Gov. Gavin Newsom vetoed a bill that would have allowed pilot sites in L.A., saying he supported “cutting-edge harm reduction strategies”, but feared “unintended consequences”.