San Francisco Chronicle - (Sunday)
Fentanyl seized, but fatal ODs soar on streets
Kelly Stanphill just wants something to change for her son, who is somewhere in San Francisco, drugaddled, gaunt and helplessly addicted to fentanyl.
So whenever she hears of a Tenderloin drug bust — like the 10 pounds of fentanyl that were seized by federal authorities last month — she can’t help but feel a tiny bit of justice and hope that her son’s endless supply of drugs will finally dry up.
But then, the reality sets in. “It’s not changing anything,” she said, sighing. “People are still dying, two a day. It’s not helping.”
More than 630 people died of overdoses in San Francisco from January to the end of November, a new record and a staggering increase from 441 in all of 2019. Amid the wave of death this spring, the San Francisco Police Department increased the number of officers focused on drug dealers in the Tenderloin — particularly those selling fentanyl to people like Stanphill’s 26yearold son.
But the added focus on the longtroubled neighborhood did not stop the surge of fatalities in 2020, most of which occurred in and around the Tenderloin. Even as police seized potentially millions of lethal doses of fentanyl — an opioid that can be 50 to 100 times more potent than morphine — more than 70% of the people who died had the drug in their system.
Overdoses killed more than three times as many people in
“When he was only on heroin, I could kind of communicate with him. ... But the fentanyl has made him like a zombie.” Kelly Stanphill, whose son is addicted to fentanyl
San Francisco last year as COVID19, and the drug epidemic shows no sign of slowing. Experts are divided over how to control it. The issue has largely pitted police and federal authorities against advocates for users and a progressive new district attorney, who favor treatment more than enforcement.
Many worry that 2021 will be another historically deadly year, as the pandemic disrupts lives and fentanyl permeates the drug supply. City leaders agree San Francisco needs increased help from the federal government and more robust drug treatment services, but they disagree on how authorities should punish streetlevel dealers who often come from out of town and are easily replaced after they’re arrested.
In the backdrop is a national reckoning over how police interact with vulnerable communities, like homeless, mentally ill and drugaddicted people. And the increased call for services comes as San Francisco faces a multimilliondollar budget deficit caused by the pandemic, which will force difficult decisions this year on what resources get funded, and which get cut.
As the city struggles to get a handle on the fentanyl epidemic, Stanphill has watched her son slip further into addiction.
“We can’t just stick BandAids on people,” she said from her home in Roseville ( Placer County). ... We just need more help. More accessible help. Affordable help. And decent help.
“It’s my kid,” she added.
Sometimes, Stanphill wishes that her son was still using just heroin. “Because when he was only on heroin, I could kind of communicate with him,” she said. “I would hear from him, I would see him, I could actually spend a day with him. ... But the fentanyl has made him like a zombie.”
When he’s sober, Stanphill said, her son with striking bluegreen eyes is charming and kind, with a quick sense of humor. She said his addiction began when he was around 14 with Xanax that he got from other students at school, which he took to calm his anxiety from being bullied. But after he started hanging with the wrong crowd, his drug use quickly escalated to cocaine, ecstasy, methamphetamine and then heroin.
Stanphill said she has tried everything — from special education resources for him in high school, to more than a dozen rehab services, to medicationassisted treatment to even walking around the Tenderloin looking for him. She has reached the point where she just wants him to have consistent access to clean needles and a safer drug supply, until he’s ready to try kicking his addiction again.
“Fentanyl gives him that small relief of escaping, and it’s so cheap,” she said. “It makes him feel nothing.”
A person can die from just 2 milligrams of fentanyl, a fraction of the lethal dose for heroin. The potent opioid is a major reason that 2020 was probably the deadliest year for overdoses in recorded history, according to the Centers for Disease Control and Prevention. According to the San Francisco medical examiner, 453 of the 636 people who died of overdoses from January to the end of November had fentanyl in their system.
That’s why the San Francisco Police Department is stepping up arrests of those who sell the drug, regardless of how much they are carrying, Chief Bill Scott said. According to the Police Department, officers made 600 arrests for drug sales in the Tenderloin and seized 192.2 ounces of fentanyl in 2020. That compares with 522 drugrelated arrests and 43.8 ounces seized in 2019. Notably, the Tenderloin narcotics unit was suspended at the beginning of the pandemic, which led to fewer arrests from March to May.
“It doesn’t take a whole lot of fentanyl to kill,” Scott said. “Had we not confiscated over ( 192.2 ounces) of fentanyl ... one has to think what that would have done in terms of having even more overdoses.”
To make a measurable difference on the streets, Scott said, all levels of law enforcement — including District Attorney Chesa Boudin — need to send a clear message that people will be punished if they break the law. While critics have accused Boudin of going easy on those accused of drug crimes, he stressed that he prosecutes nearly 80% of the drug cases that are brought to his office. That compares with the 88% that his predecessor, George Gascón, who was also criticized for being easy on drug dealers, said he prosecuted.
The district attorney says most of what’s presented to him are lowlevel dealers with small amounts of drugs, who are replaced on the streets as soon as they’re arrested.
“When it comes to effective use of law enforcement resources ... taking 0.4 grams of suspected fentanyl off the streets in an operation that probably cost taxpayers many thousands of dollars, when we don’t have treatment on demand, when we don’t have safe consumption sites, is not an effective way to prevent overdoses,” Boudin said.
Tracey Helton Mitchell, an overdose prevention advocate who has been sober for 22 years, said the city’s treatment services have dwindled, even as the demand has grown.
She said someone like Stanphill’s son needs a host of services that are hard to come by, or don’t exist, in San Francisco: Safe and supportive housing; outreach workers who can keep tabs on him; a 24hour dropin center where he can go anytime he needs help; a safe consumption site, where he can use drugs around nurses who can save him if he overdoses.
The state is working on legislation to allow San Francisco to open a safe consumption site, and the city is working on a 24/ 7 dropin center. But both of those things will probably take years to implement. Meanwhile, she said, the pandemic has exacerbated the crisis by isolating people from their communities, which they often rely on for help if they overdose.
“We are offering people things, but are they the things that they are asking for?” Helton said. “Are we giving people the tools they need to transition out of that lifestyle? I would argue no.”
The police chief and district attorney agree that San Francisco falls short when it comes to resources for people struggling with addiction. But until it bolsters its services, they disagree on what should be done in the interim: Boudin says the police should arrest people with “kilos not crumbs,” but Scott says that’s not going to help when people are dying from sheer milligrams of fentanyl.
“What’s happening on our streets ... is people selling crumbs,” Scott said. “And those crumbs are killing people. Literally.”
Stanphill has lost track of how many times her son has overdosed since the first time she found him at 16, wedged between the toilet and bathtub in her Santa Monica home.
He spent nearly two months in the hospital last summer on life support after being hit by a car, and then with a severe infection in his heart. Stanphill thought that she would finally be able to get through to him after that episode — but, instead, he left for the Tenderloin just two days after being discharged.
Now she hears from him only sporadically, and the silence in between is harrowing.
“Every time I see the ( overdose) numbers on the news, I’m like ‘ OK, is he dead somewhere?’ ” she said. “Do I have to call the coroners again? Should I call the hospitals? Do they have any unidentified bodies?”
Stanphill is so frustrated by San Francisco’s sputtering response to the crisis that sometimes she imagines herself as a midnight vigilante, sneaking into the Tenderloin to take down the drug dealers herself.
She dreams of stealing her son away from the neighborhood, and bringing him somewhere safe, like a cabin in the woods where she can help him heal among the trees and open air.
But she also knows the harsh, relentless reality of his addiction.
“He can’t just quit. It’s easier said than done,” she said. “I still have hope. I always have hope. But with each passing day it gets slimmer and slimmer.”