A UCSF expert says that interrupting the supply chain for illegal fentanyl, most of which comes out of Mexico, is far more difficult than just busting dealers and seizing their inventory. So despite the SFPD's successes in removing some of the drug from the streets of the Tenderloin in 2021, it may not make much difference on the overall epidemic, or on overdose deaths.
"Trying to stop drug supply doesn’t work as well as we’d like to think," says Dr. Daniel Ciccarone, a professor at the University of California-San Francisco School of Medicine, speaking to the Chronicle this week. He has studied the fentanyl supply chain in the U.S., and both he and the DEA say that because fentanyl, a synthetic opioid, is so potent and is sold in relatively small quantities, it can be carried across the border far more easily than heroin or other drugs.
The SFPD says that officers have seized 7.9 kilograms of fentanyl from dealers on the street and their suppliers — often in the East Bay — so far this year. If they continue at the same pace, they are on track to seize over 20 kilograms by year's end, which would be nearly four times the amount seized in 2020 (5.4 kg).
To put those quantities in perspective, a single 2 milligram dose of fentanyl can be lethal. The SFPD noted that the amount seized off the street last year alone was enough to kill every San Francisco resident three times over.
At 25 to 50 times more potent than heroin by volume, it take very little fentanyl to get high. And while dealers had been cutting heroin and other drugs with fentanyl in the past, now users on the street are buying fentanyl alone — and the addiction can be extremely difficult to recover from.
The prevalence of fentanyl on the street led to over 700 overdose deaths in San Francisco last year — nearly three times as many people than died from COVID.
This week, the mother of a San Francisco fentanyl addict took to the street to protest and call attention to the crisis. As Hoodline reports, Jacqui Berlinn says that public officials need to do more to address both the drug-dealing situation and treating mental health conditions that are often the underlying causes of drug abuse, as is the case with her son.
Wade Shannon, special agent in charge of the U.S. Drug Enforcement Agency’s San Francisco field division, tells the Chronicle that the DEA has seized 33 kilograms in this region — which includes the Central Valley and up to the Oregon border — so far this year. And he speaks of mules being able to carry fentanyl over the border in bags the size of lunch sacks, as opposed to the duffle bags one would see marijuana or heroin carried in.
"When we went from natural opiates to synthetic, it changed the game, unfortunately," Shannon says. "That’s one reason that the number of overdose deaths have been skyrocketing, not just in the Bay Area but nationally."
And the large amounts being seized could simply be an ominous indicator of how much fentanyl is circulating out there. Previously, SFist reported that the SFPD had seized four times the quantity of fentanyl last year than in 2019, likely indicating an exponential rise in supply with seizures looking to be up fourfold again.
"When the supply is up, seizures go up," as Ciccarone tells the Chronicle.
Ciccarone agrees with District Attorney Chesa Boudin in saying that "Finding low level users and dealers and locking them up... has not been a successful effort" in terms of limiting the fentanyl supply.
He recommends more early detection and treatment programs for users, and harm reduction programs, to begin to lower the demand for the drug on the streets.