A sharp increase in deaths among homeless people that began in the spring of 2020 was driven by overdose of drugs involving fentanyl, a report released Thursday by the Los Angeles County Department of Public Health.
During the first seven months of 2020, 926 homeless people died in LA County, a 26% increase over the same period in 2019.
While COVID-19 has become the second leading cause of death in the overall population of Los Angeles, it has remained a major factor in homeless deaths, following heart disease, transport-related accidents and homicide – all of which have been left behind under drug overdose.
“Despite the relatively smaller direct impact of COVID-19 … there was a worrying increase in overdose deaths in this population in the first seven months of 2020,” said the report, which was compiled by the province’s Center for the Evaluation of the health impact has been evaluated, said. “This increase was mainly driven by the more frequent involvement of fentanyl.”
“Overdose is an absolute scourge in the homeless community,” Darren Willett, director of harm reduction at Homeless Healthcare Los Angeles, said in an information session on the report.
The increase in deaths apparently flattened slightly later in the year. The department’s medical investigator coroner’s LA estimate of 1383 homeless deaths in 2020 would be a year-on-year increase of about 9%.
The province’s second annual report on homelessness deaths found that drug overdoses accounted for just under 30% of homelessness deaths in 2020, which was by far the biggest cause.
Methamphetamine, which was determined to be involved in nearly two-thirds of the deaths, still made the largest contributor. However, the presence of the potent synthetic opioid fentanyl in the mixture of drugs commonly found in a person’s system has more than doubled to 41%.
The report contains recommendations to reduce deaths, including improved street outreach, more interim housing, management of chronic diseases, increased spread of the antidote naloxone, a dramatic increase in residential beds for the treatment of drug use disorders and increasing opportunities for jail distraction. the treatment of drugs.
During the briefing, service providers emphasized that ‘harm reduction’ – the use of naloxone, syringe exchange programs and sanctioned drug use sites – is the most effective response.
“One of the main reasons why people die from overdoses is that they use it alone,” Willett said. “They do not have people to ask for help to stop the overdose.”
According to Willett, 92% of the homeless residents in the community who respond to a community needs assessment and say they inject drugs have used alone in the past year, and 60% of people said they use alone daily.
“It hides in the shadows, hides in the tents, hides in the alleys is undoubtedly the result of the crime and the social denial by the war on drugs,” he said.
Of those surveyed, only 30% said they had ever gone to a shelter. The poll is likely to increase if shelters allow drug use.
‘Change one factor – would you have access to it if you were using drugs? – 80% said they would, ‘Willett said.
Willett said he does not prefer drug use across the board in shelters, but argues that some shelters are specifically for drug users.
Soshanna Scholar of the County Office of Diversion and Reentry said the agency has distributed 50,000 doses of naloxone to inmates leaving prisons since January to address death rates up to 136% higher than the general population among those involved in the justice system.
She attributed the program to the reversal of 3,000 overdoses.
The report, which covers both 2019 and 2020, did not attempt to calculate a mortality rate for last year due to the lack of current information on the number of homeless.
The authors said they would investigate the possibility that COVID-19 had an indirect effect on the increase in deaths without oats, but that they did not have enough information to draw conclusions.
The annual census, conducted in January last year, showed a 13% increase in people living on the streets or shelters in 2019. Dramatic job losses due to the COVID-19 pandemic are likely to have left more people homeless, but there is no way to quantify it.
The increase in the number of homeless last year had a counter-intuitive effect of slowing down an increase in mortality for homeless perennials, despite the fact that the number of homeless deaths has increased sharply.
The overall mortality rate – that is, the number of people dying out of every 100,000 – has risen only slightly in 2019, after rising sharply the previous year.
In general, homeless people were three times more likely to die from any cause than the entire population. Their probability of dying was 36 times higher due to an overdose of drugs or alcohol, four times higher due to heart disease, 17 times higher due to transport-related injuries, 15 times higher due to murder and eight times higher due to suicide.
Drug suicide was not associated with the youth. The highest rates and the sharpest increase in 2019 were among the ages 55 to 61, followed by 62 and older.
The death rate due to drug overdose was the highest for whites, but remained stable in 2019, while blacks rose by 45% and Latinos by 17%.
‘It appears that the continued increase in overdose mortality rates in 2019, especially among Black and Latinx [persons experiencing homelessness], was largely driven by the increasing involvement of fentanyl in overdose deaths among these racial / ethnic groups, ”the report reads.
The overdose rate among homeless women was only slightly less than for men, a significant difference in the total population in which men are more than twice as likely as women to overdose fatally.