As the city and county of Los Angeles struggles with tens of thousands of people living on the street – the rise of homelessness and tragic youth fatalities across the country are linked to the rise in use of the synthetic drugs fentanyl, along with methamphetamine and the more potent version of meth known as P2P (phenyl-2-propanone) meth.

“Fentanyl is a class of drugs, the deadliest we’ve ever seen on the street,” said Sam Quinones, veteran journalist and author of the book, “The Least of Us” which chronicles the opioid crisis in America. Quinones has covered drug trafficking and the border for over 30 years. 

“We’re now in the synthetic drug era, traffickers in Mexico have basically transitioned away from plant drugs largely towards massive amounts of drugs they can make in a lab with only chemicals and the main two are fentanyl and methamphetamine,” said Quinones.

“I believe very strongly these two drugs, primarily meth, seem to have been a major driver in mental illness, leading to homelessness and also leading to people in [living in] tents.”

Quinones said he has seen firsthand how many of those who are unhoused are “terrified not to have access to the drugs and will go to any lengths to avoid being separated from the drug.”

“People will stay in tents, even though they’re offered housing or treatment, even though the temperatures drop to very lethal levels, even though it’s snowing. You’ll find their brains absolutely controlled by these two drugs, and living in their tents and going to any lengths to avoid being separated from the drug.”

Housing programs and facilities generally require that there be no drug use and if they have a history of drug use, they must be entered into drug programs.

An emergency room doctor who did not want to provide his name but was referred to as “Dr. John,” described the “mental illness, psychosis, vision and delusions” that are all related to methamphetamine use. “They are seeing spiders coming out of the wall but refuse to believe that it’s because of their meth use.

“They are very, very aggressive about it,” said Dr. John. “They’re seeing things that are really terrifying to them but they can’t acknowledge that the meth is the cause.”

He said it can be quite disturbing to even watch someone go through such a terrifying experience. Equally troubling is that there is no easy solution to such a powerful addiction. 

“We say, look, I think what’s going on in your life, what’s causing a lot of these issues is the methamphetamine and you get this very aggressive response back from your patient insisting that it’s ‘Absolutely not, it’s not the meth … it’s definitely not the meth.’ They’re very, very aggressive about it,” said Dr. John. 

He noted that opiate users in the past, including heroin, could and would recognize that the issues they were having were related to their drug addiction but those using these more powerful street drugs don’t appear to have the same awareness.

“I know this sounds really terrible, but you end up kind of getting, I guess, a morbid sense of humor in my profession, like the kind of joke around emergency doctors that we all say, ‘It’s not the meth, bro,’ because that’s what we hear all the time, over and over from methamphetamine users,” Dr. John explained.

Emergency room doctors can refer addicted patients to “bridge programs.” The California Bridge Program works with hospitals and emergency rooms to get patients with opioid addictions onto medication assisted treatment but the medical treatment does not cure the addiction. The patients who go into rehabilitation centers have the free will to walk out and many do as their body craves the drug. 

Making meth even more addictive, P2P meth can also be laced with fentanyl and those supplying it have little concern for checks and balances or the amount of fentanyl being supplied in counterfeit pills that can be lethal. The risk and dangers of meth, P2P meth, fentanyl and other street drugs is incalculable.

During the news briefing with Dr. John and Sam Quinones held by Ethnic Media Services (EMS), these manufactured street drugs were referred to “as the most dangerous drugs known to man are available coast to coast like never before.”

Sandy Close, EMS executive director, provided sober statistics, “Overdose deaths rose during the COVID-19 pandemic, and in 2021, more than 200,000 people died in the US of drug overdoses. About 71,000 of those deaths were related to synthetic opioids, according to the CDC. Children and teens who ingest fake prescription pills and tiny candies laced with fentanyl are becoming seriously ill or dying every week in the USA,” said Close.

The evidence of the strength of fentanyl, said Dr. John, is seen in the amount of the Narcan, Naloxone HCI, that is used for the treatment of a suspected opioid overdose that they have to administer and the greater risk for death.

“Fentanyl is much more potent. It is an opiate so you can give Narcan. But fentanyl causes severe respiratory depression, meaning you stop breathing. So that’s what kills people in an overdose, they stopped breathing, that includes heroin, morphine, Norco, oxycodone, that’s typically what kills these people is that they get severe respiratory depression and they stopped breathing,” he explained. 

“Now, fentanyl since it’s so much more potent, it happens much more frequently.”

The frustration, said Dr. John, is that with no real medical treatment – there is only a “finger wag” to tell the patient to stop using and the chances aren’t very likely that the user will stop.

“The withdrawal symptoms include diarrhea, sweating, getting pain everywhere. Just feeling like absolute garbage, nausea, vomiting, all those things Narcan will cause. Narcan does not treat the addiction itself, the addiction is a physiologic change that’s happening in your body and what happens with that addiction is that your body is used to that fentanyl,” Dr. John explained.

“It’s used to soaking these receptors called immune receptors and the receptors in opiates, and the windows for the opiates are gone. The body says where are the opiates, right? The body is always looking for homeostasis and so there’s no opiates there. And your body needs more opiates to satisfy that.”

The drugs, meanwhile, continue to come over in cars and trucks across the border with only a small percentage being checked. 

“The idea that people come to the USA with it in their backpacks or strapped to their bodies doesn’t correlate with the massive amounts entering the country. Making additional checks on vehicles,” Quinones pointed out, “could slow the US/Mexican border down to a near standstil

Previously, there was more of an attempt to make the illegal drugs emulate prescription drugs but now there is less concern and the pills are coming in multicolored with mostly or all fentanyl.

“They’re supposed to look like the press blues, but they’re like red and yellow and green and because on the street now people are addicted to fentanyl, they don’t care what the pill, what the fentanyl looks like when it gets to them — only that they get their fentanyl. And if that fentanyl, if it comes in a yellow pill or a green pill or a blooper, they do not care. They need the pill, that’s all that matters,” Quinones said.

“I went to a Snapchat protest in Santa Monica, California where families who had lost their kids who had bought pills on Snapchat were protesting and they had big posters saying Snapchat is complicit in my son’s murder,” said Quinones.  

Many of these young people may have been unaware about the amount of fentanyl they were ingesting and may have thought they were taking an Adderall or another kind of prescription drug that they could buy online. 

“A lot of this took place during COVID because the kids couldn’t leave the house. The only way they connected to the world was through their phones. And now people were anonymously selling drugs with very colorful menus [that] look like an ice cream truck menu.

“The social media app became kind of like the new street corner in a sense. I think all of this is because the supplies of these drugs are being made in catastrophic quantities that we’ve never seen before,” said Quinones.

“If you study drug history, historians will say we go through cycles: stimulants to depressants, back to stimulants and the cycles take 10 or 15 years or whatever. That’s over. It’s all one in there, stimulant and depressant at the same time in massive quantities all across the United States. And so those cycles that historians identified for the last 100 years in the United States have been upended by the two drugs that we’re talking about today.”