CA opioid epidemic: How we got here

Your guide to California policy and politics
Lynn La BY Lynn La July 25, 2023
Presented by Dairy Cares, Southern California Gas Company, Climate-Smart Agricultural Partnership and Politifest 2023

CA opioid epidemic: How we got here

With a death toll of more than 7,000 Californians in 2021, the opioid epidemic has become one of the state’s most vexing issues. The Legislature is considering several minor bills related to fentanyl — including creating an anti-fentanyl-abuse task force and increasing fines for dealers — but Republican lawmakers voice frustration that the state isn’t doing enough to end the drug crisis. 

Fentanyl has been at the center of some of the more dramatic moments this session. In April, Democrats avoided efforts by Republican Assemblymembers to force a floor vote on fentanyl bills by agreeing to debate the bills at a later special committee hearing. Days later, residents whose loved ones died from overdoses walked out of the hearing room as the Senate Public Safety Committee debated (and ultimately killed) a bill that would have required giving fentanyl dealers notice that they can be charged with homicide. And in May, a select Assembly committee held a five-hour hearing on fentanyl that included testimony from grieving family members on the verge of tears.

To learn more about what’s driving California’s opioid crisis, CalMatters has a new explainer compiled by CalMatters’ health reporter Ana B. Ibarra, data reporter Erica Yee and justice reporter Nigel Duara

Together, they dive into several aspects, including:

What makes fentanyl so dangerous: The drug is 50 times stronger than heroin and 100 times stronger than morphine. And depending on a person’s body size and tolerance, just 2 milligrams of fentanyl can be lethal. Its deadliness is one of the reasons why proponents of harsher criminal sentences for fentanyl dealers argue that comparing the current crisis with the crack cocaine epidemic is a false equivalence. 

The explainer also explores why it’s difficult for patients to access naloxone, the medication that reverses overdose. (And for more about naloxone accessibility, CalMatters’ California Voices editor Yousef Baig has a Q&A with Assemblymember Liz Ortega, a Democrat from Hayward, about her efforts to make a brand name of naloxone, Narcan, more widely available.)

A timeline covering the last 28 years of the crisis: In 1995, the Food and Drug Administration approved OxyContin, the painkiller that eventually became the main culprit in the opioid epidemic. Now, nearly three decades later,  2023 is on track to be the deadliest year in California for fentanyl overdoses. Learn what has happened in between, and which California counties have the most staggering overdose rates.

What law enforcement is doing about it: With 76% of adults citing violence and street crime as a problem in their community, per a February Public Policy Institute of California poll, there’s growing scrutiny over the effectiveness of policing and prosecuting fentanyl-connected crimes. The explainer details what the state’s doing about fentanyl seizures, trafficking at the border and jailing dealers.  Check it out.

Speaking of fentanyl: Assemblymember Reggie Jones-Sawyer is seeking $5.2 billion in bond funding to combat fentanyl overdoses, The Sacramento Bee reported Monday.

Jones-Sawyer credited May’s select committee hearing on fentanyl with helping shape the proposal. The bond would include $2 billion for substance abuse treatment, $2 billion for youth-targeted drug education programs, $400 million for harm reduction programs, and funding for other anti-drug services.

As chairperson of the Assembly Public Safety Committee, the Democrat from Los Angeles has received blowback from Republican lawmakers for not passing bills out of committee that would enact harsher penalties for dealers, as well as his temporary hold on all fentanyl bills in March.

Describing his bond proposal, Jones-Sawyer told The Bee that current efforts are “poking at the problem” but he wants to “go ahead and knock it out once and for all.”


CalMatters for Learning: From our engagement team: Lesson-plan-ready versions of our explainers on housing and homelessness, electric vehicles, wage theft, water and state government — all especially made for teachers, libraries and community groups, as part of the CalMatters for Learning initiative.


1 ‘Civility’ classes for crass CA lawyers

Lawyers and a judge speak inside a courtroom at the Madera County Superior Court in Madera on Sept. 29, 2021. Photo by Larry Valenzuela for CalMatters
Lawyers and a judge speak inside a courtroom at the Madera County Superior Court in Madera on Sept. 29, 2021. Photo by Larry Valenzuela for CalMatters

From CalMatters’ justice reporter Nigel Duara:

Are lawyers blaming an escalation in rude courtroom behavior on legal TV shows? Yes, a little. 

But they can’t blame David E. Kelly (Boston Legal, L.A. Law, The Practice, Ally McBeal) for everything. 

The legal profession in California is in the midst of a “scourge of incivility,” the state bar found in response to a barrage of complaints. Now, it’s proposing that lawyers spend one hour each year in mandatory civility training as part of their continuing education requirements. 

The targets of that incivility are often marginalized groups, the report found — young lawyers, women lawyers and lawyers of color. 

“Bullying, intimidation, and nastiness have too often replaced discussion, negotiation and skillful, hard-fought advocacy,” declared a 2021 report from the California Lawyers Association and the California Judges Association.  

The report points out that the people likeliest to take existing legal education courses on civility are already “committed to civility” or have themselves been victims of discrimination. Mandatory courses would educate attorneys about “the economic and human costs of incivility” and advise them on correcting their own behavior and the behavior of others. 

The California Supreme Court will decide whether to put their recommendations into action.  

A report from the Association of Business Trial Lawyers broke down courtroom bad actors by type, noting “uncivil lawyers come in many unappetizing flavors.” Among them:

  • Bullies: rude to opposing counsel; insults, threatens and demands. 
  • Obstructionists: ignore calls or emails, object to routine requests and interrupt depositions with long discursions. 
  • Paper tigers: generate frequent letters and emails, all  unproductive.
  • Bad apples: pathological liars, racists and misogynists.
  • The misguided: misbehavers who perhaps just need enlightenment. “These folks are our targets. They are the ones we will proselytize with the gospel of civility,” the report offered.
    “Perhaps they watched too many ‘lawyer’ TV shows.”

2 Can heat committee cool workers’ concerns?

Farmworkers pick melons in the early morning hours in Huron on Sept. 18, 2018. Photo by Marcio Jose Sanchez, AP Photo
Farmworkers pick melons in the early morning hours in Huron on Sept. 18, 2018. Photo by Marcio Jose Sanchez, AP Photo

As the state continues to swelter under heatwaves, California has a new advisory committee to study the effects of heat on workers.

The committee is expected to use data from a study by The Washington Center for Equitable Growth, a left-leaning economic research nonprofit, to help tackle hot workplace issues and assess business costs as temperatures rise and productivity falls, reports Nicole Foy of CalMatter’s California Divide team.

Quick takeaways from the nonprofit’s 2021 report:

  • Low-wage workers, particularly young men, face the greatest risk of heat injuries. 
  • Hot temperatures caused at least 360,000 workplace injuries in California from 2001 to 2018 (about 20,000 injuries a year).
  • Triple-digit-degree days can lead to a 10-15% increase in same-day injuries on the job.
  • Recovering from a heat-related injury or illness costs the average worker $35,000, including health care and long-term wage impact.

California is one of the few states with heat standards protecting outdoor workers, such as requiring employers to provide water breaks, shade and rest for employees when temperatures hit certain levels. It is also the first state to create an extreme heat warning and ranking system

But labor advocates and workers told Nicole that California still struggles with enforcing its workplace heat rules. The state also hasn’t yet passed legislation requiring companies to protect indoor workers from heat.

  • Antonio de Loera-Brust, United Farm Workers spokesperson: “We expect state agencies to be out in full strength across California to make sure employers are being compliant with the state heat rules. Heat is still a deadly hazard.”

Though state officials agree (and air conditioning costs could corroborate this) that heat reform work is urgent during a time of record-breaking high temperatures, the committee’s timeline is relatively measured. The committee convenes quarterly, meaning it met for the first time in June and is not scheduled to meet again until Sept. 19. Members, who include state agency staffers and scholars, have indicated they will likely commission another study to help steer the committee’s work. It has until 2026 to report its findings to the Legislature.


CalMatters Commentary

CalMatters columnist Dan Walters: To bridge the spending shortfall, Gov. Gavin Newsom hopes that increasing revenues will make the state budget work — but his own administration sees a string of deficits in the future.

CalMatters editor Yousef Baig and Assemblymember Ortega discuss her bill that would require health insurance providers to cover the cost of Narcan, but may drive up costs for the state and private insurance companies.


Other things worth your time

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$16M in grants to help CA tribes investigate murdered, missing Indigenous people // The San Bernardino Sun

Orange County Planned Parenthood firebombing: Third person charged  // The Orange County Register

Yosemite might bring back reservations as crowds overwhelm park // The Wall Street Journal

Young men making quartz countertops are facing lung damage. CA is taking action // NPR

Santa Barbara News-Press declares bankruptcy, ceases publication // Los Angeles Times

It hit 120 degrees in this CA town. For the homeless, ‘it’s a miserable life out here’ // Los Angeles Times

Four invasive species threaten CA water systems, and populations may be rising // The Fresno Bee

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