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Deadly overdoses stopped surging among L.A. County homeless people. Narcan could be why

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Deadly overdoses stopped surging among L.A. County homeless people. Narcan could be why

Year after year, Los Angeles County has seen devastating losses on its streets, as homeless people bedding down in tents, under tarps and on sidewalks have lost their lives to drug overdoses at soaring rates.

Now a newly released report shows the death rate from overdoses stopped rising among unhoused people in the county in 2022 — the same year L.A. County was stepping up its efforts to save lives.

Public health officials welcomed the news as a glint of hope, but cautioned it is too soon to say if the numbers are headed for a lasting downturn. They pointed to a county push to dramatically ramp up the distribution of naloxone — a medicine that bystanders can use to stop opioid overdoses — as a likely factor.

In their report, county officials touted a “near doubling” that year in the reported number of overdoses that were thwarted with naloxone, based on figures provided by a county program. The lifesaving medicine is commonly sold as a nasal spray under the brand name Narcan.

Two years ago in North Hollywood, Manny Placeres told The Times he had revived people seven times using Narcan that had been provided to him by a county team, honing his technique with time.

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“As they’re knocking on heaven’s door, I pull them back,” Placeres said.

Manny Placeres, who has administered naloxone many times to reverse opioid overdoses on the streets, embraces Leimer in 2022.

(Christina House / Los Angeles Times)

The L.A. County Department of Health Services has handed out Narcan at homeless encampments, given it to community groups and county agencies and set up vending machines to dispense it for free to people leaving county jails.

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As of February, the health services department said it had distributed more than 600,000 doses of naloxone since launching its initiative, resulting in more than 25,000 overdoses being stopped. Community groups and syringe programs have bolstered such efforts by handing out their own supplies of free naloxone provided by the state.

Dr. Gary Tsai, director of the public health department’s substance abuse prevention and control bureau, said that after years of alarming increases, “it is encouraging to see a slowing of this leading cause of death for people experiencing homelessness.”

“Efforts to increase access to naloxone and overdose prevention services have undoubtedly helped to bend this curve and provide a blueprint for reducing drug-related fatalities in this very high-risk population,” he said in a statement.

County officials said such efforts had also helped stabilize the death rate for homeless people overall after years of disturbing growth. As deadly overdoses stopped surging and COVID-19 deaths plunged, the overall mortality rate among unhoused people in L.A. County began to level off, the report found.

But homeless people remained far more likely than other county residents to die in a range of ways, including overdoses, traffic collisions, heart disease and homicide.

Their death rate overall was nearly four times higher than that of the broader population — a gap that has widened over time, public health officials found. And although it may have finally hit a plateau, the mortality rate for homeless people in L.A. County was still 60% higher than it had been three years earlier.

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“This report highlights the continued need for concerted efforts to reduce the disproportionate burden of mortality among this vulnerable population,” L.A. County Public Health Director Barbara Ferrer said in a statement.

The county report also pointed out some alarming variations in the overall trends in L.A. County: For Black people who were unhoused, for instance, the rate of overdose deaths continued to rise significantly in 2022.

The rate of fatal overdoses also kept rising among homeless people in their 20s and 40s, the report found. That was offset by dropping rates among older people, but the report raised a grim possibility: After so many deadly years, “there may now be fewer surviving fentanyl and other opioid users over 50.”

Narcan can stop overdoses from opioids such as fentanyl, a powerful synthetic drug that has been involved in a rising share of overdose deaths among homeless people in L.A. County.

But fentanyl has not been the only threat: Roughly two-thirds of deadly overdoses among unhoused people involved more than one drug. Among the most commonly mingled were fentanyl and methamphetamine, a combination involved in nearly half of overdose deaths among homeless people in the county in 2022, according to the new report.

L.A. County public health officials called for a number of steps to bring down deaths among unhoused people, including expanding housing options so that people who use drugs will not lose their housing as a result; handing out more naloxone and test strips that detect fentanyl; and expanding preventative care for people who are homeless.

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With a nudge from industry, Congress takes aim at California recycling laws

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With a nudge from industry, Congress takes aim at California recycling laws

The plastics industry is not happy with California. And it’s looking to friends in Congress to put the Golden State in its place.

California has not figured out how to reduce single-use plastic. But its efforts to do so have created a headache for the fossil fuel industry and plastic manufacturers. The two businesses are linked since most plastic is derived from oil or natural gas.

In December, a Republican congressman from Texas introduced a bill designed to preempt states — in particular, California — from imposing their own truth-in-labeling or recycling laws. The bill, called the Packaging and Claims Knowledge Act, calls for a national standard for environmental claims on packaging that companies would voluntarily adhere to.

“California’s policies have slowed American commerce long enough,” Rep. Randy Weber (R-Texas) said in a post on the social media platform X announcing the bill. “Not anymore.”

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The legislation was written for American consumers, Weber said in a press release. Its purpose is to reduce a patchwork of state recycling and composting laws that only confuse people, he said, and make it hard for them to know which products are recyclable, compostable or destined for the landfill.

But it’s clear that California’s laws — such as Senate Bill 343, which requires that packaging meet certain recycling milestones in order to carry the chasing arrows recycling label — are the ones he and the industry have in mind.

“Packaging and labeling standards in the United States are increasingly influenced by state-level regulations, particularly those adopted in California,” Weber said in a statement. “Because of the size of California’s market, standards set by the state can have national implications for manufacturers, supply chains and consumers, even when companies operate primarily outside of California.”

It’s a departure from Weber’s usual stance on states’ rights, which he has supported in the past on topics such as marriage laws, abortion, border security and voting.

“We need to remember that the 13 Colonies and the 13 states created the federal government,” he said on Fox News in 2024, in an interview about the border. “The federal government did not create the states. … All rights go to the people in the state, the states and the people respectively.”

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During the 2023-2024 campaign cycle, the oil and gas industry was Weber’s largest contributor, with more than $130,000 from companies such as Philips 66, the American Chemistry Council, Koch Inc. and Valero, according to OpenSecrets.org.

Weber did not respond to a request for comment. The bill has been referred to the House Energy and Commerce Committee.

Plastic and packaging companies and trade organizations such as Ameripen, Keurig, Dr Pepper, the Biodegradable Plastics Industry and the Plastics Industry Assn. have come out in support of the bill.

Other companies and trade groups that manufacture plastics that are banned in California — such as Dart, which produces polystyrene, and plastic bag manufacturers such as Amcor — support the bill. So do some who could potentially lose their recycling label because they’re not meeting California’s requirements. They include the Carton Council, which represents companies that make milk and other beverage containers.

“Plastic packaging is essential to modern life … yet companies and consumers are currently navigating a complex landscape of rules around recyclable, compostable, and reusable packaging claims,” Matt Seaholm, chief executive of the Plastics Industry Assn., said in a statement. The bill “would establish a clear national framework under the FTC, reducing uncertainty and supporting businesses operating across state lines.”

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The law, if enacted, would require the Federal Trade Commission to work with third-party certifiers to determine the recyclability, compostability or reusability of a product or packaging material, and make the designation consistent across the country.

The law applies to all kinds of packaging, not just plastic.

Lauren Zuber, a spokeswoman for Ameripen — a packaging trade association — said in an email that the law doesn’t necessarily target California, but the Golden State has “created problematic labeling requirements” that “threaten to curtail recycling instead of encouraging it by confusing consumers.”

Ameripen helped draft the legislation.

Advocates focused on reducing waste say the bill is a free pass for the plastic industry to continue pushing plastic into the marketplace without considering where it ends up. They say the bill would gut consumer trust and make it harder for people to know whether the products they are dealing with are truly recyclable, compostable or reusable.

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“California’s truth-in-advertising laws exist for a simple reason: People should be able to trust what companies tell them,” said Nick Lapis, director of advocacy for Californians Against Waste. “It’s not surprising that manufacturers of unrecyclable plastic want to weaken those rules, but it’s pretty astonishing that some members of Congress think their constituents want to be misled.”

If the bill were adopted, it would “punish the companies that have done the right thing by investing in real solutions.”

“At the end of the day, a product isn’t recyclable if it doesn’t get recycled, and it isn’t compostable if it doesn’t get composted. Deception is never in the public interest,” he said.

On Friday, California’s Atty. Gen. Rob Bonta announced settlements totaling $3.35 million with three major plastic bag producers for violating state law regarding deceptive marketing of non-recyclable bags. The settlement follows a similar one in October with five other plastic bag manufacturers.

Plastic debris and waste is a growing problem in California and across the world. Plastic bags clog streams and injure and kill marine mammals and wildlife. Plastic breaks down into microplastics, which have been found in just about every human tissue sampled, including from the brain, testicles and heart. They’ve also been discovered in air, sludge, dirt, dust and drinking water.

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‘Largest outbreak that we’ve seen in California.’ Death cap mushrooms linked to deaths, hospitalizations

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‘Largest outbreak that we’ve seen in California.’ Death cap mushrooms linked to deaths, hospitalizations

An exceptionally wet December has contributed to an abundance of death cap mushrooms, or Amanita phalloides, on the Central Coast and Northern California, causing what officials describe as an unprecedented outbreak of severe illness and death among people who consume the fungi.

Public health officials are issuing a second warning this winter, this time urging the public against foraging for wild mushrooms, noting that many people have mistakenly eaten the death cap that, when consumed, can cause severe liver damage and in some causes death.

In the last 26 years, “we have not had a season as deadly as this season both in terms of the total numbers of cases as well as deaths and liver transplants,” said Craig Smollin, medical director of the San Francisco division of the California Poison Control System.

“I believe this is probably the largest outbreak that we’ve seen in California, ever.”

Many of the cases, officials say, have involved people from Mexico and elsewhere for whom the death cap resembles an edible mushroom in their home countries.

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The California Department of Public health reported 35 death cap-related illness, including three fatalities and three liver transplants between Nov. 18 and Jan. 6. Affected people were between the ages of 19 months old and 67 years old.

In a typical year, the California Poison Control Center may receive up to five cases of poisonous mushroom-related illness, according to authorities.

The last major outbreak of mushroom-related illness in California occurred in 2016 with 14 reported cases and while there were no deaths, three people required liver transplants and one child suffered a “permanent neurologic impairment.”

The death cap is the world’s most poisonous mushroom, responsible for 90% of mushroom-related fatalities.

Where the death-cap outbreak is concentrated

When state public health officials first warned of the dangers of the death-cap mushroom in December, significant clusters of reported illness occurred in Monterey and the San Francisco bay areas.

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Reported hospitalizations have since grown to include Alameda, Contra Costa, Monterey, San Francisco, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz and Sonoma counties.

Death cap mushrooms are known to sprout across the state of California but they thrive in shady, humid or moist environments under live oak and cultivated cork oak trees.

Death cap mushrooms bloom particularly well after the fall and winter rains. Once they sprout, its tall and graceful characteristics are very conspicuous and catch people’s eye, said David Campbell, an expert on mushroom consumption or a mycophagist.

Who is mistakenly eating the death cap

People who have accidentally consumed the death cap were usually foraging for mushrooms in the wilderness, either alone or with a group, officials say.

Among the affected are monolingual speakers of Spanish, Chinese, Mandarin and Mixteco as well as foragers who may confuse the death cap mushroom for edible fungi from their native countries, according to experts.

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“So they have a false sense of security in their knowledge, thinking they know what they’re doing but that only applies to where they’re from,” Campbell said.

“We’re seeing that a number of patients do seem to have a Hispanic background,” said Dr. Rita Nguyen, assistant state public health officer at the California Department of Public Health.

In November, a Salinas family said they went on a hike in their community and found the death cap which looked similar to an edible mushroom they would forage for in their hometown in Oaxaca, KSBW Action News reported.

Laura Marcelino and Carlos Diaz took the mushrooms home, cooked them and ate them — their children did not. They both threw up, had diarrhea for an entire day and were later hospitalized, KSBW Action News reported. Marcelino’s condition improved but Diaz’s health declined exponentially to the point that he fell into a coma and was put on a list to receive a liver transplant, according to news reports.

Why people are mistakenly eating death cap mushrooms

The three most deadly mushrooms in California include the death cap, destroying angel (Amanita ocreata) and deadly Galerina (Galerina marginata), according to the Bay Area Mycological Society.

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The death cap mushroom has a dome-shape smooth cap with olive or yellowish-green tones. On the underside of its cap are white gills and spores.

It can be confused with the mushroom species Volvariella, which is edible.

These mushrooms appear similar because they have a volva, a cup-like structure at the base of the mushroom’s stem, and are white-ish, but lack one important key characteristic annulus, or ring, around its stem, said Ari Jumpponen, Kansas State University distinguished professor of biology.

Jumpponen said some Volvariella species can be found in Oaxaca.

What symptoms can you expect after eating a death cap?

No amount of death cap is safe to consume.

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“I also want to just stress that there’s nothing, there’s no cooking of the mushroom or freezing of the mushroom that would inactivate the toxin,” Smollin said.

The poisonous toxins from the death cap can result in a delayed gastrointestinal symptoms that may not appear until 6 to 24 hours after eating it.

Some of the early symptoms that can go away within a day include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Drop in blood pressure
  • Fatigue
  • Confusion

Mild symptoms may only be the beginning of a more severe reaction.

Severe symptoms can develop within 48 to 96 hours, include progressive liver damage and, in some cases, full liver failure and potentially death, Smollin said.

If you’ve eaten a foraged mushroom and start to exhibit any adverse symptoms, call California’s poison control hotline at 1-800-222-1222 for free, confidential expert advice in multiple languages. If you suspect mushroom poisoning, call 911.

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Leaked memo reveals California debated cutting wildfire soil testing before disaster chief’s exit

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Leaked memo reveals California debated cutting wildfire soil testing before disaster chief’s exit

California Gov. Gavin Newsom’s disaster chief quietly retired in late December amid criticism over the state’s indecisive stance on whether soil testing was necessary to protect survivors of the Eaton and Palisades fires.

One year ago, Nancy Ward, then the director of the California Governor’s Office of Emergency Services (Cal OES), petitioned the Federal Emergency Management Agency to spearhead the cleanup of toxic ash and fire debris cloaking more than 12,000 homes across Los Angeles County.

Although Ward’s decision ensured the federal government would assume the bulk of disaster costs, it came with a major trade off. FEMA was unwilling to pay for soil sampling to confirm these homes weren’t still heavily contaminated with toxic substances after the cleanup — testing that California state agencies have typically done following similar fires in the past.

Following intense backlash from fire survivors and California lawmakers, Ward pleaded with FEMA to reconsider its soil-testing stance, writing in a Feb. 19 letter that it is “critical to protect public health” and “ensure that survivors can safely return to their homes.” Her request was denied.

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However, in October, Cal OES — under Ward’s leadership — privately considered discontinuing state funding for soil testing in the aftermath of future wildfires, according to a confidential, internal draft memo obtained by the Los Angeles Times.

The Times requested an interview with Ward, and sent questions to her office asking about her initial decision to forgo soil testing and for clarity on the future of state’s fire recovery policy. Ward declined the request; The Times later published an article on Dec. 29 about allegations that federal contractors illegally dumped toxic ash and misused contaminated soil in breach of state policy.

Ward, who served as Cal OES director for three years, retired on Dec. 30; her deputy director, Christina Curry, stepped into the role as the interim chief. Ward also did not respond to several requests for comment for this article.

Ward was the first woman to serve as Cal OES director. She had also previously served as a FEMA regional administrator, overseeing federal disaster response in the Southwest and Pacific Islands from 2006 to 2014.

A Cal OES spokesperson said Ward’s retirement had been planned well in advance.

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“Director Nancy Ward has been a steady hand and a compassionate leader through some of California’s largest disasters,” the spokesperson said. “Her decades of service have made our state stronger, safer, and more resilient. The Governor is deeply grateful for her dedication and wishes her the very best in retirement.”

The internal memo obtained by The Times was written by Ward’s assistant director, and titled: “Should the state continue to pay for soil testing as part of Private Property Debris Removal (PPDR) programs? ”

It laid out three possible answers: The state could keep funding soil testing after future wildfires; the state could defer soil testing decisions to the affected counties with the possibility of reimbursing them; or the state could stop paying for soil testing entirely.

A Cal OES spokesperson said the memo was only a draft and did not represent a policy change. “The state’s position on soil testing remains unchanged,” the spokesperson said. “California is committed to advocating for the safe, timely removal of wildfire debris. Protecting the public health and well-being of impacted communities remains the state’s foremost priority.”

The primary reason for soil testing is to prevent harmful exposures to toxic metals, such as brain-damaging lead or cancer-causing arsenic. Since 2007, comprehensive soil testing has been conducted after 64 wildfire cleanups in California, according to the memo. When soil contamination still exceeded state benchmarks after the initial cleanup, the state government redeployed cleanup workers to remove more dirt and then retest the properties.

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This approach, the memo said, was critical in identifying harmful substances that “pose exposure hazards via ingestion, inhalation of dust, or through garden/food production.” Soil testing “helps ensure the safety” of children, seniors, pregnant women and people with health issues who are “more vulnerable to soilborne toxins.”

“The State has a long precedent of conducting or paying for soil testing,” the Cal OES assistant director wrote in the memo.  “Pivoting from this would be a significant policy change.”

The memo cites a report from CalRecycle, the agency that has historically carried out state-led fire cleanups, that stresses the importance of the current practice to public health.

“Soil contamination after a wildfire is an invisible threat,” wrote a CalRecycle official. “If not properly cleaned and remediated in a methodical way, property owners may encounter additional hurdles during the rebuilding process and suffer additional trauma.”

“Soil sampling,” the official adds, “is the metric by which Recyclable demonstrates that debris removal operations have successfully remediated the post-disaster threat to public health and the environment.”

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However, such soil testing and additional cleanup prolongs the cleanup timeline and can make it more expensive. The memo cites cost estimates from CalRecycle which show that soil testing and additional cleanup work usually costs some $4,000 to $6,000 per parcel, representing 3% to 6% of overall debris removal costs.

The state cost projections align with those made by independent environmental experts. Andrews Whelton, a Purdue University professor who researches natural disasters, estimated that soil testing and further remediation for the Eaton and Palisades fire would cost between $40 million to $70 million.

All told, the CalRecycle report states the usual soil-testing process has been a “relatively low-cost step” to safeguard public health.

Further, although soil testing may add some cost, when it’s taken as a proactive measure, it can save money down the road.

Forgoing soil testing and evidence-backed remediation can generate uncertainty about toxic contamination, which in turn could lower the value of homes in Altadena and Pacific Palisades, Whelton said. What’s more, the property owner may be liable for soil contamination if they fail to disclose environmental risks when selling or leasing.

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The internal CalOES memo alludes to this give and take: “Funds saved initially by skipping testing may be outweighed by later unseen costs, for example, reinvesting in remediation, addressing community complaints, litigation, or cleanup failure.”

The U.S. Army Corps of Engineers has fielded over 1,100 complaints filed by property owners affected by the Eaton and Palisades fires — over 20% of which were related to the quality of work. According to internal reports obtained by The Times, federal cleanup repeatedly deviated from cleanup protocols, likely spreading contamination in the process.

Since then, FEMA officials have backed down from their hard-line stance against paying for post-fire soil testing in California in an attempt to shore up public confidence in the federal cleanup.

The U.S. Environmental Protection Agency announced this week that FEMA will conduct a limited lead-testing program in the Eaton fire burn scar that is intended to “confirm the effectiveness of cleanup methods,” according to an EPA spokesperson. The initiative has already come under the scrutiny of environmental experts who say it lacks the rigor of California’s soil testing regimen.

It remains unclear if California will continue to implement soil-testing safeguards that made the state a national leader in fire recovery. Though state officials say these will remain unchanged, there is no legal mandate to follow these procedures.

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The internal CalOES memo circulated under Ward’s leadership has only added to the cloud of uncertainty.

One thing is clear: It’s a moot point for survivors of the Eaton and Palisades fire.

As state and federal officials debated the value of soil testing, most Altadena and Pacific Palisades residents have been left to investigate the extent of environmental fallout on their own.

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