Tim Santamour, director of outreach and networking for the Florida Harm Reduction Collective,is hardly shocked anymore.
He knows from hisoutreach work and talking to people who use drugs that calling 911 for an overdose isn't an option anymore.
"People experiencing or witnessing an overdose are afraid police might arrest someone on the scene," said Santamour.
Recent data from the collective says that from April 2021 to March 31, 2022, only 38% of people who get naloxone through the collective's mail order programcalled 911 during an overdose.Naloxone is an opioid-overdose reversal drug.
The number is even lower for people experiencing homelessness or living in hotels or temporary housing. Only 12% call 911.
"This is the data that the state's not looking at, they're not collecting it," he said. "The state thinks everyone calls 911."
Drug user advocates say the state's recent moves to increase criminalization of the already contaminated drug supply can't keep up with the demand andwill lead to more overdoses.
Thursday, Gov. Ron DeSantis signedHB95, which adds methamphetamine tothe list of substances that would allow a dealer who sold the drugs in an overdose to be charged with murder. It also increases penalties for selling drugs within1,000 feet of substance use treatment facilities and increases the mandatory minimum sentence for traffickingfentanyl.
And in late April, in an emergency rule, Attorney General Ashley Moody added eight synthetic opioids to the Schedule Iof controlled substances in Florida and saidshe will work with state lawmakers during the 2023 legislative session to codify them permanently as Schedule I controlled substances in Florida.
Last year, 107,000 Americans died from a drug overdose. In Florida, some 6,089people were killed by opioids in 2020— the equivalent of one Floridian dying every 87 minutes.
Analogues are latest to pollute Florida's drug supply
The eight drugs, known as nitazenes, are analogues of etonitazene, a synthetic painkiller. A popular analogue, isotonitazene, has been around since the spring of 2020.
The analogues are just the latest substances to pollute the illicit drug supply, which can catch unsuspecting users off guard and lead to overdose and death.
Killing them softly: Advocates say legislative inaction will result in more drug OD deaths
"These scheduling efforts are likely well-intentioned, but they reflect an incomplete understanding of both chemistry and the illegal drug market," said Claire Zagorski, program coordinator at the University of Texas at Austin College of Pharmacy's PhARM Program andharm reduction instructor withTexas Opioid Training Initiative.
It's not hard to create nitazene analogues, a college student could do it, she said. The starting ingredients are not regulated, the equipment needed is basic, and glassware for it can be sourced online without purchasing restrictions.
Zagorski said the pressure to criminalize fentanyl caused the black market need to experiment with nitazenes. They have adifferent chemical skeleton thanopioids, which people are more familiar with, but they still activate the same receptors.
"This kind of 'chemical flexibility' is great for developing new drugs, prescription or otherwise, but it also means that the slow pace of legislation won't ever be able to keep up," she said. "We have very motivated people with a toolkit that allows for endless adaptability, versus a slow bureaucracy using patchy data."
According to a press release from Moody's office, the synthetic drugs are linked to at least 15 deaths in Florida since 2020. The number of nitazene cases rose to 171 in 2021, compared to 13 found in 2020. As of March 18, 84 cases had been identified.
"Some nitazenes are many times more lethal than fentanyl and we must make sure they do not become more prevalent in our state, or I am afraid we will see overdose deaths skyrocket," Moody said in a press release.
Theemergency order makes it a felony for an individual to possess, sell, manufacture or deliver the eight nitazenes added to the Schedule I.
"The continued criminalization of substances without addressing the root problem of why people use drugs is the wrong way to go,” saidSantamour.
"The state government continues to add to the list of Schedule Isubstances but doesn’t address education around those substances, doesn’t address prevention and it does nothing to safeguard those peoplewho use those substances from overdoses."
More:Missed opportunities? As Florida lawmakers fought culture war, other issues fell by wayside
Contact Ana Goñi-LessanatAGoniLessan@tallahassee.comand follow her on Twitter@goni_lessan.
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