Hundreds of purple flags dotted the lawn at the County Administration Center on Thursday, a flag for every one of the 945 lives lost in San Diego County to accidental drug overdoses in 2024.
The stark scene is an annual reminder of the deadly toll some pay for ingesting fentanyl, methamphetamine, alcohol and other drugs.
This year, however, there were signs the tide is shifting. For the third time in three years, the number of individuals suffering unintentional deaths caused by drugs and alcohol has dropped, a trend that’s being mirrored on the national level.
Overdose deaths in 2024 declined by 21% from the previous year, when 1,203 died locally, according to a report card issued Thursday by the San Diego County Substance Use and Overdose Prevention Task Force. The county has seen a decline in overdose deaths of nearly 28% since the peak of 1,309 deaths in 2021.
Officials credit a multifaceted approach for the gains, from increased law enforcement and prosecutions to expanded public education and treatment to widespread distribution of opioid-reversing naloxone, which is sold under the brand name Narcan. They stressed that every death is preventable.
“There is hope — last year, there were 258 more flags on this lawn than there were today,” said David King, director of the High Intensity Drug Trafficking Areas program for San Diego and Imperial counties.
District Attorney Summer Stephan commemorates International Overdose Awareness Day at the County Administration Center on Thursday. (Alejandro Tamayo / The San Diego Union-Tribune)
District Attorney Summer Stephan said the declines show the county is on the right track. She said the overdose prevention task force she jointly chairs brings together medical, public health and behavioral health professionals with prevention advocates, law enforcement and others to focus on solutions.
“It shows that health and (public) safety can come together to push back against greedy cartels and drug dealers,” Stephan said. “All they want to see is profit and every day they make substances that are stronger and more addictive and more poisonous — and we must continue to fight back against them.”
Stephan noted there were zero drug overdose deaths in 2024 involving children 17 and younger. In 2021, 14 children died, according to the report.
That prompted officials to launch public education campaigns that highlighted the risk of obtaining drugs like Xanax or Percocet from sources other than pharmacies. Stressing the message “one pill can kill,” county officials explained to parents and students about how drug dealers sold counterfeit pills that look like real ones but often contain deadly doses of fentanyl.
“I love to celebrate that win of really young lives not lost and (the public’s) understanding that whatever they buy online is likely to have fentanyl in it,” Stephan said in an interview. “I think the kids began to get it and to be much more careful.”
Despite the gains, there are some worrisome trends in the task force’s annual report, such as a disproportionate number of deaths among the homeless population and in the region’s Black communities.
People experiencing homelessness accounted for about 30% of the overdose deaths in 2024, while Black county residents experienced the highest mortality rate — 68.6 per 100,000 residents — compared to other racial and ethnic groups. By comparison, the rate for White people was 34.5 and Hispanic/Latino individuals was 20.5.
Stephan said the numbers show “how much pain is going on in our homeless population and what a death sentence it is to be on the street.” Those living on the street can’t access treatment services and need to be offered shelter options, she said.
Stephan said efforts are already underway to better provide drug education and resources to Black communities. Some faith leaders have told her that cultural barriers may be keeping some community members from seeking mental health treatment.
“We know that lots of times people are self-medicating, using painkillers and other things, which of course lead to accidental fentanyl use, because they are trying to treat their own pain,” she said.
Stephan would like to see better access to mental health treatment and prevention education and said the task force is planning “train the trainer” sessions to get the word out to Black pastors and others.
“I think we need to have a very focused message and communication from trusted leaders who can communicate that message in a very specific way to our African-American communities,” she said.
Two drugs remain at the center of the overdose crisis: fentanyl and methamphetamine. Fentanyl accounted for 494 deaths in 2024, and methamphetamine was responsible for 600. Nearly all overdose deaths involved more than one substance, including alcohol.
The Drug Epidemic Memorial booth at a resource fair at the County Administration Center Thursday. (Alejandro Tamayo / The San Diego Union-Tribune)
Some survivors turn grief into action. That’s what Denise Barnes is trying to do in the aftermath of her son Cameron’s death. The 23-year-old died after he took a pill he thought was Xanax that was laced with fentanyl, his mother said.
Barnes said an 18-year-old girl with her son administered naloxone when he showed signs of an overdose but failed to call 911. The young woman told investigators they went back to sleep, his mother said.
According to the National Institute on Drug Abuse, naloxone typically reverses overdoses for 30 to 90 minutes. But many opioids remain in the body longer than that.
“He is one of these flags out here, representing a loved one who is lost,” Barnes said, her voice breaking. “Now we are left with this devastation, and our hearts are just shattered completely.”
Barnes said her mission now is to get the message out that giving a dose of naloxone is not enough in the case of accidental overdoses.
“Today I want to spread awareness about ‘Narcan plus 911’ — it is like they are married, they’ve got to go together,” she said. “Don’t just rely on that Narcan, because it gives you a false sense of security … Make that call.”