Column: ‘I can’t cope with life sober’: Response to MacArthur Park drug epidemic not enough

Hunched, swaying, and barefoot, he stood on a dirty sidewalk at the end of an alley where fires burned, drug addicts gathered day and night, and death lurked.

Slowly, he made his way across the back parking lot. Yoshinoya Restaurant at Wilshire Boulevard and Alvarado Street. It’s not a normal gait, but you see it every day in MacArthur Park.

The head is hung low. His eyes darkened. Over time, fentanyl attacks the muscles and spine, cutting people in half, tying them in knots, and burying them. In 2022, 1,910 people died from fentanyl overdoses in Los Angeles County.

I approached as the man pulled up in the parking lot. His face was covered in blood-red scabs and ulcers, shotgun-scarred. This is also a common phenomenon and is a symptom of mixing fentanyl with the veterinary sedative xylazine.

He said his name was Aaron and he came to Los Angeles from Louisiana two years ago. He couldn’t remember what happened to his shoes. One foot is bare, the other is covered with a dirty sock. He told me that when he was using fentanyl, “it’s kind of like, you start floating outside of yourself.” But then withdrawal sets in and you feel nauseous and need to go into treatment again.

Steve Lopez

Steve Lopez is a California native who has been a columnist for the Los Angeles Times since 2001.

He is still a young man. I asked him if he had the chance, would he go to rehab and try to start his life over again?

“Everyone wants to do it,” he said. “But is it possible? I doubt it.

Aaron, 31, said he has been diagnosed with bipolar disorder. When I asked what would help him and others stay clean, he said, “People don’t want to stay clean. They want to get high. It’s better, he said, to just give them a prescription for the drug they crave.”

“I couldn’t cope with life soberly,” he said.

Near an alley in Westlake known for drug use, a homeless man wrapped in a blanket walked past two men preparing to smoke fentanyl pipes.

(Genaro Molina/Los Angeles Times)

I’ve seen a lot of Aaron over the past few months. They hang in parks, sleep in the surrounding streets, crowd in drug alleys, Marching in a state of grief The body was deteriorating, and everything was stripped away except the desire to receive the next blow.

So, what steps are being taken?

The short answer is quite a bit, but not enough.

Los Angeles City Councilman Eunisiss Hernandez, who represents the Westlake community, plans to hold a news conference Thursday morning to announce “initiatives designed to improve public health, safety and cleanliness of the park.”

i have has written about some of her plans and plans, These include cleanup crews, peace ambassadors, overdose response teams and medical partnerships designed to treat patients and get them into stable housing. A homeless services center is also under construction, and a small children’s playground that burned down a few months ago will be rebuilt in the new year.

All of this is laudable, but the addiction crisis in the MacArthur Park area is a public health emergency, and I felt like I was watching the fire department wander into a burning building without adequate personnel or tools.

Unfortunately, there are no easy answers.

Despite efforts to direct homeless people to housing and treatment, the crisis in the MacArthur Park area remains a public health emergency.

(Genaro Molina/Los Angeles Times)

There was a time when people were arrested for drug possession and had the option of going to jail or receiving treatment. But laws, policies and attitudes have changed, and there is a general consensus that addiction should be considered a disease rather than a crime.

The problem is, for many Aaronic people, there is no treatment at all.

Dr. Gary Tsai, chief of the Substance Abuse Prevention and Control Division of the Los Angeles County Department of Public Health, said various public and nonprofit organizations are targeting MacArthur Park.

The list includes substance abuse counselors, mental health professionals, overdose prevention units and social workers who try to guide homeless people to housing and treatment. Harm reduction teams provide clean pipes and syringes to prevent the spread of disease while working to build relationships that may lead to treatment.

“I think we all want results faster,” Tsai said, but noted overdose death As the service scales up, the situation has stabilized.

Unfortunately, fentanyl is highly addictive, further complicating an already daunting challenge nationwide: Only about a quarter of the nearly 50 million people with addiction problems receive treatment. For those who are not receiving treatment, Tsai said, 95% “are not interested or don’t see a need for these services.”

My colleague Emily Alpert Reyes reported earlier this year on Tsai Ing-wen’s strategy of “getting more people into” treatment programs and keeping them there. That means lowering barriers to service and relaxing zero-tolerance rules for failed customers. Tsai has also been working to expand access to medications to help reduce drug cravings.

A man collapsed on Seventh Street, about a block from Lange’s Deli in the MacArthur Park area.

(Genaro Molina/Los Angeles Times)

There is no doubt that many drug addicts would benefit from these methods. But some people — especially those who use multiple drugs and may suffer from mental illness — are so incapacitated that they “are unable to make decisions,” said Richard Rosen, a psychologist and addiction expert at UCLA. The decision to receive treatment.”

“If someone is actively using drugs … and you want to make sure they’re using clean needles and they’re using naloxone so they don’t die and their wounds are treated — all of those harm reduction things are absolutely priceless, Rosen said.

“But when someone becomes so incapacitated that they can’t stand… to say you’re just going to provide them with harm reduction and hope they don’t die, I think that falls short of our responsibility to each other and to each other. The sickest people.

He believes policymakers must find a way to proceed cautiously, respecting people’s civil rights while also being aware of “how vulnerable they are to death.” If they are seriously ill, some form of enforcement action may be necessary.

“We need to have a way to tell these people that they do need help and get treatment,” Rosen said. “Not a prison, but some kind of medical facility where we can start treatment and help their brains recover to make voluntary decisions and Carry out the next step.”

Outreach specialist Catalina Hinojosa gets a hug from Barron Gay at the MacArthur Park Metro station. Guy is trying to find housing for his family.

(Genaro Molina/Los Angeles Times)

Catalina Hinojosa, a former meth user who served in prison and now leads an outreach group trying to convince addicts to get housing and treatment, told me she prefers Adopt a more coercive strategy.

She leads a Christ-centered ministry team at the Westlake/MacArthur Park subway station, looking for clients on the platform from 7 to 9 a.m. every day, but often encounters resistance from the most severe addicts.

“They need someone to make decisions for them because they can’t make decisions for themselves,” Hinojosa said.

Recently, she became frustrated with a particular client she managed to place who refused treatment for fentanyl addiction. “This girl is a third of my age and she looks the same age as me,” Hinojosa said. She used the word to describe “dying.”

This echoes California’s decades-long conversation about severe mental illness and involuntary treatment. Some believe that with adequate care and prevention, mandatory treatment is not needed.

But that is not the case, and people continue to suffer, wasting away in the public eye.

The ground at MacArthur Park was littered with lighters and drug paraphernalia after police asked drug suspects to empty their pockets.

(Genaro Molina/Los Angeles Times)

The same thing happens with addiction. Even with all teams working in the MacArthur Park area, there still isn’t enough to meet demand.

The shocking daily human suffering is a massive, deep-rooted catastrophe, and Congressman Hernandez himself cited the dire shortage of needed resources. Changing the status quo will require more prevention, intervention, treatment, and what local leaders have historically lacked—consistent, long-term, coordinated follow-up.

Effective recovery is not a drive-in experience. This is a years-long commitment.

But there are enough success stories to give people hope and to hold ourselves to a higher standard.

I spoke with Andrew, 35, who has struggled with depression and addiction to alcohol, cocaine, and fentanyl most of his life and is now in a residential recovery program at San Pedro Lighthouse House for a year.

“It took me 20 years to get here,” he said, “but now I don’t think about suicide every day anymore.”

People huddled together in an area of ​​MacArthur Park known for drug use.

(Genaro Molina/Los Angeles Times)

In the parking lot where I met Aaron, he told me that he had overdosed and that narcotics had been used to revive him about 20 times. A 41-year-old man named James pushed his bike next to us and eavesdropped on our conversation, so I asked him if he had any ideas about how to solve the drug epidemic.

“Forced detox,” James said.

I asked him what he did.

“I’m a drug addict,” James said. His drug was methamphetamine, not fentanyl, which he believed was more destructive.

“I’ve seen a lot of people die here,” James said, adding that stronger measures must be taken to end this madness. “Within about five to 10 days…a carefree kid comes to Los Angeles, and then a week later, he has no shoes. And he’s dead.

steve.lopez@latimes.com