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Speaker 1: Hey, f I am six forty live everywhere on the

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Speaker 1: iHeartRadio app. If you are someone you know suffers from

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Speaker 1: a mental indoor substance use disorder, call the National toll

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Speaker 1: free helpline at one eight hundred six six two help.

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Speaker 1: That's one eight hundred six six two four three five seven.

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Speaker 1: I'm Steve Gregory and this is Deadly pill. Prue Cooper

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Speaker 1: is a licensed advanced alcohol and drug counselor with Pacific Clinics,

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Speaker 1: part of the largest nonprofit organization in California that deals

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Speaker 1: without patient mental health issues. Prue, Welcome to the program.

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Speaker 1: Thanks for having you, Steve, so Prue in our quest

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Speaker 1: here to sort of learn more about the opioid crisis. Obviously,

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Speaker 1: one of the biggest parts of this is the addiction component.

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Speaker 1: You deal with addiction disorders, you deal with this on

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Speaker 1: a daily basis. Is the opioid crisis bigger now than

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Speaker 1: than it's ever been since you can remember. The opioid

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Speaker 1: crisis has received a lot more press and notoriety lately,

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Speaker 1: mainly because fentanyl, which is a manufactured or synthetic opiate,

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Speaker 1: has been widely spread amongst not just opioids, but other

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Speaker 1: drugs as well. And the way that it became more

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Speaker 1: of a problem for our community is we're seeing kids

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Speaker 1: use pills and not understanding that these pills were laced

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Speaker 1: with fentanyl and then overdosing as a result. So I

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Speaker 1: think that that is really one of the main ways

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Speaker 1: it became on everybody's mind because now we're seeing young people,

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Speaker 1: not just your so called quote unquote drug addicts, using opioids.

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Speaker 1: But now, you know, what would you say, would you say,

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Speaker 1: is the average age range then of patients that you

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Speaker 1: see with an opioid addiction. So the age range of

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Speaker 1: opioid addictions is just really wide and varied. You know,

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Speaker 1: we have clients as young as fifteen with opioid addictions,

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Speaker 1: and then we also see people in their sixties with

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Speaker 1: opioid addictions. I can't imagine a teenager coming in with

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Speaker 1: an addiction issue that at that early age. It just

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Speaker 1: it kind of mind boggles me a bit. Are these

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Speaker 1: usually addictions for all ages? Are these usually addictions that

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Speaker 1: stem from let's say, pain management from a medical issue

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Speaker 1: medical condition, or are you seeing most of these addiction

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Speaker 1: issues as a result of just more recreational use both both.

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Speaker 1: So there's definitely a large faction of people that get

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Speaker 1: hooked on pain meds and then you know, once they

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Speaker 1: get cut off by their doctor, start to buy pills

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Speaker 1: on the street. And that's where a fentanyl really has

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Speaker 1: played a huge part. Not so long ago, maybe about

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Speaker 1: two or three years ago, there was an article in

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Speaker 1: the La Times that talked about how labs in China

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Speaker 1: were manufacturing synthetic opioids and the way that they were

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Speaker 1: doing it and getting away with it is they were

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Speaker 1: actually changing the chemical compounds of what they were making

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Speaker 1: ever so slightly, so it wasn't actually classified as a

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Speaker 1: Schedule one drug because it was a new compound. And yeah,

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Speaker 1: these drugs are manufactured in labs in China and then

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Speaker 1: shipped over people were receiving their opioids in the mail well.

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Speaker 1: And those are the ones that are sort of manufactured in,

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Speaker 1: for lack of a better term, a licensed facility, as

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Speaker 1: opposed to the ones that are coming in illegally from

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Speaker 1: Mexico or via the tails or things like that. Right now,

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Speaker 1: these ones that I was referring to are actually manufactured

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Speaker 1: in a lab in China. Right But when you say

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Speaker 1: in a lab, then it is that a medical lab.

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Speaker 1: I mean they're being manufactured for supposed you know, legal use, right,

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Speaker 1: They're being manufactured to make money, Okay, yeah, yeah, yeah,

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Speaker 1: so whatever that use might be. I see, the way

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Speaker 1: they get around getting in trouble or getting caught right

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Speaker 1: away is the biology or the science of it. They're

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Speaker 1: manufacturing drugs that aren't really they're new. They're changing the

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Speaker 1: chemical compounds of the opiates synthetic opiates, and they're not

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Speaker 1: They're just a brand new substance. So Prue, you've got

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Speaker 1: someone that comes to see you and they whether it's

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Speaker 1: an opioid addiction or any well, let me since we

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Speaker 1: are talking about it, let me say, let's do a hypothetical.

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Speaker 1: Someone comes and they've been taking fentyl. How do you

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Speaker 1: Where do you start? I mean, when you sit someone

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Speaker 1: down across from you, where do you go? What do

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Speaker 1: you say? And how does it get going? Tell me

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Speaker 1: about your story, how can I help you? And then

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Speaker 1: how apprehensive are they to tell you the truth or

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Speaker 1: tell you exactly what's going on in their life by

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Speaker 1: the time they get to you. Are you sort of

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Speaker 1: a last resort or are you someone that you see

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Speaker 1: or you see them pretty quickly or pretty early on

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Speaker 1: in their addiction, usually not super early on that midway

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Speaker 1: through towards like last resort. In the clinic that I

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Speaker 1: work in, you know, we're primarily mental health, but we

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Speaker 1: find that there's a huge population that have what we

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Speaker 1: call co occurring disorders, and that's really kind of the

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Speaker 1: area that I'm most interest stood in. Research says that

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Speaker 1: there's up to seventy five percent of people with serious

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Speaker 1: mental illness have a co occurring in an addiction or

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Speaker 1: substance use disorder. So that's a really huge percentage. I

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Speaker 1: want to ask you this question, and we were talking

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Speaker 1: a little bit off air about it, but is an

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Speaker 1: addiction a mental health disorder? So it is? It is.

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Speaker 1: It is in the DSM five, which is the Encyclopedia

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Speaker 1: of Mental health disorders. It is part of that. However,

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Speaker 1: oftentimes treatment is separated. How do you mean, Well, if

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Speaker 1: you have a substance used disorder, you go to treatment

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Speaker 1: that's specialized in substance use disorders. If you have depression

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Speaker 1: or bipolar disorder or anxiety disorder, you go to a

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Speaker 1: treatment facility that is mainly skilled in treating mental health disorders.

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Speaker 1: Got it? So one's a physio I'm sorry, Go ahead, one,

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Speaker 1: there's this sort of like kind of I don't know,

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Speaker 1: old school thinking that in order to get good treatment,

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Speaker 1: in order for somebody to help another addict, they have

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Speaker 1: to know what that person has been through. But when

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Speaker 1: you when it comes down to it, when you look

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Speaker 1: at like, what are evidence based practices for people with

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Speaker 1: mental health disorders and people with substance use disorders, they're

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Speaker 1: the same practices. There's the same evidence based theories that

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Speaker 1: work for both. So you would see them, you would

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Speaker 1: help them on the mental illness of the mental behavior

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Speaker 1: side of it. Correct my specialties in the addiction side,

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Speaker 1: so we have other I have coworkers on colleagues part

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Speaker 1: of the treatment team. So for example, of the psychiatric

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Speaker 1: nurse practitioner or a psychiatrists and then LSW or MFT

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Speaker 1: clinician would do more of the mental health stuff. The

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Speaker 1: psychiatrist and psychiatric nurse practitioner obviously can prescribe medications that

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Speaker 1: can treat both substance use disorders and mental health disorders.

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Speaker 1: And actually, when you talk about the medication that could

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Speaker 1: possibly help somebody with a substance use disorder, there are

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Speaker 1: some crossovers. So some of the medications that are used

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Speaker 1: to treat mental health disorders have also been found useful

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Speaker 1: to treat people with substance use disorder and vice versa.

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Speaker 1: You were talking about how you break down each of

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Speaker 1: the issues with somebody and each has their own specialist,

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Speaker 1: if you will, so back to you on the addiction

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Speaker 1: part of this. Can you walk us through like a

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Speaker 1: success story? Can you tell us a story? And obviously

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Speaker 1: I can't identify the individual, I get it, But what

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Speaker 1: I want to know is if what you do work,

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Speaker 1: do you get somebody at whatever age and walk them

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Speaker 1: through this addiction journey and get them out on the

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Speaker 1: other side. Sure, absolutely, Steve. So, we had a fifteen

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Speaker 1: year old come to our outpatient clinic several years ago

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Speaker 1: and she had an issue substance she used disorder for

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Speaker 1: fenton al was her drug of choice along with other

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Speaker 1: mental health disorders. So she was what we call co occurring,

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Speaker 1: had co occurring disorders, and she had had three or

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Speaker 1: four unsuccessful attempts through going to a residential treatment facility

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Speaker 1: for the opioid disorder, she had also had a suicide

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Speaker 1: attempt and through our care at our clinic where she

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Speaker 1: got what we call integrated care. So that's somebody that's

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Speaker 1: going to address both the mental health and the addiction

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Speaker 1: or substance side. She was able to progress through her

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Speaker 1: treatment and now she's been sober for eight months. You

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Speaker 1: can hear an extended interview with Prue by downloading the

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Speaker 1: Deadly Pill podcast on the iHeartRadio app. Coming up, we

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Speaker 1: head down to Whittier and the headquarters for the La

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Speaker 1: County Sheriff's Narcotics Bureau, where we meet with the Captain

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Speaker 1: in charge. But first, this is Deadly Pill on KFI

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Speaker 1: AM six forty. Time Now for a news update. KFI

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Speaker 1: AM six forty live everywhere on the iHeartRadio app. I'm

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Speaker 1: Steve Gregory and this is the KFI News special Deadly Pill.

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Speaker 1: Captain Brandon Deane has been with the La County Sheriff's

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Speaker 1: Department for more than twenty years. Most recently he was

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Speaker 1: assigned to the Homicide Bureau, but he's now in charge

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Speaker 1: of the department's Narcotics Bureau. We had a chance to

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Speaker 1: sit down and talk about his plans to stop fentnel

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Speaker 1: from hitting the streets of La County and how he's

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Speaker 1: created a new task force to do just that. Captain Dean,

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Speaker 1: thanks for joining us. Some problems, So just how busy

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Speaker 1: are you on a daily basis. So here at Narcotics

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Speaker 1: Bureau in Detective Division, there's seven bureaus that are in

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Speaker 1: Detective Division, and we're the largest bureau. That kind of

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Speaker 1: gives you an idea of how much narcotics are actually

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Speaker 1: here in Los Angeles County. We have seven different regional

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Speaker 1: crews which cover like your local station areas, like your

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Speaker 1: city and county area problems. And then we also have

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Speaker 1: what's called our narcotics Major violators, which are the guys

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Speaker 1: and gals that are more advanced detectives that kind of

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Speaker 1: go after the even bigger seizures. We have a lot

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Speaker 1: of them attached to federal task force and then our

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Speaker 1: own in house task force that we have going on. Well,

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Speaker 1: when you talk about task forces and you're working constantly,

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Speaker 1: I think people don't understand that you're always partnering with somebody,

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Speaker 1: right in terms of drugs, the da O, their local

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Speaker 1: law enforcement. You're always partnered with somebody usually, right. So

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Speaker 1: our regional crews which handle our little are our local problems. No,

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Speaker 1: those are independent and they're here in the Sheriff's Department.

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Speaker 1: But our narcotics majors are attached to like the LA

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Speaker 1: Heida Program, LA Impact Program, and several different federal agencies.

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Speaker 1: What is Heida High Intensity Drug Trafficking Area and why

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Speaker 1: is that an important group? It shows the relationship that

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Speaker 1: we have not only with our federal partners, but there's

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Speaker 1: also several other local agencies that are on HEIDA and

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Speaker 1: LA Impact, which shows the cooperation between not only state

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Speaker 1: and local. But we have cases that go both ways, right,

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Speaker 1: you have cases that you take to the state side,

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Speaker 1: and then we have some cases that meet the federal

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Speaker 1: threshold and we take them federally. Speaking of that, you know,

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Speaker 1: with our proximity to the border, what are we only

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Speaker 1: three hours north of the border. What kind of a

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Speaker 1: problem is that. I've been told that LA is a gateway.

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Speaker 1: You know that a lot of drugs they come here,

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Speaker 1: either by ship or by train or by mule, that

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Speaker 1: they're coming to LA. Do you find that that's an

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Speaker 1: overwhelming prospect for your unit? Yeah, I mean Los Angeles

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Speaker 1: County is a hub for Narcotics Bureau Southern California as

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Speaker 1: a whole, as a hub anywhere Riverside County, San Diego,

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Speaker 1: but Orange County, but Los Angeles county is a hub, right,

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Speaker 1: We were a very populated county, and like I said,

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Speaker 1: we see things coming from across the border, we see

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Speaker 1: it being shipped. I mean. One of the things that

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Speaker 1: I didn't touch on is we I mean, we even

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Speaker 1: have a team here at Narcotics Bureau that handles packages,

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Speaker 1: you know, at the LA Airport, or that handles parcels.

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Speaker 1: It's called Pacnet. They handle specifically things for parcels, things

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Speaker 1: drugs that are being drugs or money vice versa right,

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Speaker 1: either buying or selling that are being shipped through parcel units,

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Speaker 1: FedEx ups, things like that, nature and things going through

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Speaker 1: the LA Airport. You know, let's speak of that was

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Speaker 1: recently a case. And it's funny because when you and

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Speaker 1: I spoke about this case of the candy boxes that

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Speaker 1: were coming through LAX and they were filled with over

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Speaker 1: twelve thousand of these fentinel pills, it was just another

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Speaker 1: day at the office for you, but it was kind

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Speaker 1: of an interesting look at just how desperate people are

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Speaker 1: to get this stuff through. So talk about how you

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Speaker 1: work with LAX and why is that such an important

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Speaker 1: place to be LAX. I mean, you got I don't mean,

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Speaker 1: I don't know what the number would be, but millions

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Speaker 1: and millions of travelers every year, right, and they're trying

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Speaker 1: to smuggle things through to LA and smuggle things out

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Speaker 1: of LA. Right. So over there we have a federal

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Speaker 1: task force which is made up of LA County sheriffs

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Speaker 1: along with D agents, an LAX police officer, and a

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Speaker 1: couple of LAPD canine dogs. The particular incident you're talking

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Speaker 1: about was last week. TSA did a great job at screening,

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Speaker 1: saw some irregularities with somebody trying to pass through TSA

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Speaker 1: screening flagged them instantly and we're able to see several

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Speaker 1: candy boxes that had approximately twelve thousand fentanyl pills in it.

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Speaker 1: You know, do we think that that person was going

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Speaker 1: to hide pills and people's candy boxes for Halloween? Know?

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Speaker 1: I mean, it's just another way of smuggling it, right,

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Speaker 1: They're small. Fentinel pills are small. Sometimes they can be colored.

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Speaker 1: You've seen it rainbow pills before. If they're colored and

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Speaker 1: they're in a candy box, it's more concealment than trying

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Speaker 1: to put it inside a kid's candy. But having that

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Speaker 1: crew at the airport is crucial because I mean, we

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Speaker 1: see people trying to smuggle things through the airport constantly.

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Speaker 1: So what is this task course then you were talking

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Speaker 1: about at the at the airport on a daily basis,

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Speaker 1: What would the members of your department be doing with

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Speaker 1: that task force? So they're assigned it's it's a task

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Speaker 1: force made up of LA County Share three detectives of mine,

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Speaker 1: a sergeant and then it's also made up of DA

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Speaker 1: agents and LAX police officer and the canine dogs. So

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Speaker 1: their job is basically to intercept any drugs coming through

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Speaker 1: the airport packages, people shipping things in luggage. A lot

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Speaker 1: of times we catch people with money that are shipping

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Speaker 1: money out maybe purchasing drugs. So it's going both ways, right,

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Speaker 1: We're catching drugs coming in and money coming in or

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Speaker 1: drugs going out money coming out. How frequently is that happening?

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Speaker 1: Is that daily? Constantly? Yeah? I mean this Narcotics Bureau

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Speaker 1: as a whole, whether it's the LAX crew or the

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Speaker 1: local crews or the major crews, we're doing warrants and

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Speaker 1: operations daily. So far this year we have served over

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Speaker 1: eight hundred search warrants just here at Narcotics Bureau alone. Okay,

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Speaker 1: So for comparison though, eight hundred in a year doesn't

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Speaker 1: sound like a lot in the number, But how is

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Speaker 1: that for like a homicide you know, the homicide Bureau.

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Speaker 1: How many warrants give us a comparison to another unit?

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Speaker 1: Is that, you know, how many would relieve? The number

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Speaker 1: for operations Safe Street, which would be our gang unit,

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Speaker 1: which is a comparable unit doing a lot of proactive

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Speaker 1: law enforcement work, which is what we do here at

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Speaker 1: Narcotics Bureau, was around four hundred at this time so far,

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Speaker 1: twice the number of double where they are this yea,

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Speaker 1: so far. And that's not because they're not working, you

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Speaker 1: know what I mean. OSS is doing a great job

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Speaker 1: and they're out there getting a lot of guns and

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Speaker 1: solving a lot of crimes. There's just so much dope

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Speaker 1: in this county that the volume for us to be

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Speaker 1: doing these warrants and that eight hundred is just that's

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Speaker 1: what we can get done in time and personnel. Right,

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Speaker 1: We could be doing more if we had more personnel,

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Speaker 1: more time. Is that always the case? Yes, always the case,

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Speaker 1: need more resources. So let me ask you, since you're

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Speaker 1: on the front lines of this on a daily basis,

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Speaker 1: especially here in La account. You know, the war on drugs.

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Speaker 1: It's been going out for decades. Do you feel like

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Speaker 1: you guys are spending your wheels two steps forward, five

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Speaker 1: steps backwards. Are you making a difference? I would like

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Speaker 1: to think we are. I mean, you know, we're taking

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Speaker 1: a lot of drugs off the street, which is obviously

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Speaker 1: affecting our communities, right. I mean, you know forty seven

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Speaker 1: passed several years ago making possession of drugs a misdemeanor.

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Speaker 1: So we're we're not focusing on people that are merely

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Speaker 1: on possession, right. We're not going after people that might

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Speaker 1: have a drug problem and maybe just fell on hard times.

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Speaker 1: I mean a lot of people have substance abuse problems

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Speaker 1: and drug problems. We're not going after those people. We're

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Speaker 1: going after the people that are selling these drugs and

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Speaker 1: making money in our communities off of people we know,

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Speaker 1: family members and people that live in our community that

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Speaker 1: have problems and are ruining their lives. We're trying to

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Speaker 1: take those people and get them to stop selling this stuff.

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Speaker 1: You're so busy, I just I can't. It's hard to

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Speaker 1: keep up really with how much you've got going on.

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Speaker 1: But I want to ask you, it sounds like to me,

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Speaker 1: based on what you told me in the in the

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Speaker 1: last segment, you're more interested in those people who sell

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Speaker 1: illicit drugs and make those drugs, then you are the

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Speaker 1: ones that use them, right correct. You can hear some

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Speaker 1: exclusive content with Captain Dean by downloading the Deadly Pill

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Speaker 1: podcast on the iHeartRadio app. Coming up, we head out

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Speaker 1: to San Bernardino County, where the District Attorney is aggressively

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Speaker 1: pursuing those who knowingly sell deadly drugs. But first, this

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Speaker 1: is Deadly Pill on KFI AM six forty. Time Now

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Speaker 1: for a news update. KFI AM six forty live everywhere

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Speaker 1: on the iHeartRadio app. If you are someone you know

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Speaker 1: suffers from a mental indoor substance use disorder, call the

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Speaker 1: National toll free helpline at one eight hundred six six

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Speaker 1: two Help. That's one eight hundred six six two four

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Speaker 1: three five seven. Welcome back to Deadly Pill on kfis

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Speaker 1: Steve Gregory. Jason Anderson is the District Attorney for San

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Speaker 1: Bernardino County and has been an advocate for the victims

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Speaker 1: of crime. But now he's on a crusade to go

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Speaker 1: after those who knowingly sell or provide any drug that

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Speaker 1: kills another mister Day, thank you for joining us. Thank you, Steve,

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Speaker 1: my pleasure. I wanted to begin with the case of

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Speaker 1: eighteen year old Brian and Iya Escavel the team from Pomona,

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Speaker 1: who you prosecuted or providing a drug laced with fentnyl

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Speaker 1: to a seventeen year old from Chino Hills who died

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Speaker 1: as a result. Can you walk us through that case. Yeah,

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Speaker 1: that case was one that we charged, and it was

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Speaker 1: the first murder case that we've charged as a fentyl case. Obviously,

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Speaker 1: you've got the difference in fentnyl that immediately can cause

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Speaker 1: death is different than drugs in the past, and so

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Speaker 1: that's why you're seeing a different approach by prosecutors in

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Speaker 1: that instance because it's a poisoning issue. And then also

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Speaker 1: in that case, you're also talking about evidence that would

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Speaker 1: suggest that there was knowledge on behalf of the dealer

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Speaker 1: that the fentnyl would result in an overdose in that

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Speaker 1: because of that knowledge and yet providing it to someone

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Speaker 1: and when they know that that victim had overdosed in

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Speaker 1: the past, it shows a recklessness in termative. So that's

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Speaker 1: why when you're talking about a reckless disregard for human life.

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Speaker 1: Then you get into the murder category. And I want

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Speaker 1: to be very careful see that case is active and

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Speaker 1: so obviously that that defendant remains innocent until proven guilty.

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Speaker 1: But we have actually gone past a preliminary hearing on

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Speaker 1: that matter. So the judge a judge has hurt evidence

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Speaker 1: and found that at that stage there was sufficient evidence

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Speaker 1: to proceed with murder charges. Interesting, So did that surprise you? No,

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Speaker 1: we did a significant amount of research in regards to

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Speaker 1: the recklessness angle. If you if you know something can

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Speaker 1: cause death and then you provide it anyway. There's certainly

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Speaker 1: instances of that in other areas also, um, you know,

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Speaker 1: take a dui if you have a dui conviction, you're

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Speaker 1: advised that you know, if you get in the car

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Speaker 1: and you you you kill somebody, that's a recklessness right,

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Speaker 1: and so there are instances and precedent to show that.

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Speaker 1: There's also the theory of poisoning because of the definition

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Speaker 1: of a poisoning substance, it fits within the penal code

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Speaker 1: and the case law where because of the power fentanyl,

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Speaker 1: you can charge poisoning. So we're actually proceeding on both

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Speaker 1: of those theories. Isn't it difficult? Though? In this case

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Speaker 1: with Brian Esquivell, is it a hard threshold to overcome

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Speaker 1: that he knew that this was a dangerous substance. How

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Speaker 1: do you get there? Well, I don't want to talk

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Speaker 1: about the specifics of his case, but I will tell

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Speaker 1: you hypothetically, when you see the cases that law enforcement investigates,

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Speaker 1: and primacy is very important, and so obviously text messages,

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Speaker 1: social media indications, conversations between a victim and the dealer

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Speaker 1: that have occurred in the past on social media or

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Speaker 1: on text messages. When you have a situation in which

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Speaker 1: a dealer has supplied one individual with fentnyl in the

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Speaker 1: past and that person is overdosed but not died, and

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Speaker 1: there's a discussion about it, or the dealer themselves has

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Speaker 1: had an overdose experience with their own drug and continues

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Speaker 1: to supply it to others, then you start talking about, well,

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Speaker 1: if you're aware of the risks and you continue to

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Speaker 1: go forward, that's the reckless component. Also, because of the

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Speaker 1: educational aspect of fentyl. In the last couple of years, again,

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Speaker 1: you're talking about the fact that you realize that fentnyl

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Speaker 1: is specifically used in medical situations and should not be

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Speaker 1: used on the street, and therefore you have the poisoning aspect.

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Speaker 1: You know, it's fascinating to me because not as if

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Speaker 1: you guys are not busy already. How overwhelming are these

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Speaker 1: types of cases now for your office? In twenty twenty one,

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Speaker 1: we've had over three hundred deaths just in San Fardino

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Speaker 1: County and that's you know, obviously we're into October. You're

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Speaker 1: going to have an additional You're gonna have additional body

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Speaker 1: count by the end of the year just because of

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Speaker 1: the pathology's not done on many of the cases. UM,

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Speaker 1: So there are all three hundred, more than three hundredths

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Speaker 1: just from fentnyl. Yes. Yeah, in twenty twenty one, we

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Speaker 1: had three hundred and nine overdose desks for fentnyl. Wow,

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Speaker 1: let me give you a stat I was at. I

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Speaker 1: was at a summit with law enforcement on Wednesday, and

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Speaker 1: the Sheriff of Riverside County gave us, gave us statistic

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Speaker 1: that I've not heard before. UM. People, the law enforcement

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Speaker 1: and medical professionals in the field, first responders who have

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Speaker 1: the NARCANU, the antidote to opioid fentyl overdose. UM, they

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Speaker 1: have saved thousands of people from dying. And those are

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Speaker 1: the stories you don't hear about, right, So the ones

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Speaker 1: that the desks that we see, unfortunately are the people

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Speaker 1: that are typically alone and and and then it just

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Speaker 1: shuts down their their their central nervous system and their debt.

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Speaker 1: So so three hundred nine and twenty twenty one, and

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Speaker 1: we're on track this year to actually increase that. Wow.

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Speaker 1: So then how do you approach this as a prosecutor?

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Speaker 1: Not in every case, though, when there's an overdose death

404
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Speaker 1: like this three hundred and nine, not in every case.

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Speaker 1: Do you know where those folks got them the drugs? Right?

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Speaker 1: That's correct. So there's two approaches that we do, Steve.

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Speaker 1: We we have partnered for the last year and a

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Speaker 1: half with our local educators. We've also partnered with the

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Speaker 1: US Attorney's Office in the Central District to roll out

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Speaker 1: an educational campaign because it's different. I mean, if you

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Speaker 1: told a young person, hey, here's here's a drug that

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Speaker 1: only doctors should use in limited circumstances, fentnyl. Do you

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Speaker 1: want to take it? They'll say no. But what they

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Speaker 1: think they're taking is a separate pill that's laced with fentnyl.

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Speaker 1: Because it increases the profit margins for the drug houses

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Speaker 1: and the dealers that are pushing it. So there's there's

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Speaker 1: obviously the educational campaign of it is the is the

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Speaker 1: one approach. Then there's a law enforcement approach. We have

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Speaker 1: a task force in Sanreno County that we're part of,

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Speaker 1: and I know that you know everybody says they got

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Speaker 1: task force and all that stuff, But the task force

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Speaker 1: is primarily to try to figure out where all these

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Speaker 1: pills coming in from and stop the dealing in the

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Speaker 1: first place. In California, you could still charge someone with

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Speaker 1: a felony if they possess something to distribute or for sale. Unfortunately,

426
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Speaker 1: there aren't any weight enhancements anymore, and so if you

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Speaker 1: sell two fentnyl pills, you're going to get the same

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00:25:21,600 --> 00:25:24,520
Speaker 1: punishment is as if you're pushing twenty thousand fentnyl pills.

429
00:25:24,920 --> 00:25:27,040
Speaker 1: That's a problem obviously, right because you don't want to

430
00:25:27,119 --> 00:25:29,880
Speaker 1: encourage that. So those are the two fronts that we're

431
00:25:29,920 --> 00:25:33,119
Speaker 1: attacking it on. And certainly there is a number of

432
00:25:33,200 --> 00:25:36,159
Speaker 1: cases in which people have overdosed which we would not

433
00:25:36,280 --> 00:25:38,840
Speaker 1: be able to charge murder because you don't have those components.

434
00:25:38,880 --> 00:25:42,280
Speaker 1: And Oftentimes you will have situations where the dealer may

435
00:25:42,320 --> 00:25:46,880
Speaker 1: not know that the pill is laced, or the person

436
00:25:46,960 --> 00:25:50,320
Speaker 1: who took it was dead for several days before they

437
00:25:50,359 --> 00:25:52,840
Speaker 1: were discovered. And there's just note that that primacy has gone.

438
00:25:52,840 --> 00:25:55,560
Speaker 1: There's no way to connect the dots. You think this

439
00:25:55,720 --> 00:25:58,840
Speaker 1: is going to make a dent. I do believe it

440
00:25:58,880 --> 00:26:01,000
Speaker 1: will make a dent. And here the reason why we

441
00:26:01,160 --> 00:26:03,720
Speaker 1: have to start somewhere. And here's the analogy I use

442
00:26:03,920 --> 00:26:06,280
Speaker 1: all the time with people. And I was talking to

443
00:26:06,400 --> 00:26:08,879
Speaker 1: a group last night and they were asking me the

444
00:26:08,960 --> 00:26:12,359
Speaker 1: same question. I want you to think back to forty

445
00:26:12,640 --> 00:26:16,639
Speaker 1: years ago, when the blood alcohol limit around this country

446
00:26:16,760 --> 00:26:19,680
Speaker 1: was point one five or point one seven, or maybe

447
00:26:19,760 --> 00:26:22,439
Speaker 1: nothing at all, right, and then all of a sudden,

448
00:26:22,480 --> 00:26:25,680
Speaker 1: the body started piling up. And then what happened the

449
00:26:25,800 --> 00:26:29,320
Speaker 1: seminal time is when one mother decided that's enough, my

450
00:26:29,480 --> 00:26:32,399
Speaker 1: son was murdered and mad was started. And then you

451
00:26:32,440 --> 00:26:35,160
Speaker 1: saw the blood alcohol levels come down right to point

452
00:26:35,200 --> 00:26:37,520
Speaker 1: o eight in California, even lower in other states. Right.

453
00:26:38,119 --> 00:26:41,000
Speaker 1: I guarantee you there were politicians back forty years ago

454
00:26:41,080 --> 00:26:45,760
Speaker 1: that resisted voting in favor of reducing the blood alcohol level.

455
00:26:46,280 --> 00:26:48,520
Speaker 1: And today those people look like fools. You can hear

456
00:26:48,560 --> 00:26:51,520
Speaker 1: my extended interview with da Anderson on the Deadly Pilled

457
00:26:51,600 --> 00:26:56,240
Speaker 1: podcast available on the iHeartRadio app. Coming up, the last

458
00:26:56,440 --> 00:26:59,560
Speaker 1: stop we speak with the medical examiner of LA County

459
00:27:00,000 --> 00:27:02,560
Speaker 1: gives us a brutally honest view of the opioid crisis

460
00:27:02,840 --> 00:27:05,000
Speaker 1: from the perspective of the man who deals with the

461
00:27:05,080 --> 00:27:08,600
Speaker 1: dead bodies. But first, this is Deadly Pill on kf

462
00:27:08,760 --> 00:27:11,320
Speaker 1: I AM six forty. Time Now for a news update

463
00:27:13,640 --> 00:27:18,080
Speaker 1: KFI AM six forty live everywhere on the iHeartRadio app.

464
00:27:21,080 --> 00:27:24,720
Speaker 1: I'm Steve Gregory and welcome back to Deadly Pill. Doctor

465
00:27:24,840 --> 00:27:27,840
Speaker 1: Jonathan Lucas is the medical Examiner for LA County, one

466
00:27:27,880 --> 00:27:31,920
Speaker 1: of the nation's busiest corner operations. Doctor Lucas begins with

467
00:27:32,119 --> 00:27:35,720
Speaker 1: his view of the opioid crisis. Well, really, in the

468
00:27:35,840 --> 00:27:42,440
Speaker 1: last five to ten years, opioids have have grown and

469
00:27:42,720 --> 00:27:48,720
Speaker 1: grown in terms of overdose deaths in Los Angeles County.

470
00:27:49,600 --> 00:27:53,480
Speaker 1: Certainly over the last five years, you know, we've seen

471
00:27:54,119 --> 00:28:00,720
Speaker 1: all unintentional overdoses increase or double, basically, number of deaths

472
00:28:01,240 --> 00:28:05,399
Speaker 1: up to about two sorry three thousand in twenty twenty one,

473
00:28:05,960 --> 00:28:10,240
Speaker 1: that's where that year was, and opioids have been growing.

474
00:28:11,080 --> 00:28:16,399
Speaker 1: They've been driving that increase. Primarily opioids, of course are

475
00:28:16,480 --> 00:28:21,600
Speaker 1: a class of drugs, but have really became a main

476
00:28:21,840 --> 00:28:25,760
Speaker 1: player in overdose deaths here in La County. Did you

477
00:28:25,880 --> 00:28:29,160
Speaker 1: see this coming? I mean I would talk to general physicians,

478
00:28:29,760 --> 00:28:33,800
Speaker 1: emergency room doctors, cops, firefighters, and they said it was

479
00:28:33,840 --> 00:28:36,439
Speaker 1: just like one day a switch was flipped and they

480
00:28:36,520 --> 00:28:38,480
Speaker 1: had all these ods and they just didn't know what

481
00:28:38,600 --> 00:28:41,440
Speaker 1: was happening and where it was coming from. Now. Absolutely,

482
00:28:41,920 --> 00:28:46,520
Speaker 1: you know, fifteen years ago we were talking about the pills,

483
00:28:47,200 --> 00:28:51,160
Speaker 1: people getting addicted to prescription medications, and then there was

484
00:28:51,360 --> 00:28:55,440
Speaker 1: the illegal market. But even then the numbers weren't growing

485
00:28:55,520 --> 00:28:59,720
Speaker 1: all that much. It was really in the last six

486
00:28:59,840 --> 00:29:05,280
Speaker 1: or years where things have really exploded at a pace

487
00:29:05,400 --> 00:29:09,160
Speaker 1: that I don't think anybody could have ever predicted. Correct

488
00:29:09,200 --> 00:29:12,640
Speaker 1: me if I'm wrong. Is this not the largest corner

489
00:29:12,720 --> 00:29:17,920
Speaker 1: operation in the country. We serve the largest population. Okay,

490
00:29:18,080 --> 00:29:21,560
Speaker 1: So I know, and I for many years have covered

491
00:29:21,640 --> 00:29:23,880
Speaker 1: this this department down here, and the one thing you're

492
00:29:23,880 --> 00:29:27,800
Speaker 1: always short of, in addition to staff, is room and

493
00:29:27,960 --> 00:29:30,160
Speaker 1: that's always been a big challenge. So when something like

494
00:29:30,280 --> 00:29:33,480
Speaker 1: that happens, did you find that your department was a

495
00:29:33,520 --> 00:29:38,680
Speaker 1: little overwhelmed. Well, yes, we've had some stressors over the

496
00:29:38,800 --> 00:29:42,280
Speaker 1: last few years, well with COVID as well. Correct, But

497
00:29:42,760 --> 00:29:48,080
Speaker 1: I say that because this opioid epidemic, this opioid explosion

498
00:29:49,000 --> 00:29:54,040
Speaker 1: was happening at the same time as the pandemic. It

499
00:29:54,240 --> 00:29:57,760
Speaker 1: started the numbers really started accelerating it towards the end

500
00:29:57,760 --> 00:30:01,480
Speaker 1: of twenty nineteen, and it took us a little while

501
00:30:01,560 --> 00:30:04,840
Speaker 1: to get our heads around because of the testing that's involved,

502
00:30:04,880 --> 00:30:06,920
Speaker 1: and it takes some time to figure out really what

503
00:30:07,120 --> 00:30:11,800
Speaker 1: was driving the increase. And um so where we are

504
00:30:11,880 --> 00:30:15,960
Speaker 1: today now that COVID has sort of calmed down, certainly

505
00:30:16,040 --> 00:30:20,520
Speaker 1: from a fatality perspective, strength, thank goodness, is that we

506
00:30:20,640 --> 00:30:25,280
Speaker 1: are left with this this opioid problem, overdose problem. And yes,

507
00:30:25,440 --> 00:30:27,520
Speaker 1: we've we've struggled with room, We've had to bring in

508
00:30:27,760 --> 00:30:33,760
Speaker 1: additional storage on site. We've adapted quite well. Um it's

509
00:30:33,880 --> 00:30:36,080
Speaker 1: we need we're looking at long term solutions, but for

510
00:30:36,160 --> 00:30:41,120
Speaker 1: now we're stable. But it absolutely was a big impact

511
00:30:41,600 --> 00:30:44,600
Speaker 1: to this office. When did you realize there was a problem.

512
00:30:45,800 --> 00:30:49,600
Speaker 1: We actually probably not tell the middle or end of

513
00:30:49,680 --> 00:30:53,040
Speaker 1: twenty twenty in terms of the drug overdose because the

514
00:30:53,080 --> 00:30:57,360
Speaker 1: focus at that time was the pandemic we actually got.

515
00:30:58,080 --> 00:31:05,400
Speaker 1: We obtained extra storage cold storage around April of twenty

516
00:31:05,480 --> 00:31:10,400
Speaker 1: twenty in anticipation of the pandemic. Right, So we did

517
00:31:10,560 --> 00:31:13,680
Speaker 1: end up using it for that. But here we are

518
00:31:13,800 --> 00:31:16,560
Speaker 1: now and we're using it primarily for just the excess

519
00:31:16,600 --> 00:31:18,880
Speaker 1: work that we've been doing related to the opioids. Where

520
00:31:18,920 --> 00:31:21,160
Speaker 1: were we at five years ago in relation to where

521
00:31:21,160 --> 00:31:27,000
Speaker 1: we're at now, So in twenty seventeen, we recorded about

522
00:31:27,080 --> 00:31:32,120
Speaker 1: fourteen hundred overdose deaths unintentional, not talking about suicides here,

523
00:31:33,200 --> 00:31:39,000
Speaker 1: about fourteen hundred overdose deaths. Opioids represented about six hundred

524
00:31:39,080 --> 00:31:45,600
Speaker 1: of those, so just under a half, right, and Fennel

525
00:31:46,720 --> 00:31:51,560
Speaker 1: was a quarter of the opioid deaths, about one hundred

526
00:31:51,600 --> 00:31:55,960
Speaker 1: and fifty that year. Fast forward to twenty twenty one. Okay,

527
00:31:56,480 --> 00:31:58,720
Speaker 1: we've doubled the number of overdoses. As I mentioned, we're

528
00:31:58,760 --> 00:32:03,880
Speaker 1: at about thirty one hundred for for last year of

529
00:32:04,040 --> 00:32:09,800
Speaker 1: those opioids, or two thirds up from just under half, right,

530
00:32:11,040 --> 00:32:15,840
Speaker 1: and Fentyl accounts for just looking at the numbers here,

531
00:32:15,880 --> 00:32:20,400
Speaker 1: I think it's close to seventy eight percent of those cases,

532
00:32:20,640 --> 00:32:27,040
Speaker 1: so about almost seventeen hundred fentanyl deaths in twenty twenty

533
00:32:27,080 --> 00:32:35,000
Speaker 1: one out of nineteen hundred opioid deaths. Okay, and that's

534
00:32:36,040 --> 00:32:40,040
Speaker 1: that's where we are today. So fentanyl really is it

535
00:32:40,200 --> 00:32:46,760
Speaker 1: went from being a known but relatively minor contributor five

536
00:32:46,920 --> 00:32:54,200
Speaker 1: six years ago to driving the overdose numbers in general.

537
00:32:54,560 --> 00:32:57,720
Speaker 1: Someone in your field, have you ever seen anything else,

538
00:32:57,760 --> 00:32:59,800
Speaker 1: any other cause or manner of death that has had

539
00:32:59,840 --> 00:33:04,760
Speaker 1: to think of a trajectory other than covid. No, Nothing

540
00:33:05,160 --> 00:33:10,720
Speaker 1: in my experience personally or in my knowledge has really

541
00:33:10,840 --> 00:33:15,760
Speaker 1: swung workload for us. And when I say workload, I

542
00:33:15,840 --> 00:33:20,880
Speaker 1: mean deaths in our community in the way that the

543
00:33:20,960 --> 00:33:24,760
Speaker 1: opoids have. It really just has um excluding the pandemic

544
00:33:25,160 --> 00:33:28,240
Speaker 1: being the number one. It's really one of the largest

545
00:33:28,240 --> 00:33:30,640
Speaker 1: public health problems that we have right now, public safety problems.

546
00:33:31,480 --> 00:33:34,120
Speaker 1: What exactly does an opioid due to the body when

547
00:33:34,160 --> 00:33:35,960
Speaker 1: you get it, in the state that you get it.

548
00:33:36,600 --> 00:33:39,800
Speaker 1: What do you see when you open up a body? Sure, well,

549
00:33:39,880 --> 00:33:47,160
Speaker 1: it's primary method of action is by depressing respirations in

550
00:33:47,280 --> 00:33:54,840
Speaker 1: the brain, so it slows your drive to breathe. When

551
00:33:54,920 --> 00:34:00,760
Speaker 1: we see that at an autopsy, we see what that

552
00:34:00,880 --> 00:34:04,200
Speaker 1: manifests as is extra fluid in the lungs, so they

553
00:34:04,280 --> 00:34:06,520
Speaker 1: take on a lot of pulmonary dema would be the

554
00:34:06,560 --> 00:34:10,320
Speaker 1: medical term, but it's basically fluid on the lungs. They're

555
00:34:10,480 --> 00:34:17,080
Speaker 1: very heavy. It can also inhibit the drive to urinate,

556
00:34:17,160 --> 00:34:19,719
Speaker 1: so a lot of times the bladders very fall of

557
00:34:19,960 --> 00:34:24,160
Speaker 1: urine U and not a lot else really, to be

558
00:34:24,200 --> 00:34:30,120
Speaker 1: honest with you, opioids heavy lungs and retained urine. That's

559
00:34:30,360 --> 00:34:33,279
Speaker 1: that's kind of how they how quickly if you know this,

560
00:34:33,440 --> 00:34:37,239
Speaker 1: how quickly does fentanyl or an opioid take effect into

561
00:34:37,320 --> 00:34:41,919
Speaker 1: the system, and how quickly doesn't have that impact? Well?

562
00:34:42,360 --> 00:34:47,200
Speaker 1: It actually it used to be that fentanyl, because it's

563
00:34:47,239 --> 00:34:52,880
Speaker 1: so strong, um could actually result in death so fast

564
00:34:53,200 --> 00:34:55,680
Speaker 1: that there wasn't actually time for the lungs to react

565
00:34:56,560 --> 00:35:01,080
Speaker 1: with fluid accumulation or urinary retention. But now we're seeing

566
00:35:01,280 --> 00:35:07,839
Speaker 1: so many people that have developed tolerances to this really

567
00:35:07,960 --> 00:35:12,920
Speaker 1: strong drug that they have findings that we see similar

568
00:35:12,960 --> 00:35:18,959
Speaker 1: to things like heroin or other opioids, oxycodone, morphine, where

569
00:35:19,480 --> 00:35:21,560
Speaker 1: deaths tend to be a little slower and they're not

570
00:35:21,640 --> 00:35:24,160
Speaker 1: as strong as fentanyl. But you know, it used to

571
00:35:24,200 --> 00:35:27,640
Speaker 1: be that fentanyl deaths, we'd have blood concentrations around the

572
00:35:27,760 --> 00:35:31,920
Speaker 1: number let's say six ten, twelve, something like that, and

573
00:35:32,080 --> 00:35:36,440
Speaker 1: now we're seeing them over a hundred. And that doesn't

574
00:35:36,480 --> 00:35:39,960
Speaker 1: mean the Fennel's any weaker. It means that people have

575
00:35:40,080 --> 00:35:42,680
Speaker 1: developed a tolerance. That means they've been using this drug

576
00:35:42,840 --> 00:35:44,800
Speaker 1: over and over and over again and building up a

577
00:35:44,880 --> 00:35:47,640
Speaker 1: tolerance and then finally one day it gets the better

578
00:35:47,719 --> 00:35:50,720
Speaker 1: of them. For a fascinating extended interview with doctor Lucas,

579
00:35:50,800 --> 00:35:53,680
Speaker 1: go to the Deadly Pill Podcast on the iHeartRadio app,

580
00:35:53,960 --> 00:35:57,239
Speaker 1: speaking of which, the Deadly Pill Podcast features not only

581
00:35:57,360 --> 00:36:01,239
Speaker 1: extended interviews, but also exclusive content with experts we just

582
00:36:01,280 --> 00:36:04,160
Speaker 1: couldn't fit into the radio special, including a warning for

583
00:36:04,280 --> 00:36:07,960
Speaker 1: parents and a deeper dive on narcan. I'm Steve Gregory

584
00:36:08,000 --> 00:36:10,920
Speaker 1: with the CAFI News Department. Thank you for listening. If

585
00:36:10,960 --> 00:36:13,320
Speaker 1: you are someone you know suffers from a mental indoor

586
00:36:13,400 --> 00:36:17,279
Speaker 1: substance use disorder, call the national toll free helpline at

587
00:36:17,320 --> 00:36:20,040
Speaker 1: one eight hundred six six two Help. That's one eight

588
00:36:20,200 --> 00:36:25,120
Speaker 1: hundred six six two four three five seven. Deadly Pill

589
00:36:25,239 --> 00:36:27,960
Speaker 1: is a production of the CAFI News Department for iHeartMedia,

590
00:36:28,080 --> 00:36:32,200
Speaker 1: Los Angeles. Robin Bertalucci, Program director, Chris Little, news director,

591
00:36:32,320 --> 00:36:35,560
Speaker 1: the program's executive producer and host is Steve Gregory and

592
00:36:35,760 --> 00:36:38,920
Speaker 1: is co produced by Jacob Gonzalez and Alex Rozzo. The

593
00:36:39,000 --> 00:36:43,000
Speaker 1: show's digital producers are Alex Rozzo and Lena Chappelle. Coming

594
00:36:43,120 --> 00:36:46,760
Speaker 1: up Unsolved with Steve Gregory, But first, This is KFI

595
00:36:46,880 --> 00:36:49,440
Speaker 1: AM six forty Time Now for a news update