Fentanyl’s scourge plainly visible on streets of Los Angeles

Nov 28, 2022, 8:22 AM | Updated: 7:02 pm
A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the ...

A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)

(AP Photo/Jae C. Hong)

LOS ANGELES (AP) — In a filthy alley behind a Los Angeles doughnut shop, Ryan Smith convulsed in the grips of a fentanyl high — lurching from moments of slumber to bouts of violent shivering on a warm summer day.

When Brandice Josey, another homeless addict, bent down and blew a puff of fentanyl smoke his way in an act of charity, Smith sat up and slowly opened his lip to inhale the vapor as if it was the cure to his problems.

Smith, wearing a grimy yellow T-shirt that said “Good Vibes Only,” reclined on his backpack and dozed the rest of the afternoon on the asphalt, unperturbed by the stench of rotting food and human waste that permeated the air.

For too many people strung out on the drug, the sleep that follows a fentanyl hit is permanent. The highly addictive and potentially lethal drug has become a scourge across America and is taking a toll on the growing number of people living on the streets of Los Angeles.

Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700.

Fentanyl was developed to treat intense pain from ailments like cancer. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it’s 50 times more potent than heroin, even a small dose can be fatal.

It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention said.

The drug’s toll spreads far beyond the streets.

Jennifer Catano, 27, has the names of two children tattooed on her wrists, but she hasn’t seen them for several years. They live with her mother.

“My mom doesn’t think it’s a good idea because she thinks it’s gonna hurt the kids because I’m not ready to get rehabilitated,” Catano said.

She has overdosed three times and been through rehab seven or eight times.

“It’s scary to get off of it,” she said. “The withdrawals are really bad.”

Catano wandered around a subway station near MacArthur Park desperate to sell a bottle of Downy fabric softener and a Coleman camping chair she stole from a nearby store.

Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness.

A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders.

Billions of dollars are being spent to alleviate homelessness in California but treatment is not always funded.

A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn’t qualify.

Help is available but it is outpaced by the magnitude of misery on the streets.

Rita Richardson, a field supervisor with LA Door, a city addiction-prevention program that works with people convicted of misdemeanors, hands out socks, water, condoms, snacks, clean needles and flyers at the same hotspots Monday through Friday. She hopes the consistency of her visits will encourage people to get help.

“Then hopefully the light bulb comes on. It might not happen this year. It might not happen next year. It might take several years,” said Richardson, a former homeless addict. “My goal is to take them from the dark to the light.”

Parts of Los Angeles have become scenes of desperation with men and women sprawled on sidewalks, curled up on benches and collapsed in squalid alleys. Some huddle up smoking the drug, others inject it.

Armando Rivera, 33, blew out white puffs to attract addicts in the alley where Smith was sleeping. He needed to sell some dope to buy more. Those without enough money to support their habit, hovered around him, hoping for a free hit. Rivera showed no mercy.

Catano couldn’t sell the chair, but eventually she sold the fabric softener to a street vendor for $5.

It was enough money for another high.

___

This story has been updated to correct the spelling of Downy fabric softener.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Ryan Smith, a 36-year-old homeless addict, falls asleep after smoking fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Forensic assistant Laurentiu Bigu, left, and investigator Ryan Parraz from the Los Angeles County coroner's office cover the body of a homeless man found dead on a sidewalk in Los Angeles, Monday, April 18, 2022. The 60-year-old man died from the effects of methamphetamine, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A banner advocating housing for the homeless, with an image depicting Martin Luther King Jr., hangs on a fence in the Skid Row area of Los Angeles, Friday, April 15, 2022. (AP Photo/Jae C. Hong)
            
              Drug addicts smoke fentanyl next to piles of trash in an alley in Los Angeles, Tuesday, Aug. 23, 2022. For too many people strung out on the drug, the sleep that follows a fentanyl hit is permanent. The highly addictive and potentially lethal drug has become a scourge across America and is taking a toll on the growing number of people living on the streets of Los Angeles. (AP Photo/Jae C. Hong)
            
              Kelly Richardson, a mental health case manager from the People Concern, a social services agency based in Los Angeles County, talks to a homeless person while carrying pouches containing Narcan nasal spray kits in Santa Monica, Calif., Monday, Sept. 19, 2022. (AP Photo/Jae C. Hong)
            
              A mentally-ill homeless man talks aloud to himself as pedestrians walk across the street in downtown Los Angeles, Thursday, April 14, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Two drug addicts smoke fentanyl in an alley in Los Angeles, Monday, April 18, 2022. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Jennifer Catano, a 27-year-old fentanyl addict, shows tattoos of the names of her two children, Evan and Audrey, in Los Angeles, Tuesday, Aug. 23, 2022. "My mom doesn't think it's a good idea because she thinks it's gonna hurt the kids because I'm not ready to get rehabilitated," said Catano who hasn't seen them for several years. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman leans on a rail after wetting her hair at a drinking fountain in the Skid Row area of Los Angeles, Monday, May 23, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Holly Ferrante, 28, right, smokes fentanyl as her husband, Clark Veater, pack their belongings in Los Angeles, Monday, May 23, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. (AP Photo/Jae C. Hong)
            
              A drug addict holds the handle of a scooter as he falls asleep after smoking fentanyl in Los Angeles, Tuesday, Aug. 9, 2022. For too many people strung out on the drug, the sleep that follows a fentanyl hit is permanent. The highly addictive and potentially lethal drug has become a scourge across America and is taking a toll on the growing number of people living on the streets of Los Angeles. (AP Photo/Jae C. Hong)
            
              Two homeless addicts share a small piece of fentanyl in an alley in Los Angeles, Thursday, Aug. 18, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              A homeless addict holds pieces of fentanyl in Los Angeles, Thursday, Aug. 18, 2022. Use of the powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless man stands on a piece of cardboard on a sidewalk in Los Angeles, Friday, April 15, 2022. A controversial bill signed by Gov. Gavin Newsom could improve that by forcing people suffering from severe mental illness into treatment. But they need to be diagnosed with a certain disorder such as schizophrenia and addiction alone doesn't qualify. (AP Photo/Jae C. Hong)
            
              Two addicts sleep in an alley in Los Angeles, Wednesday, Sept. 21, 2022. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. Overdose was the leading cause of death, killing more than 700. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless woman mumbles to herself while standing in an alley with a crate over her head in Los Angeles, Tuesday, Aug. 9, 2022. (AP Photo/Jae C. Hong)
            
              Vino, a 25-year-old drug addict who gave his first name only, smokes fentanyl in an alley in Los Angeles, Wednesday, Sept. 21, 2022. (AP Photo/Jae C. Hong)
            
              An addict kneels on a sidewalk to smoke fentanyl as pedestrians walk past him in Los Angeles, Thursday, Aug. 25, 2022. For too many people strung out on the drug, the sleep that follows a fentanyl hit is permanent. The highly addictive and potentially lethal drug has become a scourge across America and is taking a toll on the growing number of people living on the streets of Los Angeles. (AP Photo/Jae C. Hong)
            
              A mentally ill homeless man walks across the street with a thick blanket over him in Los Angeles, Friday, April 15, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              Luisa Gibson, 20, bathes using water from a fire hydrant in Los Angeles, Wednesday, July 27, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              Dolores Flores, a 57-year-old homeless drug addict, bathes using a soda can filled with water from a drinking fountain in the Skid Row area of Los Angeles, Thursday, July 21, 2022. Drug abuse can be a cause or symptom of homelessness. Both can also intersect with mental illness. A 2019 report by the Los Angeles Homeless Services Authority found about a quarter of all homeless adults in Los Angeles County had mental illnesses and 14% had a substance use disorder. That analysis only counted people who had a permanent or long-term severe condition. Taking a broader interpretation of the same data, the Los Angeles Times found about 51% had mental illnesses and 46% had substance use disorders. (AP Photo/Jae C. Hong)
            
              A paramedic performs CPR on a homeless man, who collapsed after a physical altercation over a coat with another homeless person, in Los Angeles, Wednesday, July 27, 2022. The 33-year-old man died of asphyxia and neck compression, according to his autopsy report. Nearly 2,000 homeless people died in the city from April 2020 to March 2021, a 56% increase from the previous year, according to a report released by the Los Angeles County Department of Public Health. (AP Photo/Jae C. Hong)
            
              Jenn Bennett, who is high on fentanyl, sits on her skateboard with a visible black eye as her friend, Jesse Williams, smokes the drug in Los Angeles, Tuesday, Aug. 9, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              Armando Rivera, 33, smokes fentanyl mixed with methamphetamine in an alley in Los Angeles, Thursday, Aug.18, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. (AP Photo/Jae C. Hong)
            
              Homeless addicts Brandice Josey, left, uses a straw to blow a puff of fentanyl smoke into the mouth of Ryan Smith, who is high on the drug, in Los Angeles, Thursday, Aug. 18, 2022. (AP Photo/Jae C. Hong)
            
              Anthony Delio, 36, falls asleep on a sidewalk after smoking fentanyl in Los Angeles, Tuesday, Aug. 23, 2022. Use of fentanyl, a powerful synthetic opioid that is cheap to produce and is often sold as is or laced in other drugs, has exploded. Because it's 50 times more potent than heroin, even a small dose can be fatal. It has quickly become the deadliest drug in the nation, according to the Drug Enforcement Administration. Two-thirds of the 107,000 overdose deaths in 2021 were attributed to synthetic opioids like fentanyl, the U.S. Centers for Disease Control and Prevention says. (AP Photo/Jae C. Hong)
            
              A homeless man injects a Narcan nasal spray into the nose of a female addict who appears to be overdosed in Los Angeles, Thursday, Aug. 25, 2022. For too many people strung out on the drug, the sleep that follows a fentanyl hit is permanent. The highly addictive and potentially lethal drug has become a scourge across America and is taking a toll on the growing number of people living on the streets of Los Angeles. (AP Photo/Jae C. Hong)

AP

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Associated Press

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Fentanyl’s scourge plainly visible on streets of Los Angeles