Agenda Item No. 7
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TO: Honorable Mayor and City Council
FROM: Fermin Preciado, Acting City Managerv,_�
Shane Massoud, Public Information Officer/Grant Coordinator FOR: City Council Meeting of February 27, 2023
SUBJECT: Senate Bill 44 - Alexandra's Law
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That City Council review and approve a letter of support for Senate Bill 44 (SB 44) - Alexandra's Law by Senator Thomas J. Umberg (D - Orange County).
According to the Pacific Northwest National Laboratory (PNNL), fentanyl was created in 1959 by Dr. Paul Janssen as an intravenous surgical pain -reliever. The drug is 50 to 100 times more potent than morphine. Because of its strength, the drug was rarely used except in hospital operating rooms.
In the 1990s, a new transdermal skin patch for fentanyl was developed to treat chronic pain. The non -surgical delivery mechanism offered some unique advantages over other drugs, including quick onset of action, relatively few cardiovascular risks, and low histamine release. These attributes made it a good prescription choice for some patients, because it reduced some of the risks of medical complications that other pain relievers have.
Lozenge, lollipop, tablet, and nasal spray versions soon followed, under such names as Actiq8, DuragesicO, and SublimazeV. The ease and effectiveness of these user-friendly delivery methods led to abuse, and the criminal manufacturing fentanyl analog market was born. Simply put, fentanyl analogs are illicit —and often deadly —alterations of the medically prescribed drug fentanyl. The analogs have similar but not the same chemical structure, and they mimic the pharmacological effects of the original drug.
From 1999 to 2011, the death rate in the United States due to opioid analgesics nearly quadrupled, then began to skyrocket around 2013-2014. This timing coincided with the first detection of illicit pills containing fentanyl, fentanyl (analogs), and other novel synthetic opioids.
Warning signs of the fentanyl-fucled opioid crisis first emerged in the Northeast. William R Brownfield, Assistant Secretary for the Office of National Drug Control Policy, warned that Massachusetts was "a preview of coming attractions." Across the United States, drug abuse, 58 addiction, and overdoses were responsible for 50,000 deaths in 2015, the majority of which involved an opioid.
In addition, the Center for Disease Control and Prevention (CDC), notes that the rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl and fentanyl analogs, increased over 56% from 2019 to 2020. The number of overdose deaths involving synthetic opioids in 2020 was more than 18 times the number in 2013. More than 57,000 people died from overdoses involving synthetic opioids in 2020.
The latest provisional mortality data from CDC indicate that more than 107,000 Americans died from a drug overdose in the 12-months ending in January 2022. Of these deaths, it is estimated that 80,590 of these deaths, or 75%, involved at least one opioid, with 71,450 (66.5%) involving synthetic opioids, primarily illicitly manufactured fentanyl or fentanyl analogs. Stimulant overdose deaths are also on the rise, with approximately 33,128 (30.8%) deaths involving methanaphetarnine and 24,751 (23%) involving cocaine.
On December 12, 2022, City Council approved a letter of support for Senate Bill 13 by Senator Ochoa Bogh.
On February 3, 2023, City staff was made aware by Senator Ochoa Bogh's staff that she had decided to pull this bill and be co-author of Senator Umberg's bill. This piece of legislation is identical to S13 13, which was previously supported by Council; however, Senator Ochoa Bogh decided to be a joint author with Senator Umberg to work in a bipartisan manner to hopefully get this potentially life-saving policy enacted.
Currently, existing law makes it a crime to possess for sale or purchase for purpose of sale, transport, sell, furnish, administer, give away, manufacture, compound, convert, produce, derive, process, or prepare various controlled substances, including, among others, fentanyl, peyote, and various other opiates and narcotics. SB 44 would require a person who is convicted of, or who pleads guilty or no contest to, the above crimes to receive a written advisory of the danger of manufacturing or distribution of controlled substances and that, if a person dies as a result of that action, the manufacturer or distributor can be charged with voluntary manslaughter or murder.
The bill would require that the fact the advisory was given be on the record and recorded on the abstract of conviction.
SB 44 continues to receive widespread support from across the State. For example, the 9-1-1 Ambulance Providers Alliance , California District Attorneys Association, California Police Chiefs Association, City of Orange, County of Orange, Drug Awareness Foundation, Orange County District Attorney, Todd Spitzer, Orange County Sheriff, Don Barnes; Riverside County Sheriff, Chad Bianco; Sacramento County Sheriff, Jim Cooper; and Sall Diego County District Attorney, Summer Stephan.
City staff is recommending that City Council review and approve a letter of support for Senate Bill 13 by S Senator Thomas J. Umberg (D — Orange County) 59 ATTACHMENTS:
Letter of Support to Senator Umberg
Pacific Northwest National Laboratory
Senate Bill 44 Fact Sheet
WO
Monday, February 27, 2023
Honorable Senator Thomas J. Umberg
10210 Street, Suite 6530
Sacramento, CA 95814
Dear Senator Umberg:
On behalf of the City of Yucaipa, we write in support of Senate Bill 44.
As you are aware, the Center for Disease Control and Prevention (CDC), notes that the rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl and fentanyl analogs, increased over 56% from 2019 to 2020. The number of overdose deaths involving synthetic opioids in 2020 was more than 18 times the number in 2013. More than 57,000 people died from overdoses involving synthetic opioids in 2020. In 2021 synthetic opioid deaths (primarily illicitly manufactured fentanyl or fentanyl analogs) reached 71,450.
With such a significant increase in overdose deaths, the time is now to pass meaningful legislation that changes the current course of this crisis.
Senate Bill 44, if passed, will help establish the necessary framework that will suppress the criminal manufacturing of fentanyl (analogs).
We thank you for your continued support of our community.
Sincerely,
Justin Beaver
Mayor
Councilmember
Mayor Pro Tem
Matt Garner Chris Venable
Councilmember Councilmember
cc: Senator Rosilicie Ochoa Bogh, Via FAX No. (916) 651-4023 Laura Varela, League of California Cities, lvarela owcalgities.oror Meg Desmond, League of California Cities, mdesmond awcalcities.org Jason Gonsalves, Joe A. Gonsalves & Son, Jason( gonsalvi.corn City of Yucaipa
34272 Yucaipa Blvd, Yucaipa, CA 92399
909-79Z,2489
JOINT AUTHOR- Senator Ochoa Bogh
PRINCIPAL CO-AUTHORS.- Senators Caballero, Portantino, Stern SENATE CO-AUTHORS- Alvarado -Gil, Archuleta, Becker, Blakespear, Dodd, Glazer, Grove, Jones, Min, Newman, Niello, Nguyen, Seyarto, Wilk
ASSEMBLY CO-AUTHORS: Alanis, Chen, Davies, Dixon, Essayli, Lackey, Nguyen, Joe Patterso Petrie -Norris, Ouirk-Silva, Rodriguez, Rubio, Sanchez, Ta, Wood I Senate Bill 44 — Alexandra's Law -- will
require that a written advisory or
admonishment be issued to a person convicted
of a fentanyl-related drug offense notifying the
person of the danger of manufacturing and
distributing controlled substances and of
potential future criminal liability if another
person dies as a result of that person's actions.
With respect to deaths resulting from DUls, the
California Supreme Court held in People v.
Watson (1981), 30 Cal. 3d 290, 298, in
affirming a second-degree murder conviction,
that "when the conduct in question can be
characterized as a wanton disregard for life,
and the facts demonstrate a subjective
awareness of the risk created, malice may be
implied."
To codify this notion, California Vehicle Code
§23593 was implemented in 2004 to require
that courts read an admonishment to anyone
convicted of reckless driving or Driving Under
the Influence (DUI) to inform them of the
state's ability and intent to charge a repeated
future offense with manslaughter or murder.
California Health & Safety Code §§11351-
11352 make it unlawful to sell, traffic, or
transport specified opiates and opiate
derivatives including fentanyl.
Fentanyl is a synthetic opioid 100 times more
potent than morphine. It can be found in
methamphetamine, cocaine, heroin, and vaping
products, as well as fake pills of Xanax,
hydrocodone or Oxycodone.
NEED FOR THE BILL
Statistics show the opioid crisis has
significantly worsened since fentanyl entered
the illicit drug market.
Sadly, synthetic opioids were responsible for
the majority of drug related deaths in
202 1. Specifically, fentanyl was the number one
cause of death last year for people ages 18-45,
outpacing suicides and COVID-19.
Fentanyl causes a fatality every 8.57 minutes,
approximately, and is linked to 64% of total
drug fatalities.
It is believed that fentanyl-specific
admonishments have been individually adopted
by at least 28 out California's 58 counties.
Unfortunately, lack of statewide adoption
and/or consistent use allow for gaping cracks in
its enforcement.
IN
S13 44 introduces the California Fentanyl
Admonishment, otherwise known as
Alexandra's Law, modeled after the state's
current DUI Advisory.
The admonishment required by SB 44 will help
law enforcement and prosecutors establish
implied malice in cases of drug -induced death
resulting from fentanyl sold or furnished by a
previously -convicted dealer or trafficker.
San Diego Mayor Todd Gloria (Sponsor)
9-1-1 Ambulance Providers Alliance
California District Attorneys Association
California Police Chiefs Association
City of Orange
County of Orange
Drug Awareness Foundation
Orange County District Attorney, Todd Spitzer
Orange County Sheriff, Don Barnes
Riverside County Sheriff, Chad Bianco
Sacramento County Sheriff, Jim Cooper
San Diego County District Attorney, Summer
Stephan
City of Yorba Linda Councilwoman, Beth
Haney
12 Individuals
OPPOSITION
Ella Baker Center
FOR MORE INFORMATION
Jackie Koenig
Phone: (916) 651-4034
Email: Jackie.Koeniggsen.ca.gov
UPDATE'D FEBRUAWV2,2023
63 EM
What are fentanyl analogs.?
Simply put, fentanyl analogs are illicit —and often deadly —alterations of the WIN=. 11111;111111
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Fentanyl is a very strong synthetic narcotic primarily used to ease the suffering of patients with chronic pain or terminal illnesses. Since the 1990s, the drug has been available in a patch or lozenge for easy and effective delivery of the time -released medicines. Fentanyl is so potent that residual chemicals in used patches have been suspected of contaminating water supplies when flushed down the toilet. Used patches have also been known to stick to children or animals, causing unintentional overdoses.
But accidental overdoses from legal prescriptions pale in comparison to deaths attributed to illegally imported versions of the drug and its analogs starting in the late 1990s. The effectiveness of the drug, combined with user-friendly delivery methods, drew the attention of bad actors seeking to profit from its potency.
Take heroin, for example. In the height of the opioid epidemic, a kilogram of heroin could be purchased for approximately $6,000 and sold for appropriately $80,000. For the same purchase price, a kilogram of illegally imported fentanyl could be sold for approximately $1.6 million, then cut into heroin and other drugs to expand their volume.
64 The availability of black-market fentanyl and fentanyl analogs led to a U.S. opioid epidemic that continues to cause thousands of overdose deaths each year and destroy families and communities in the process. Harm from fentanyl analogs also extends to first responders. A lethal dose of carfentanyl, a fentanyl analog, is about the size of the head of a pin, requiring the full protection of hazmat suits.
Fentanyl analogs are similar in chemical structure to the synthetic opioid, fentanyl. (Photo:
Shutterstock.com)
65 Fentanyl was created in 1959 by Dr. Paul Janssen as an intravenous surgical analgesic. The drug is 50-100 times more potent than morphine. Because of its strength, the drug was rarely used except in hospital operating rooms or on large animals.
In the 1990s, a new transdermal skin patch for fentanyl was developed to treat chronic pain. The non -surgical delivery mechanism offered some unique advantages over other drugs, including quick onset of action, relatively few cardiovascular risks, and low histamine release. These attributes made it a good prescription choice for some patients, because it reduced some of the risks of medical complications that other pain relievers have.
Lozenge, lollipop, tablet, and nasal spray versions soon followed, under such names as Actiq@, Durageslc@, and Sublimaze@. The ease and effectiveness of these user- friendly delivery methods led to abuse, and the fentanyl analog market was born.
Criminal manufacturers began creating designer drugs —analogs with modified chemical structures —to avoid identification as a controlled substance.
From 1999 to 2011, the death rate in the United States due to opioid analgesics nearly quadrupled, then began to skyrocket around 2013-2014. This timing coincided with the first detection of illicit pills containing fentanyl, fentanyl analogs, and other novel synthetic opioids such as U-47700.
Warning signs of the fentanyl-fueled opioid crisis first emerged in the Northeast.
William R Brownfield, Assistant Secretary for the Office of National Drug Control Policy, warned that Massachusetts was "a preview of coming attractions." Across the United States, drug abuse, addiction, and overdoses were responsible for 50,000 deaths in 2015, the majority of which involved an opioid. 66 In 2017, the President issued Executive Order 13784, establishing a Commission on Combating Drug Addiction and the Opioid Crisis. Many of the 45,000 drug -related deaths that year were determined to have resulted from abuse, addiction, and overdoses due to fentanyl.
Many of the 45,000 drug -related deaths in 2017 were caused by fentanyl overdoses. (Image: Shutterstockcom)
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A • contributor to the opioid drug crisis was availability. Modern internet e- - commerce enabled individual players, small-scale drug trafficking organizations • and large-scale DTOs with their • production facilities to ••• the illicil drug market with fentanyl. The drugs could be purchased and delivered through 67 ,j,
Carfentanyl, a fentanyl analog, is an odorless white powder. It is one of the most potent opioids known and used commercially. According to the National Institute on Drug Abuse, carfentanyl is approximately 10,000 times • a• than morphine, 100 times more than fentanyl, and 50 times more than heroin. Marketed under the trade name Wildnil@, it is used as a general anesthetic for very large animals.
In July 2016, carfentanyl was found cut into heroin and fentanyl sold on the streets of Ohio. In a span of three days, 35 overdoses and 6 deaths occurred there. In the same year, in Anoka County, Minnesota, six overdoses and two deaths occurred in a 12-hour period in October 2016. These instances and similar cases throughout the nation pointed to single batches of fentanyl-laced heroin as the culprit for dramatic spikes in overdose cases.
Most opioid users do not intentionally seek out fentanyl analogs. To unsuspecting customers, the drugs can i• like legal opioids or benzodiazepines for •r relief.
And once a person is exposed to a higher -toxicity drug, the brain chemistry alters further, • the user will seek • the most •• form • the drug. At the height of addiction, • users are unable to •' risk and are willing to go to any length to obtain the drug, including boiling fentanyl patches to extract the drug • • • ingestion. And if a user is new to taking opioids, the risk • overdose is even higher •` their bodies have no tolerance to the drug.
Fentanyl analogs, including fentanyl-laced heroin, come in many flavors, with street names such as white heroin, Perc-O-Pops, Chiclets, Apache, China Girl, White China, Dance Fever, Jackpot, Murder 8, TNT, Tango and Cash, Friend, Goodfella, and Redrum (murder spelled backward). The sheer variety of the drug, including emerging combinations, make toxicology testing and accurate death reporting extremely challenging.
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Investigations into drug overdoses have shown the difficulty in identifying whether drugs were commercially or illegally produced. For example, carfentanyl and other analogs do not show up on traditional opioid toxicology testing. And specific testing for these substances is not routinely performed. An investigation may show all the scene indications and autopsy findings of an opioid overdose death, but simple toxicology tests can still be negative for opioids. in many states, medical examiners are often too overwhelmed by the numbers to do the testing to determine which analog was involved.
The toll of drug abuse and overdoses extends far wider than deaths, which in 2019 reached nearly 50,000. The costs to families, communities, and emergency response in terms of dollars, psychological, and health effects are incalculable.
Nipping the problem in the bud —keeping illicit drugs from reaching the market —is critical for stemming the tide of illegal drug activity and protecting the nation from the scourge of fentanyl analogs.
As part of the federal response to EO 13784, the Department of Homeland Security's Science and Technology Directorate established a collaboration among U.S.
Customs and Border Protection (CBP), the United States Coast Guard, other federal agencies, and first responders. Their goal is twofold- (1) to identify and develop improved fentanyl detection capabilities, including standards and advanced rapid detection technologies and analytics, and (2) to increase capacity to disrupt the supply of drugs being smuggled into the United States.
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Federal agencies have increased efforts in recent years to stop fentanyl and its analogs from being smuggled into the United States. (Photo- Shutterstock.com) Synthetic opioids present immense challenges to detection, particularly in the vast infrastructure that enables speedy and high -volume legitimate trade. From shipping docks and airports to border crossings and mailrooms, smugglers go to great lengths to hide their drugs in the flow of legal commerce.
and emergency response settings for more than 50 years. The first drug -sniffing dogs were put into service in the mid-1 960s and are now regularly seen in cargo 70 • • 1111 1 1 1 111
suffer health effects • the chemicals and fumes associated with illicit drugs such as fentanyl analoas. Even a minute amount • drug -to -skin contact can be deadly.
Specialized laboratory equipment and analytical techniques such as GC -MS (gas chromatography mass spectrometry) and LC-MS/MS (liquid chromatography tandem mass spectrometry) can identify regulated fentanyl compounds. As emerging new compounds appear on the market, nontargeted testing can •' •'• with LC-HRMS (liquid chromatography high -resolution mass spectrometry).
MM
, or
spectrometers, came out in quick succession. TruNarc debuted in 2012, followed by TacticID in 2014. The compact, lightweight, and robust devices have simple push button controls and work by scanning. For illicit or dangerous substances such as fentanyl, heroin, cocaine, or methamphetamine, the screen turns red. Drug precursors or chemicals that can mask some narcotics' Raman signals return a yellow or orange screen. Green means all clear.
In 2019, SwabTekTM introduced new field kits
with dry test strips capable of detecting fentanyl and other dangerous narcotics. The • recyclable spot test uses a paper strip with • reagent test • applied 71 1111111i lll;ll i � -IMMMMM
hazardous alternative to the industry standard "Wet chemistry" field 1<6� Field technologies such as the ones described above require close contact to the sample source. One example of a new standoff detection technology is Pacific Northwest National Laboratory's (PNNL's) ultrasensitive vapor detection system, VaporlD. Rather than searching for particle residue using surface swipes or pulses of air to dislodge particles for analysis, the system 'sniffs' for vapors, much the way canines do.
VaporlD joins an atmospheric flow tube with a mass spectrometer. The system can accurately detect organophosphorus compounds and narcotics at ultra -low levels previously impossible to detect in the presence of other chemical #• The technology could complement or replace contact and canine -assist detection methods for drug screening used in mailrooms, airports, and shipping centers. 72 Technology developed at PNNL identifies vapors of narcotics in the air. (Photo by Andrea Starr I Pacific Northwest National Laboratory)
Unscrupulous scientists persist in exercising their craft, working in underground labs to manipulate fentanyl, isolate analogs, and create deadly combinations. The collection of hard -to -trace substances entering the market continues to ki users and sicken law enforcement as they battle the epidemic.
The Depaof Homeland Security (DHS) has a significant role in countering the trafficking of opioids and other narcotics into the United States, including detection and interdiction of illicit narcotics, as well as investigative efforts to disrupt and dismantle smuggling operations. The DHS Science and Technology Directorate 73 I NEI=
state/local law enforcement in four primary areas:
• High -throughput, nonintrusive screening technologies to rapidly and automatically - Automated alarm resolution technologies to provide confirmation of opioids and IN I IT. M U-STOMMOVe",
In January 2021, DHS announced a new multiphase study to improve the detection of synthetic opioids. In collaboration with PNNL, the study will assess the performance of field -portable drug detection equipment from industry against fentanyl and fentanyl-related compounds, other drugs, and cutting agents.
For the study, the industry partners will obtain the latest reference spectra for approximately 50 DEA-controlled substances, including novel synthetic opioids, as well as independent test results, which will enhance their capability and marketability. End users of the equipment —the first responder and interdiction communities, as well as interested federal, state, and local agencies —will also •' by receiving system updates With the expanded libraries at no • They wil' gain a broader understanding of the capabilities and limitations of current field detection equipment to feel more secure with detection performance. 74 ,nass spectrometers, ion mobility spectrometers, Raman spectrometers, and Fourier IMM20M
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data collection for govern ment-owned spectral libraries and will initiate a new Opioi(i PNNL scientists conduct fentanyl analogs research to help first responders better detect the dangerous illicit substances. (Photo by Andrea Starr' Pacific Northwest National Laboratory)
At PNNL, teams of biologists, chemists, and engineers work every day to solve
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Rich Ozanich is a PNNL project manager of opioids standards and equipment testing. In June 2021, he kicked off the DHS S&T Directorate's Whole -of - Government Virtual R&D Showcase https://www.dhs.gov/science-and-technology/"virtual-r showcase> as part of an expert panel discussion, "Opioids Detection and • Responding to a Public Health Crisis." The • highlighted PNNL' partnership with DHS S&T, industry, and communities to improve detection of synthetic opioids toward stronger and more resilient communities. I As part of that partnership, PNNL's fentanyl handling and detection experts are helping assess the performance of detection equipment used by emergency responders. The work informs standards and tools for quickly detecting fentanyl and its analogs. Advances in both these areas aim to reduce the exposure of dangerous drugs to emergency responders.
Kristin Omberg, leader of PNNL's Chemical and Biological Signatures group, worke(#' with fellow subject -matter experts on the Biodefense Policy Landscape Analysis Tool. Unlike any other product of its type available, the tool captures relevant biodefense policy directives and sections of the U.S. Code in a format conducive to visualization. Launched in 2018, it was designed to help the government understand the current state of the U.S. biodefense enterprise.
Building on that work, Omberg and her team also developed the National Response Framework Policy Landscape Analysis Tool for the Federal Emergency Management Agency. The visualization tool, debuted in March 2021, lays out the United States' strategy for responding to any type of emergency. It parses the framework's requirements and elements in the form of icicle and sunburst charts. 76 Robert Ewing is a chemist at PNNL and the lead inventor of the TaporlD technology, which was named Geekwire's Innovation • the Year in • Before a public version hits the streets —or the airport, or the mailroom, or any number of places where public safety is imperative —portability and integration into existing screening •• are key hurdles that need to be overcome.
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Pacific Northwest National Laboratory has established a preeminent capability to research oplol . • •-a -Pacific • National Laboratory)
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