Teen Overdose Confirms Arrival of Deadly Opioid in San Francisco

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Alexis Madrigal (0:33)

Welcome to Forum, I'm Alexis Madrigal. For many years, San Francisco was a model of containing heroin overdoses. Then fentanyl and the pandemic sent overdose numbers spiraling out of control. While it wasn't fentanyl's potency alone that caused the surge of deaths, its properties did make overdoses harder to prevent.

Over the past couple years, public health and public safety efforts have pushed down the numbers of people dying on our streets.

Which is why it was troubling to hear that there is a new, even more potent drug circulating in San Francisco. It's called cyclorphine. In April, a 16-year-old boy was the city's first confirmed overdose involving the drug. And here to discuss what's happening and how the city plans to keep tabs on the spread of the drug and other synthetic opioids like it, we're joined by Heather Knight, San Francisco Bureau Chief for the New York Times. Of course, she wrote the recent story, 18 Autopsy Marks the Arrival of a Deadly Drug in San Francisco. Welcome, Heather.

Heather Knight (1:32)

Thank you.

Alexis Madrigal (1:33)

We've also got Dan Tsai, Director of the San Francisco Department of Public Health. Welcome, Dan.

Dan Tsai (1:37)

Thank you.

Alexis Madrigal (1:38)

And we've got Daniel Ciccherone, who is Professor of Family and Community Medicine and Addiction Medicine at UCSF.

Heather Knight (1:45)

Welcome.

Daniel Ciccarone (1:45)

Good morning.

Alexis Madrigal (1:47)

So Heather, let's just start with you. The San Francisco Department of Public Health reported this overdose on April 23rd, saying the tragedy marks the first time that cyclorphine estimated to be 10 times more powerful than fentanyl, and also undetectable by fentanyl strips had been detected in San Francisco. That was almost six months ago, right? What's the news that has come out recently about what happened?

Right.

Heather Knight (2:13)

So the city did warn that this drug was here and had killed someone, but didn't say who it was or the circumstances. And I was able to figure that out. It was a 16-year-old boy named Dante LaCorte. He lived in Lower Nob Hill, and his mother found him dead in his bed the morning of April 7th. He just had an overdose. She tried to give him Narcan. It didn't work, and he passed away.

Alexis Madrigal (2:35)

Oh, man. And do we know if there have been any other reported deaths, or is that just the one so far?

Heather Knight (2:41)

Just the one so far. Yeah.

Alexis Madrigal (2:44)

Dan Sy, can you tell us more about this drug, and just where did it come from? We call it new, but actually it synthesized quite a while ago, right?

Dan Tsai (2:54)

Sure. So to understand cycloraphene and why we're so concerned about this, it's helpful to think back to where we are with fentanyl category of synthetic opioids that are even more potent than traditionally what folks were using with oxycodone and other products. And as we've seen very much here in San Francisco and across the country, we've had a crisis where fentanyl, as many of us have said, has changed the game relative to how potent it is, and therefore the approaches we've needed to think about from a care and treatment standpoint.

And in San Francisco over the past few years, Heather, as you noted in your article, we've had over 4,000 people die of an overdose death at point over two people per day. And every single one of those deaths is unacceptable, it's preventable. What we see now with cyclorhpne, a new category of synthetic opioids, potentially 10 times more potent than fentanyl. Of course, it's a great cause for concern. Part of, I think, what the mayor said at a recent press conference in response to just Heather, a very tragic story, a family that you spoke with, thank you for profiling that, is to shout from the rooftops, from a public health, public kind of advisory standpoint, to make sure folks understand how potent these illicit drugs are, and that the safest way, especially for parents, I've had a lot of parents ask about this, the safest way to protect your kids or for someone using is to not take any counterfeit pills, not to take illicit drugs, and that there is treatment, there are options to help folks be able to enter treatment if they are needing to use.