California’s Bold Moves to Curb Fentanyl Deaths Leave Experts Urging for More

California is forging ahead with a series of new laws aimed at reducing overdose deaths, even as opioid overdose rates have started to decline slightly. The new measures signed by Gov. Gavin Newsom this week include expanded access to addiction treatment, life-saving overdose reversal medications, and more.

“California legislators have shown a serious commitment to addressing the fentanyl crisis,” said Dr. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University. While deaths remain higher than pre-pandemic levels, the Centers for Disease Control and Prevention reports that fatal overdoses across the country have dropped to their lowest numbers in three years. California is just beginning to see a downward trend.

The reasons for this shift remain unclear. “Why? The best answer is, ‘We don’t know,'” said Dr. Dan Ciccarone, a professor of addiction medicine at UCSF. “People will point to different interventions, whether it’s restoring public order, increasing access to naloxone, or expanding treatment options, but none of these happened swiftly or broadly enough to fully explain the drop.”

Fentanyl, the inexpensive opioid that’s 20–40 times stronger than heroin, has flooded the drug market in San Francisco and other cities in recent years, leading to record deaths.

“It’s not just about one law — it’s a coordinated suite of policies focused on prevention, treatment, and harm reduction. As both an addiction researcher and a resident, I feel California is moving in the right direction,” Humphreys said.

Among the newly signed bills is AB 1842, which eliminates the need for insurers to require prior authorization before treating patients with opioid use disorder. Ciccarone called it a critical move, describing prior authorization as “a clinical barrier that frustrates both doctors and patients and ultimately stifles care.”

Another key piece of legislation, AB 1976, will require businesses to stock naloxone, a medication that can instantly reverse opioid overdoses, in their first-aid kits by 2027. Meanwhile, AB 1841 will provide two doses of naloxone to resident advisors at public colleges in California.

Access to methadone, a medication used to treat opioid addiction, will also be broadened under AB 2115, which allows patients to take home more doses and increases the number of practitioners permitted to prescribe it. Current regulations require most patients to visit clinics daily to receive a single dose.

“I support most of these bills and believe each will contribute in small but meaningful ways,” Ciccarone said. He singled out the elimination of prior authorization requirements as particularly impactful and praised the expansion of naloxone access into schools and workplaces as “a great package of ideas.”

Yet, Ciccarone noted the absence of a more controversial measure: supervised drug consumption sites, where individuals can use illicit drugs under the supervision of trained staff. Research shows that such sites reduce hospitalizations, lower public costs, and save lives. Gov. Newsom vetoed a bill in 2022 that would have allowed a limited number of California cities to pilot these facilities.

“The most effective solutions are often the ones people fear the most,” Ciccarone said. “What we need now is the courage and political will to take bolder steps.”

Another critical policy gap, according to Humphreys, is the failure to pass a bill that would have mandated wastewater testing for illicit drugs. This measure died in committee earlier this year.

“Wastewater testing reveals where drugs are being used and what’s circulating in the community,” Humphreys said. “It’s an early warning system for dangerous substances, and it also shows whether investments in treatment, prevention, and law enforcement are actually making a difference.”

Last year, 7,748 Californians died from fentanyl overdoses, more than double the number just five years ago, according to the CDC. While the new laws represent significant progress, addiction experts caution that the road to reversing the opioid crisis remains long.

Several additional bills signed by Newsom are aimed at curbing fentanyl use and saving lives:

• AB 2429: Expands high school health education to include lessons on the dangers of fentanyl use.
• AB 2136: Prevents law enforcement from arresting individuals who allow harm reduction service providers to test their drugs.
• SB 997: Authorizes middle and high school students to carry naloxone and requires schools to stock and distribute fentanyl test strips.
• SB 908: Directs the state’s health department to investigate fentanyl-related deaths among children ages 0 to 5.
• SB 1468: Encourages providers to prescribe a three-day supply of narcotic medication to begin detoxification or maintenance treatment for people using opioids.
• SB 910: Enhances programming, drug testing, and medication-assisted treatment for individuals in the criminal justice system.