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San Francisco Chronicle photojournalist Stephen Lam and reporter Trisha Thadani spent a year as part of a large team producing a multimedia project exploring the city’s growing number of fentanyl overdose deaths. They told the story through the lives of people caught in the crisis. Photo: Marissa Leshnov

In the year following the arrival of COVID-19, more than 100,000 people died of drug overdose in the US. In San Francisco in 2020 and 2021, a total of 1,300 people died of drug overdoses, twice the number of deaths from COVID-19. A common culprit was the illicit drug fentanyl. To help readers better understand the ongoing crisis, the San Francisco Chronicle engaged a large team of reporters, editors and photojournalists to follow people over the course of a year to put a human face on this crisis. The result was a multimedia package of stories, videos, graphics and photos published on February 3, 2021 as “A disaster in sight”.

I recently spoke with journalist Trisha Thadani and photojournalist Stephen Lam to find out how they approached this challenging project. One of the people they followed was Anthony Alexander, 42, who lives in an 80-square-foot room in the Mission District and is addicted to fentanyl. Our conversation has been lightly edited for length and clarity.

Q: This project reflects an important commitment from Crónica. You interviewed over three dozen people, including several regular fentanyl users, and spent a year doing so. Why did you decide to invest so much time?

Thadani: Instead of writing another one-off story, I really wanted to bring readers closer to the lives of people affected by addiction. Then I met Anthony by chance and started to develop a relationship with him. We took Stephen, and he went from there. When we started this in February 2021, I thought it would take a month or two.

Lam: It took time to build trust. Anthony was very open when I met him. But I still took the time to meet here and there. Maybe after a few months, I was finally able to visit him in his room. As the project progressed, there were times when I would spend half a day sitting in his room without a camera, just watching him and hanging out with him when he played video games.

Thadani: If it hadn’t been for Stephen’s persistence, we wouldn’t have reported a story as deeply as we did, especially with the footage. The amount of time he spent with Anthony was insane. They watched almost an entire season of Squid Game on Netflix together, and no photos were taken during it. That was just the time spent maintaining this relationship.

Anthony Alexander wearing a mask in the rain, San Francisco, CA.Anthony Alexander, one of the people the Chronicle followed: “The contours of Anthony’s life now at 42 (addiction, homelessness, depression) were not part of his plan,” the Chronicle reported. Photo: Stephen Lam / San Francisco Chronicle

Q: What were your editors’ reactions when they saw you develop these relationships?

Thadani: I think they saw the potential very quickly. Getting this access with trusted people is unique. My editor asked me to explore the idea of ​​what it takes to overcome an addiction to fentanyl. We got Anthony and another man into a unique precontemplative space where they said out loud, “Maybe I want to make a change.” We knew that if we spent more time with them, we might be able to capture them going through the ups and downs of trying to overcome addiction. And that’s exactly what ended up happening. One day Anthony came to us and said, “I’m going to the health center tomorrow.” And I said, “Oh my God, we’re coming with you. This is so exciting.” The next day he got there and asked for a detox. The nurse said, “There are no beds today. There is nothing available.” And then he left. To see him rejected was truly infuriating.

Lam: It was heartbreaking. We entered the center. It was very quick, and Anthony got out and quickly walked two blocks to the Tenderloin District. We walked over and he told us to wait a second, he disappeared and then came back with some fentanyl and started smoking right in front of us. Everything happened so fast. I could not believe it. He finished smoking his fentanyl and got on the bus and went home.

Q: Your project made it clear how useful it would be if the real-world system reflected the interconnectedness of job training, stable housing, addiction treatment, and physical health care, and that this kind of of services are not currently connected in this way.

Thadani: It was just a glimpse of how deeply disjointed the system is. There was no one to sit down and talk to Anthony about what the options were. We thought it was going to be the story of recovery and a guy who beat the odds. Unfortunately, it ended up being another story about how things could have lined up for him if the system worked. He is a perfect candidate for recovery who knows he wants to make a change in his life. He’s ready for it, but instead he ran into all these barriers. I saw it as the harsh reality of addiction colliding with a cracked San Francisco system. The crux of the problem is that the system is fragmented. With addiction, you really need to catch someone at that exact moment where their brain chemistry is aligning. They are fine that day. They decide they want help.

Anthony Alexander walking near City Hall, San Francisco CA.Anthony Alexander walks past San Francisco City Hall after being told no treatment beds were available. “Despite the death toll, San Francisco leaders have not treated the fentanyl crisis as the all-hands-on-deck emergency that many residents and advocates recognize,” the Chronicle reported. Photo: Stephen Lam / San Francisco Chronicle.

Q: What surprised you the most?

Thadani: I was amazed at Anthony’s determination and how much he wanted to stop using drugs. I think he is the most remarkable person because he would always take these steps. I went in and said, “It shouldn’t be like this. You deserve better housing and you shouldn’t live like this.” He wasn’t angry. He was resigned to it. I don’t think he even thought he deserved better, which he didn’t. it’s true. he does. he deserves so much better than him.

When he tried to quit smoking, you would see his behavior change a bit. And it was usually around the fifth day that I relapsed, because I couldn’t deal with it. As strong-willed as he was, he was no match for this drug. It is very difficult to stop using it alone, without help. I hope the readers have taken this away that it is not easy and many people with addictions are trying.

Q: What reaction have you gotten from San Francisco policy makers?

Thadani: Catherine Stefani, a member of the San Francisco Board of Supervisors, presented the article at a hearing on the city’s response to overdoses and at other public meetings. Another supervisor, Hillary Ronen, told me the story was a clear example of how the system doesn’t work because it doesn’t accommodate the realities of addiction. Many people can figure out how to navigate the system if they have the resources, money, time and mental space to do so. But this system is not tailor-made for the people with addiction it is meant to serve.

Q: I couldn’t help but wonder how Anthony felt when you follow him so closely. Was Anthony comfortable being scrutinized by reporters for an entire year?

Thadani: There was a part of him that was proud to be a part of this piece. But we never took that for granted. We would consult with him a lot. I’d say, “We know this is weird. We’re just here with you and peppering you with questions for hours at a time. If we ever cross a line or you just don’t want to be a part of this anymore, let us know and we’ll move on.” back.” And he always said, “No. I like talking to you.” And I think for him, I guess we were just people listening, which he hadn’t really had before.

Q: Stephen, the photos with this story are very compelling. What did you want the reader to learn from your images?

Lam: We were very intentional about how much we showed him smoking and when, because again, the point of the story is that he’s so much more than that. We were very conscious of reflecting that in how we portrayed him.

Fentanyl use in San Francisco, CAAnthony Alexander “isn’t worried about dying from fentanyl. What scares him most is a life strangled forever,” the Chronicle reported. Photo: Stephen Lam / San Francisco Chronicle

Thadani: This was a good example of what can happen when a newspaper has the resources to publish an important story that reporters really believe in. There were something like 20 people who contributed to this effort, but that may be an undercount. This was a lift for the entire newsroom. The amount of time and resources and people and meetings it took was enormous. I am very grateful that it was a very large group of people working on this, who were very diverse in age and background. It was a great asset, there was room for people to have their say, and that made it a more empathetic piece.

There were times when I thought, “I don’t want to do this anymore. i want to leave it I give up.” But I’m grateful that they kept pushing us to make it better, to spend more time. It was hard but it was definitely worth it. I was so proud to be a part of this place.

As a local newspaper, we are on the ground every day covering the addiction crisis in San Francisco. Chronicle reporters have maintained a steady focus on this issue for several years by covering town meetings, filing public records requests, walking the Tenderloin and interviewing elected officials. I firmly believe that our constant coverage of the issue has attracted more attention and action from the City Council. Without strong local newspapers, communities lose this important voice. It’s a good reason to subscribe to local news.

Lisa Aliferis

Lisa Aliferis is a senior communications officer focused on CHCF’s work to improve the integration of physical and behavioral health care, particularly in Medi-Cal, and to advance market research and analysis publications of the foundation Read more

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Marissa Leshnov is a self-taught portrait and documentary photographer based in Oakland, California. It often focuses on the disproportionate impacts on people caused by America’s political and cultural systems, as well as the people working to bridge the gaps of inequality. Marissa contributed to a Marshall Project article on the life-altering impact of police dog bites, an investigative story that received the 2021 Pulitzer Prize for National Information. She was one of 10 photographers nominated for the 2020 Atlanta Celebrates Photography Ones to Watch list. Marissa is a frequent contributor to the New York Times, The Wall Street Journal, The Guardian, and the San Francisco Chronicle.

Source: Patience and commitment help reporters capture the harsh realities of fentanyl addiction