With the Fentanyl crisis reaching epidemic proportions, a renewed push in the Bay Area seeks to stem the steady supply of a deadly drug that has wreaked havoc across the country.

On Friday, Gov. Gavin Newsom officially tasked a cadre of California National Guard and California Highway Patrol officials to fight the rampant rise of fentanyl in San Francisco. Now, leaders from Northern California’s largest city say they, too, would welcome state help.

“The enforcement side is incredibly important,” San Jose Mayor Matt Mahan said in an interview. “We are really understaffed. So do we need more help there? Yes.”

In San Jose, 96 accidental overdose deaths were attributed to fentanyl in 2022, according to data from the Santa Clara County Coroner dashboard. San Francisco had 620 accidental fatal fentanyl overdoses, according to the Office of the Chief Medical Examiner — 85% more deaths than San Jose, which has about 200,000 more residents.

At the same time, Mahan said some of the focus should be on getting people into involuntary drug treatment where they could stay for months to detox — an option that doesn’t exist in the capacity that’s needed.

The debate on the best strategy to fight fentanyl — punishment, prevention or both — comes as the city made national headlines late last month after a San Jose police union official was arrested on suspicion of trafficking the drug from China and India. It’s the type of crime that San Francisco officials and their state counterparts say they will recommit to snuffing out.

It is unclear whether the governor will be offering help to other municipalities in the same manner — or how many law enforcement officers will be deployed when the crackdown on fentanyl suppliers starts on Monday.

“When launched, we expect this operation will create positive ripple effects across the state, including in the Bay Area and San Jose,” said Izzy Gardon, a spokesperson for Newsom.

In his announcement, the governor said the state will collaborate with San Francisco police and the district attorney’s office — and clarified that the crackdown was not targeting those who are addicted, but to dismantle the fentanyl trade. Fentanyl is an extremely potent synthetic opioid that is 50 times stronger than heroin — and can be found in illicit Adderall and painkiller pills. Its ingredients are usually made in China and then manufactured in Mexico.

“Those who traffic drugs, guns and human beings are not welcome in our communities,” Newsom said Friday. “That’s why we’re launching this operation. This is not about criminalizing people struggling with substance use — this is about taking down the prominent poison peddlers and their connected crime rings that prey on the most vulnerable, and harm our residents.”

Across California, fentanyl overdoses make up one in five deaths among those ages 15 to 24 last year, according to an analysis by the Bay Area News Group.

San Jose councilmember David Cohen — an opponent of some of the mayor’s more hardline proposals on issues such as homeless encampments — agrees with Mahan that the city needs more state resources to battle fentanyl drug trafficking. He squarely put the responsibility for combatting traffickers on the state and federal government.

“Any kind of help we can get would be great,” Cohen said. “I do know that we would be grateful to have it.”

Instead, San Jose’s resources should be spent on prevention efforts like providing a wide supply of Narcan, a medicine that can reverse an overdose and save lives, Cohen said. Efforts are already underway at the local and state level to get Narcan, also known as Naxolone, into places like libraries and schools. On Thursday, a slew of fentanyl-related bills passed the state legislature, but three focused on penalizing dealers and those possessing large quantities of the drug failed.

Some in the South Bay’s medical community are skeptical about the governor’s plan.

“What I see helping people is not law enforcement but treatment, treatment treatment,” said Dr. Rachel Sussman, a primary care doctor who works at San Jose’s O’Connor Hospital and specializes in addiction medicine. Those facing drug addictions “will just go elsewhere. They’ll try harder. They’ll buy less safe versions (of drugs) like xylazine. I just worry it is sort of like one gopher pops up and you bop it down.”

Getting addiction treatment is exceedingly difficult, Sussman said. She cited an example of a small business owner she’s been treating for a 30-year-long opioid addiction and whose wife works in the healthcare industry. His journey to get treatment was immensely challenging as he navigated the complexity of the health insurance industry.

And for San Jose’s homeless residents facing addiction issues, these challenges are even steeper, Sussman said. Outreach to those in San Jose is especially difficult because it’s homeless population is spread out and reside along out-of-the-way areas like the city’s rivers.

San Jose’s epidemic “is a little less visible and less in your face,” Sussman said. “It would be such a shame for this kind of law enforcement measure to go through without a corresponding level of help. People are going to be desperate — unless they have access to treatment.”

Others, like Councilmember Pam Foley, are waiting to endorse Newsom’s plan until it bears results — and emphasized that a weak mental health infrastructure is partially to blame for the crisis.

“The governor’s position is one tool,” she said. “Will it be successful? That remains to be seen. If you take away the demand, the supply moves elsewhere or goes away. But I’m not naive to think it’ll ever go away.”