Quick Take
The number of fatal drug overdoses has doubled in the past three years, Santa Cruz County’s chief coroner told a public meeting Thursday. The county is grappling with the devastating effects of the fentanyl crisis, with overdoses hitting a three-year monthly high in May, leading to a rising demand for treatment services and prevention efforts.
Santa Cruz County Coroner Dr. Stephany Fiore told a public meeting Thursday that her caseload of deaths involving accidental drug overdoses has doubled in the past three years as the county struggles with the escalating effects of the fentanyl crisis.
“Now, about 40% of my caseload is spent handling accidental drug overdoses, and most of that is fentanyl,” she told a gathering of about 100 community members and local officials organized by SafeRx, a local substance-use safety coalition under the Health Improvement Partnership of Santa Cruz County.
The opioid crisis has had severe local impacts for the past several years, mostly driven by the synthetic opioid fentanyl. It has been such a scourge that Santa Cruz County will receive more than $20 million over the next decade from a national opioid settlement, a $26 billion fund paid for by drug manufacturers, distributors and pharmacies to compensate state and local governments for the county’s opioid crisis.
Nationally, the opioid crisis caused about 715,000 deaths between 1999 through 2022, making it the third-deadliest event in U.S. history behind the COVID-19 pandemic and the Civil War, county Deputy Health Officer Dr. David Ghilarducci told the gathering. “The big difference is that this is ongoing and continuing to grow, so I think there’s every expectation we’ll see this rise to the very top of this list,” he said.
Fiore said there have been 115 fatal drug overdoses so far this year, a 17% increase over the 98 deaths in 2022. There have also been 61 fatal overdoses of unhoused people, an increase of almost 33% over the 46 deaths in 2022.
The county experienced higher numbers of drug overdoses in most months of this year compared to 2022, Ghilarducci said. Overdoses, both fatal and non-fatal, peaked in May, at 101 — the highest single-month total of the past three years. Most months of 2022 saw more overdoses than 2021, illustrating the harsh reality of the worsening crisis.
These figures are “most certainly an undercount,” Ghilarducci said, because they reflect only those cases where someone called 911 to report an overdose and paramedics were dispatched to assist – and also because Narcan, a nasal-spray medication that can reverse the effects of an opioid overdose, has been much more widely distributed over the past year or so.
“We probably all know of overdoses that occur every day that never reached that system.”
Ghilarducci said the level of Narcan needed to reverse an overdose is higher than it has ever been. That can be attributed to a number of factors, including nasal administration being less direct than intravenous administration, but most importantly, that the fentanyl available to drug users is more potent than it was in the past.
Santa Cruz County Sheriff’s Office Lieutenant Nick Baldrige said that sheriff’s deputies have taken just over 10,000 crime reports in unincorporated parts of the county so far this year, and about 1,400 of those involved a narcotics investigation. Over time, he said that more opioid drug users are beginning to actively seek out fentanyl due to the rising price of heroin.
“Users that started on heroin when it was really cheap are going to fentanyl for a little more bang for their buck,” Baldridge said. “We’re starting to see that transition from heroin users to users seeking out fentanyl.”
He added that many drug seizures show that there are a lot of pills on the streets that appear to be prescription drugs like Xanax, but that around half of the pills the sheriff’s office tests are actually fentanyl.
“That creates another problem because people get hooked on fentanyl that way,” Baldridge said. “Then they, too, will start seeking fentanyl following that.”
Fiore said she has not seen any fatal overdoses among people under the age of 20 so far this year, and that the majority have been among people in their 40s. White men are still the most commonly affected demographic. She also said that only 16% of people who have died from an overdose this year had never been booked into the jail system, and that 6% of those who had been incarcerated overdosed within a week of release and 11% within a month of release.
Fiore added that more than half of those who died from an overdose did not have a diagnosed mental health disorder, but she suspects that a significant portion of this group might have suffered from a mental health disorder that they had not sought medical treatment for.
Even as the opioid crisis rages locally, services to prevent overdoses, and to educate and support the community on the risks of fentanyl, are becoming more accessible and common around the county.
SafeRx program manager Rita Hewitt said that the organization has worked with the County Office of Education to educate students and their parents about the crisis, the resources available to them, and even provide training to middle and high school students on how to administer Narcan. She also said that the organization has partnered with Monterey and San Benito counties to form a collaborative project to focus on increasing substance use disorder treatment in the region. The tri-county collaborative has applied for a grant to develop an adolescent young adult learning collaborative to fund that effort.
“Our intention is really to have an equitable approach because many of our residents work, go to school and play across the borders,” she said. “I’d love to see that anyone seeking these resources or treatment has the same experience in each county.”
Hewitt lauded the Narcan popup drive-thru distribution events held at various campuses across the county. Their first one at Cabrillo College in April got about 550 doses of Narcan into the hands of caregivers, parents and youth.
She added that SafeRx’s pilot project aimed at giving Narcan to local bars has distributed more than 450 boxes of Narcan to patrons and staff of participating establishments, including the Slough Brewing Collective in Watsonville, the Rush Inn in downtown Santa Cruz, The Jury Room on Ocean Street and Moe’s Alley on the Eastside.
On the law enforcement side, Baldridge said the sheriff’s office installed amnesty boxes in the main jail in May, which allows inmates to hand over drugs in their possession without facing additional charges.
He added that the jail’s medication-assisted treatment program — a program that allows the use of medications approved by the U.S. Food and Drug Administration and behavioral therapies to treat alcohol and opioid use disorders — has 620 inmates participating this year. Baldridge said law enforcement is working to install a Narcan vending machine in the jail to allow people to get the medication freely.
But, he explained, educating youth and their parents about signs of substance abuse disorder and addiction has to be the main focus of prevention efforts, because “we’re not going to arrest our way out of this problem.”
“As long as there’s that demand, that dealing aspect is always going to be there,” Baldridge said, adding that hearing from parents who have lost children has proved to be powerful.
“I can talk stats all day, but the impact that an individual has on other parents is huge because they talk about how they were naive that it would never be their kid.”
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