As fentanyl’s painful death toll grows in Santa Cruz, taking young lives, it’s time for meaningful solutions

At the highest levels of government, among those battling the now decadeslong opioid addiction crisis, claims of victory can be heard thanks to a recent $26 billion settlement against OxyContin producer Purdue Pharma and three other companies.

But there is nothing to celebrate in the home of Sophie Veniel, a longtime Santa Cruz resident, French teacher and mom of two who in January lost her 26-year-old son, William, to counterfeit Xanax laced with a lethal fentanyl dose.

“This cannot keep going on,” she said, choking back tears. “Your whole life is just shattered.”

On so many seemingly peaceful Santa Cruz County streets, two years into the isolation of a worldwide pandemic, the loss of young lives cut short thanks to pain, trauma and addiction — and sometimes just to a single pill popped for fun at a party — has hit a troubling crescendo.

The county’s fentanyl fatalities quadrupled year over year in 2020, totaling 20, according to a December presentation by the coroner, Dr. Stephany Fiore. It was in 2021 that the problem shot to another level with a preliminary report of 29 fatalities in just the first nine months of the year, with the anecdotal evidence showing no decline in the seven months since.

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PARTS 2 & 3

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Fiore, who falls under the auspices of the sheriff’s department, didn’t respond to multiple requests for updated data or anecdotal observations about how the community has fared since her December presentation.

But according to those who get regular preliminary reports from Fiore, and to the stories of grieved mothers such as Veniel that the community has been left to sort through on social media channels, it’s clear that the problem has not improved.

“We’re seeing the worst-case scenario: The number of deaths is going up and the age of those dying is going down,” said Rita Hewitt, the program manager for SafeRx, part of a county health coalition called the Health Improvement Partnership, and the de facto leader in the local effort to troubleshoot the opioid and addiction problem. “Sadly, it’s going to get worse before it gets better. The wave is just starting to hit us.”

Santa Cruz isn’t unique to an opioid overdose crisis that has killed an astounding half-million Americans the past two decades, according to the Centers for Disease Control and Prevention. Fentanyl, the same evil infiltrator that first stormed the Eastern Seaboard two years ago, has now come raging west.

It’s the same deadly synthetic opioid that has been pouring across the Mexican border, and finding its way from China, for years. Only it is no longer a bit player because it is cheap, addictive and can be easily added to other drugs. Why? Because, from a business sense, experts believe, it hooks a clientele instantly on a certain product — even if it eventually has the potential to kill them.

While opioids have long taken lives, fentanyl has become its deadly black mamba thanks to a makeup that is 50 times stronger than heroin and 100 times stronger than morphine. Most of the record 100,000 lost lives to opioid overdoses in 2021 were related “primarily to fentanyl,” the CDC reported. Of California’s 5,502 overdoses in 2020, 72% were related to fentanyl.

Alarmingly, the opioid overdose death rate among U.S. adolescents, driven by fentanyl, nearly doubled from 2019 to 2020, and a recent study confirmed that the trend has not shifted — neither here nor anywhere in America.

The poisonous nature of fentanyl, and an uptick in young people dying after ingesting another drug in which fentanyl was lurking, is giving health departments, law enforcement agencies and leaders of local jurisdictions whiplash.

Street drugs mimicking prescription drugs, increasingly popular with young people and found easily on social media, are a major culprit. Xanax, Adderall and Percocet are the most mimicked due to demand from young people, experts say.

“We’ve got to get the word out to kids that these counterfeit pills will kill you,” Paul Di Lella of the Drug Enforcement Administration told a group of county leaders in December.

“This is a crisis — fentanyl is everywhere right now,” Santa Cruz County Assistant District Attorney Johanna Schonfield, who is in charge of prosecuting drug cases, told Lookout. “I don’t think I can overstate the danger that this presents to our collective community.”

That’s why SafeRx, the county’s substance-use safety coalition, will gather leaders from the local medical, public health, criminal justice and nonprofit sectors, as well as Fiore, the county’s chief forensic pathologist, to participate in a virtual community town hall meeting Monday night from 6-7 p.m.

The meeting presents a valuable opportunity for Santa Cruz County leadership to get the message out about the deadly nature, and prevalence, of fentanyl.

Lookout spent a month interviewing, and having wide-ranging conversations with, those on the front lines, and also reviewed a December meeting and presentation given by Fiore that provided a stark look at the fentanyl trend. That was nearly five months ago, and local experts say the trend has not reversed.

Lookout’s own findings provide important insights into how, as in many other places across the state and country, fentanyl has snuck up on this community with little warning. And they also illuminate the strong, swift action it will take from local leadership to head it off. Our key conclusions:

• Santa Cruz County will need a more closely coordinated effort among law enforcement, doctors, pharmacists, educators, emergency responders, addiction specialists, elected officials and those in public health to address the crisis effectively. No one denies that some important conversations aren’t happening.
• Parents, kids and the general public desperately need more information on this topic, including understanding the life-saving role played by Narcan (the brand name for naloxone), the opioid antagonist nose spray that can instantly save a life.
• Educators need to play a more active role in that process, providing information and training to their teachers, students, nurses and families on fentanyl’s persistent presence in street drugs and the “fire extinguisher” effect Narcan can have if it’s available when needed in an emergency.
• Closer communication between public health and the coroner’s office is essential to staying on top of trends that could be harmful to the community and need to be relayed to the public. Toxicology reports can take many months, so any information on overdoses and deaths gleaned by the coroner need to be automatically relayed to public health, which then has the onus of alerting the community.
• The criminalization of drug deals that lead to fentanyl poisonings is still developing. Some prosecutors around the state, most recently in Riverside and Santa Clara counties, have begun to pursue murder charges. Locally, Schonfield says her office hasn’t yet seen such prosecutable evidence and is working with local police on the type of detailed investigative procedures that could allow such prosecution.
• Important programs that didn’t get funded during the pandemic — including a widely used mapping system that can head off fatalities — need funding. Santa Cruz County is expected to receive a $20 million windfall from the Purdue Pharma settlement, which could be used for that program and others more specifically targeted at addiction services.

Nearly everyone Lookout spoke with agreed that the biggest barrier for this community to increasing awareness and prevention is breaking the stigma attached to drug use and addiction. Keeping addiction hidden prevents mobilizing those — whether in an emergency room, doctor’s office, pharmacy, workplace or home — from coordinated and effective responses.

“People need to understand that addiction is something that runs through our community. It doesn’t matter how much money you have, it doesn’t matter where you live, it doesn’t matter what school you go to,” Santa Cruz County Sheriff Jim Hart told Lookout. “These drugs that are killing people; they don’t differentiate between a homeless person or somebody who’s living in a multimillion-dollar home.”

Hart knows firsthand. He lost his 27-year-old nephew, a grad school student trying to beat addiction, to a fentanyl overdose in July 2020.

The collision of pandemic and epidemic has overwhelmed many people, but especially our young people, says Dr. David Ghilarducci, the county’s deputy public health officer and an emergency-room doctor.

He said it’s been devastating to watch the age of those being fatally poisoned by fentanyl drop, and he senses a definite correlation between the struggles many kids face to get adequate mental health care and an honest assessment of how they’re doing two years into the pandemic.

His advice to parents: This is no time to have your head in the sand.

“The war on drugs has largely failed because we look at the problem too simplistically,” he said. “Kids will access drugs if they want them. You can’t lock the kids at home, but you can educate them and talk to them ahead of time about what’s going on out there.”

Wherever the breakdown, young people aren’t getting a very important message about the high stakes of ingesting anything off the streets, he said.

“It’s not just a party — it could be the last party.”

‘I can’t be the next mother holding a picture of her son’

Sophie Veniel wishes she wasn’t too scared to go after the drug dealer who “murdered my son.”

Instead, she suppresses the anguish and says she is dedicated to educating herself about what more she could’ve done to save William’s life — hoping to pass along lifesaving tips to other parents.

“The message right now needs to be: There is no room for experimentation,” she said. “Young people think they are immortal, that it can’t happen to them. But right now you’re not touching anything that came from the street.”

And that should include cannabis, she says, which has recently been entangled in the fentanyl conversation, most believe as a result of accidental contact with dealers who sell the full gamut of drugs.

“Unless you grew it yourself, or it’s from the dispensary, don’t do it,” Veniel warns.

Veniel couldn’t bear to have her photo taken for this story — the pain is too raw: “I can’t be the next mother holding a picture of her son.” But she passed along some of her favorite photos that help her get through the grief each day.

A month and a half before his Jan. 7 death, William had lost a good friend in similar fashion, to a fentanyl-tainted pill, and posted to his Facebook page: “Fentanyl is killing all my friends … killing off my generation of beautiful, talented people.”

Veniel doesn’t want it to be too late for other parents. She wants them to take the measures she believes they probably don’t know about either, understanding how childhood trauma and pain can translate into anxiety and addiction if left unchecked.

Veniel says the social media moguls who are making it possible for kids to get pills delivered to their door with a simple click on Snapchat or Instagram — safely buffered from parental oversight and the law — should be held accountable for preying on a vulnerable population of struggling young adults.

“I moved here in 1989, and I don’t recognize the place,” she said. “Kids are lacking mental health support. There is a lot of trauma. There is a lot of poverty. There is a lot of desperation. And high tech needs to be accountable. They know it’s happening. A drug dealer doesn’t have to make a phone call, and he can reach thousands of kids in a minute.”

Veniel knew William was struggling with anxiety and said trying to get him adequate help through their private insurance provider was “a nightmare.” They had had conversations about the dangers lurking in street drugs. “I kept telling him to be safe. ‘Yes, Mom, I’ll be safe,’” she said.

But now she thinks he had perhaps been hooked by a fentanyl-laced pill years earlier and had simply been surviving the game of Russian roulette until that January evening.

“The addiction to fentanyl is impossible to fight — you’re either going to die or be fighting that addiction your entire life,” she said. “I hadn’t realized that before I lost him.”

As she attempts to process those facts, while dealing with the unbearable pain, Veniel also has one other key educational point to punctuate. She wants the world to stop referring to what happened to her son as an overdose.

“He was poisoned,” she said. “He was murdered.”

An eye-opening December meeting

What began as a regularly scheduled annual meeting on county overdose deaths in early December, with county coroner Fiore presenting her latest findings, turned into a wake-up call about how fentanyl was killing younger and younger people.

“(Fentanyl) was always kind of a background noise until 2020, then it started shooting up,” Fiore told a large group via Zoom. “The youngest had been 19, but I just got my first 16-year-old who is probably going to be a fentanyl overdose, so it’s starting to seep into the juvenile age group.”

That November death of Lace Price, days from her 17th birthday, at a home in Corralitos, led to multiple charges against 23-year-old Michael Russell, but not the murder charges her family believes were warranted.

Though neither Assistant District Attorney Schonfield nor Sheriff Hart would comment on the case or specific charges, it is believed the district attorney’s office didn’t feel it had evidence to pursue murder charges because the sheriff’s office hadn’t treated the case as a homicide at the scene of the death.

Schonfield, who will be part of Monday’s town hall, did speak to Lookout more generally about how the tide is shifting in terms of treating certain overdose cases differently in the fentanyl era.

“There’s definitely a mind shift in how we’re looking at these cases because of the toxicity of fentanyl and because it’s not what people think they are taking,” she said. At the same time, there is not yet proof from other cases around the state that murder charges against the person who provided the drug will become a new norm.

“Emotions run high, especially when a child is lost, and people want these serious charges,” she said. “And I really feel for these families; it’s devastating. But we need to be able to prove guilt beyond a reasonable doubt, and that’s not easy in most of these cases.”

Fiore, who local leadership says studies and tracks these trends at a meticulously detailed level, declined to make herself available for an interview with Lookout. She will, however, be part of the panel at Monday’s town hall.

And her December presentation offers clues to what she will cite Monday. It charted 49 fentanyl-related overdose deaths from January 2020 through September 2021 — 29 of which occurred in those first nine months of 2021, preliminary data shows. Among the key findings:

• More than half of the deaths happened in people’s own homes rather than on the streets or in a park, where many assume this problem predominantly exists.
• Once considered a white, wealthy person’s affliction, like all opioid addictions, the trend showed an uptick in its effect on the Latino community beginning in 2020.
• Increased cases marked both teenage and young adults in their 20s — illustrating the larger trend of young people experimenting with pills.

Experimentation with addictive pills starts for many in their own medicine cabinets — often ones prescribed for young people, who are the most likely to undergo common procedures such as the removal of wisdom teeth.

A habit often picked up with legally prescribed pills will then continue via the street or dark web when the ability to get a legal prescription dries up. And that’s when it gets far more dangerous.

While the county has made great strides in reducing opioid prescriptions — the number went from 270,000 prescriptions in 2012 to 107,000 in 2020 — those numbers have their own ironic dark side. Making it harder to get drugs legally has opened up a gold mine for drug dealers dedicated to peddling toxic fentanyl.

“In many ways I wish we were still having doctors overprescribe,” Monterey doctor Casey Grover said in the meeting, “because at least we knew what was in those pills.”

What’s happening at our schools and universities?

Carrie Luther remembers the rapt gymnasium full of teenagers she stood before only months after her 29-year-old son, Tosh Ackerman, became the county’s first notable fentanyl death, in 2015.

“It was two different assemblies of 1,000 kids each, and you could hear a pin drop in that room,” she said. “They could really connect to who Tosh was.”

Luther has become the exception to the unwritten rule, the one that says far too many parents of children who die from drugs fall into a world of stigma, shame and silence. Instead, Luther has taken her son’s death as a calling to help educate people and destigmatize a topic that touches the lives of far more people than most want to admit.

She has talked to health classes at Aptos High School, PE classes at Watsonville’s Lakeview Middle School and that packed gym at Soquel High that elicited tears and many hugs afterward. Her message is simple.

“I emphasize that my son was just like you — and you need to know that,” she said. “He had so much more to do still in his life. He had a good job, he was a great athlete, he did good in school, and he had a future ahead of him.”

Luther is concerned that the awareness level in schools, with parents, with kids, has actually waned as the deaths have increased. Her family was featured on ABC’s “20/20" and in the Wall Street Journal in the years after Tosh’s death. She traveled to Washington to help lobby and advise on how fentanyl is destroying families.

“Kids are being preyed upon and everyone needs to be more aware of that,” Luther said.

Experts say some education has happened at the high school level locally, but not nearly enough to spread necessary awareness. Marin County innovated a program called “Let’s Talk” — predicated on the reality that teens are “hardwired for risk” — that SafeRx is using to help the Santa Cruz County Office of Education craft a version for ninth graders. Educators here also are discussing the integration of such programs into middle schools, where the culture of experimentation often begins.

Jennifer Buesing, who is in charge of school safety for the County Office of Education, acknowledges a growing awareness that extra education is needed outside of just health class — and that stigmatization has only worsened the problem.

“We used to think about heroin and associate it with a certain group of people, not our students,” she said. “Now, we’re trying to bring awareness to all of our students and say things like, ‘You think you’re going to a party, and you take a pill and you think it’s safe’ … but with fentanyl, everyone is at risk.”

Buesing said the availability of and education about Narcan has increased in local high schools; that’s one of middle school extension tactics now under discussion.

She also acknowledges a wider range of troubling behavior. An increase in drugs being brought to campus and an increase in antisocial, erratic behavior since the pandemic began has school administrators, staff and nurses concerned.

Buesing said her office is using funds from the Mental Health Student Services Act to identify students exhibiting signs of trauma and substance abuse.

“A lot more of these kinds of resources are coming because the need is there, and it won’t be going away,” she said.

The parents of UC Santa Cruz’s 19,457 undergraduate and graduate students have perhaps even more reason for concern given that the majority aren’t within close distance of their son or daughter. Recent overdose deaths at Stanford, including one that drew a lawsuit from parents who both work at the university, has raised awareness among parents of college students.

At UCSC’s student health center, known as SHOP, harm reduction is the focus, and the message is “Party like a Slug!”

“From years and years of failed attempts, we know that abstinence-only education doesn’t work,” said SHOP health educator Amber Parker. “People use drugs, and harm reduction doesn’t condemn that fact. We accept it as a reality and equip people with tools to do what they’re already going to do more safely.”

The tools for a potential overdose — Narcan and fentanyl test strips — are handed out “completely free, no judgment” along with addiction resources. Students who drop in can receive drug counseling and even begin medication-assisted treatment (MAT) — a holistic treatment method utilizing a combination of medication, counseling and behavioral therapy. UCSC became the first University of California school to launch such a program, in 2020.

Getting more information — and Narcan — into the hands of on-campus resident assistants, so it is always present in case of an emergency, is the next level local experts hope to achieve. Cal Poly-San Luis Obispo has set the bar by providing overdose prevention kits.

Who is leading the effort on this?

SafeRx leaders Rita Hewitt and Dr. Jen Hastings are on the very furthest front lines of the fight against opioid addiction in Santa Cruz County.

And it’s a personal battle for both of them. Like all prescribing doctors, Hastings was part of the Big Pharma problem that helped feed opioid addiction and is now in a position to help undo the damage.

Hewitt’s connection is even closer to the heart. She was on the path to becoming a pharmacist when she began losing friends to opioid addiction. More tragically, she watched her older sister become addicted to pain medication, beginning a 15-year journey of homelessness, jail time, failed rehab efforts and near-death experiences including a recent fentanyl overdose.

Hewitt, 30, swerved the other direction, got a master’s in public health, and has placed herself on the frontlines of the fight against addiction.

“I worry I could get that phone call at any time,” she said of her sister.

As leaders of SafeRx, which is part of an innovative county and non-profit-funded coalition called the Health Improvement Partnership (HIP) of Santa Cruz County, it is their job to work, in social services parlance, both upstream and downstream.

On the downstream side there is a harm-reduction focus: getting Narcan into the places it’s needed most critically, getting the mapping program in place so first responders, and even community members, can help track “bad batches” of drugs that are causing overdose outbreaks,

The upstream side entails getting individuals in need connected to addiction services such as MAT (medication-assisted treatment), while introducing others to the availability of trauma screening programs such as ACEs (adverse childhood experiences). Early on, of course, the major focus was tackling that massive number of opioid prescriptions in the county that has been cut in more than half the past five years.

Hastings’ mission is to help other doctors and pharmacists understand how they can help undo the damage by learning to administer the newest in addiction treatment drugs such as buprenorphine (an ingredient in Suboxone) and embracing the reality of Narcan as a lifesaving tool that should be in as many hands as possible right now. Because it’s affecting everyone.

“This affects your upstanding citizens, your lawyers, your doctors, your executives,” Hastings said. “I think we have a lot to do in our community to say this is not other people. This is us. And how can we connect and support each other?”

Sophie Veniel, like many moms who have lost their son or daughter, has a hard time not letting her mind drift to those responsible for supplying her son with a fentanyl-laced Xanax.

But she also knows that the key to putting drug dealers out of business ultimately comes down to supply and demand. Part of reducing demand involves increasing awareness and compassion for mental health challenges that still aren’t widely understood.

“If you have a son or daughter who has battled cancer, which is horrible, you get the compassion,” she said. “But if you have a child that is battling anxiety, that has faced trauma, then it’s, ‘You didn’t do a good job.’ Well, it’s really hard to do a good job with the way it’s all set up.”

Here is a recent documentary produced by PBS that dives deep into how this country got into the addiction crisis that it’s in.