Hungry for answers: Fentanyl town hall confirms a community plague and crying need for a better response

town hall
Panelists for the fentanyl town hall Monday night.

A crowd of 175 heard and talked with a panel of local experts about the fentanyl plague that is increasingly targeting young people in Santa Cruz County. The town hall offered a start at confronting numerous knotty issues that were raised in the recent Part 1 of Lookout’s “Poisoned” series.

Concerns and fears were met by information and empathy Monday night during a well-attended virtual town hall and listening session on the ever-present fentanyl crisis attacking an increasing number of young people in Santa Cruz County.

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A panel of experts from all sectors it touches — education, medical, behavioral and public health, addiction services, law enforcement — faced a crowd of 175 people hungry for information and feedback.

The topics ranged from talking to children about fentanyl to why it’s hidden in so many other drugs to every conceivable detail about the potentially life-saving anti-opioid drug Narcan (naloxone). SafeRx, under the umbrella of the Health Improvement Partnership (HIP) of Santa Cruz County, pulled together the meeting, the culmination of many non-public talks among those who have seen the crisis build over years.

The county plans to use Monday night’s feedback as a precursor to a larger discussion on the topic in June.

SafeRx presented for 25 minutes and the next hour was dedicated to taking written questions from the crowd for the panelists to help answer both verbally and in the Q&A chat.

Among the key participants: county coroner Stephany Fiore, Johanna Schonfield from the district attorney’s office, deputy public health officer Dr. David Ghilarducci and Dr. Alexander Threlfall, the county’s chief of psychiatry.

Panelists didn’t sugarcoat the problem, or the concerns it raises for a community that saw the number of teenagers lost to a fentanyl overdose quadruple in 2021. And there is little doubt the power of inquiry and concern is pushing the issue forward at an important time, since the 2022 trend line isn’t looking any more promising.

“We’re seeing a lot in the younger age groups,” Fiore confirmed, speaking to the trend of 2021 data and preliminary findings in 2022. Her latest data, presented by SafeRx at the session, shows that 2022 overdose deaths are tracking similarly to 2021’s record-setting pace, largely, the evidence shows, because of fentanyl’s presence.

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(Via SafeRx)

“Drug deaths, in general, tend to peak with people in their 50s. With fentanyl, we’re seeing it peak in the 30s and drift down into the teens. It’s something that I haven’t seen since I’ve been here in the last eight years.”

Monday’s event emerged after weeks of interviews and conversations Lookout had with numerous community stakeholders about fentanyl, and which produced Part 1 of Lookout’s “Poisoned” series. This news organization came to it as a topic being discussed increasingly loudly on social media, or in text threads with friends and acquaintances, with little more than a peep from the offices of public health, law enforcement or elected officials.

Lookout wondered whether the community concerns being expressed were real — nearly two dozen interviews confirmed they were — and, if so, why we weren’t hearing more about it as a community.

Part 1 of our series outlined many of the problems evident in the community’s ineffective response to the rising tide of fentanyl-related deaths. Those issues ranged from communication gaps between the coroner’s office and county public health to an inconsistent and still-developing law enforcement approach to seeing fentanyl overdoses as “poisonings” that can leave a drug dealer, or even a friend of the victim, facing murder charges.

Monday’s meeting took a step toward alleviating concerns — many expressed by the front-line sources themselves — that stakeholders weren’t coming to the table together to confront these challenges, and the public, head-on.

“People don’t have enough information about this,” was a refrain heard multiple times over multiple conversations.

After Monday night’s meeting — which will be available for replay — there will be a new proactive resource guide that could become a valuable community repository for parents, teachers, administrators and anyone else who has an unanswered question. Officials expect the video replay and Q&A portion to be available on the HIP website by Tuesday afternoon.

Among the roughly 100 questions asked, a few main themes emerged that are also consistent with what Lookout had heard from others.

  1. Parents are seeking good information to share with their kids.
  2. Information available in schools is lacking.
  3. Narcan (naloxone) information is not widely available.

Those are the lifesaving tips that could change the course of events for an unsuspecting young person, or their family, all panelists seemed to agree.

Some of the panelists for Monday night's town hall and listening session on fentanyl.
(Via SafeRx)

Many who participated in the Q&A expressed gratitude for the thoughtful group of panelists brought together by SafeRx leaders Rita Hewitt and Dr. Jen Hastings.

SafeRx is the local leader on improving safety and reducing stigma around opioids and other addiction disorders.

A handful of community members who had experienced the pain of losing young loved ones added their stories and questions in the Q&A — as well as their concerns about what steps are being taken to ensure other young people aren’t next.

Santa Cruz Police Department detective Carter Jones answered a question from a pained grandfather who said he lost his 26-year-old granddaughter in October as she and three friends used cocaine in Derby Park on Santa Cruz’s far Westside.

“She didn’t die of an overdose, she died of poisoning,” he wrote. “The cocaine that was purchased by a friend was laced with fentanyl.”

Jones confirmed that the SCPD finds signs of fentanyl’s existence all over town and cautioned that awareness has never been more important.

Assistant District Attorney Schonfield was brief in reiterating that her office has not yet seen a case that rose to the level of fentanyl-related homicide charges.

“If and when a police agency in our county brings us a case with sufficient evidence to establish guilt beyond a reasonable doubt for a death caused by fentanyl poisoning, then we could file homicide charges,” she said. “We’ve not been presented with that type of case yet.”

Fiore had been unresponsive to interview requests for Part 1 of this series. But she reached out to Lookout via email on Monday with information on the latest data she has culled and an explanation for her previous silence: “I wasn’t trying to be evasive,” she said. “Just doing the best I can.”

Fiore has been the chief forensic pathologist for the Santa Cruz County Sheriff-Coroner’s Office since 2014, which means she has tracked the area’s drug death trends since the early days of the opioid crisis.

She watched opioid deaths drop over several years from the county’s efforts to curb the number of prescriptions doled out, saw the rise of heroin and methamphetamine overdose deaths in 2018 and 2019, and now she’s in Year 3 of watching the fentanyl epidemic unfold.

Her latest data shows that 2022 overdose deaths are tracking similarly to 2021’s record-setting pace — largely, the evidence shows, because of fentanyl’s presence.

“Fentanyl is definitely here and doesn’t seem to be going away,” she told Lookout before Monday’s town hall. “I did another OD case today that is likely fentanyl, and just got two new tox reports back with fentanyl detected in both.”

Fiore added that her office’s handling of the issue is backed-up, given its resources meeting a caseload that has ticked upward by 30% the past two years. “We don’t have an automated way of compiling these stats,” she said. “It’s all done manually by me and it’s very labor-intensive.”

Fiore told the town hall group that the prevalence of fentanyl in cocaine, and even possibly in marijuana, is just a modern reality with the street drugs our community is facing.

“If you’re buying these drugs off the street right now, it’s Russian roulette,” she said.