Quick Take
Santa Cruz County recorded 101 opioid overdoses in May, spiking above the monthly average of 70 to 80 for the previous months of 2023. Santa Cruz County Deputy Health Officer Dr. David Ghilarducci points to a changing street drug supply as a possible culprit, as the county expects to see more than $20 million in opioid settlement funds over the next decade.
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Santa Cruz County has seen an alarming rise in opioid overdoses in recent months, including a man found dead of a suspected overdose in Capitola this week. Public health officials point to changes in the composition of street drugs as one likely reason for the region’s escalating overdose crisis.
On Wednesday morning, Capitola police found a deceased 36-year-old man near the Bay Avenue Highway 1 overpass in Capitola. Capitola Police Chief Andy Dally said that though investigators have not yet determined an official cause of death, the paraphernalia in the man’s possession indicates he died of a fentanyl overdose. If so, that would make it the county’s third recorded fentanyl overdose death of 2023. Two others died of overdoses in May.
Santa Cruz County recorded 101 total overdoses last month, higher than any one-month total in 2022. There has been an average of 70 to 80 overdoses a month since January, higher than in much of last year, when overdoses ranged from 32 to 86 per month.
As of Thursday, the county had seen 19 overdoses in June, indicating a return to pre-May numbers, said Santa Cruz County Deputy Health Officer Dr. David Ghilarducci. He added that those numbers come with a big caveat.
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“This is all EMS [emergency medical services] data, so these are only cases where 911 was contacted,” he said. “There are likely many more that we don’t know about.”
Jen Hastings, lead physician for SafeRx Santa Cruz County — the part of the Santa Cruz County Health Improvement Partnership most involved with harm reduction, drug awareness and combating the opioid crisis — said that the high rate of overdose or fentanyl poisoning is a harsh reality.
“I am not surprised. They will be ongoing,” said Hastings.
The opioid crisis has been a scourge in Santa Cruz County for the past several years, largely driven by the synthetic opioid fentanyl. From 2020 to 2022, the county saw overall overdoses rise almost monthly. In fact, the crisis has been so acute 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 manufactures, distributors and pharmacies to compensate state and local governments for the country’s opioid crisis. The county’s Health Services Agency will hold a town hall in July during which members of the public can advocate for various ways to use that money.
Ghilarducci said that the May spike and heightened 2023 monthly rates have a few possible explanations, most notably a change in the street drug supply. Fentanyl is increasingly finding its way into street drugs, which has caused some users to develop a higher tolerance to the drug over time, ultimately leading to a increased risk for users, said Ghilarducci.
“The street supply is very erratic — you could go to your supplier and get a dose and have an expectation of how strong it is, but that can vary dose to dose, day to day,” he said. “They may get surprised by a very strong amount that sends them into an overdose.”
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Other dangerous substances are also being added to street drugs. Xylazine, colloquially referred to as “tranq,” is a powerful animal sedative used as a cheap way to lengthen the effects of a fentanyl high. Ghilarducci said that although he could not confirm that tranq is in the local drug supply, he believes that it is present. Narcan, which is used to reverse the effects of an opioid overdose, is not effective against tranq. Ghilarducci said that while there are ongoing efforts to create treatment protocols for those suffering from xylazine withdrawal, there is no available treatment for a xylazine overdose.
Health care and harm reduction professionals say they hope that the advent of over-the-counter opioid overdose reversal medications could increase access to potentially life-saving treatments, even if their price and whether they will be covered by insurance are still major questions.
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“I think it will reduce barriers and stigma to treatment. They might be reluctant to ask their doctor for a prescription or embarrassed if they feel that they’re at risk,” said Ghilarducci.
But for Hastings, those unknowns are still too big: “Unless the price comes down, I am not optimistic that over-the-counter availability will increase access.”
Given those accessibility barriers, and the opioid crisis’ toll on youth, SafeRx is partnering with the County Office of Education to host a Narcan distribution pop-up at Watsonville High School on Saturday, June 17.
