The number of deaths from fentanyl poisoning accounted for a staggering 80% of fatalities from all opioids in 2021 in Santa Clara County, 12 times the number of fentanyl-related deaths in 2018, data from the county's Medical Examiner-Coroner shows.
So far in 2022, from Jan. 1 through May 27, the number of deaths involving fentanyl accounted for 78% of all opioid-related deaths identified by the coroner's office, according to the Medical Examiner-Coroner's public dashboard.
The shocking rise in deaths from the powerful narcotic that is being taken recreationally has sparked a campaign by Santa Clara County Supervisor Cindy Chavez and the county's Fentanyl Working Group to find ways to put life-saving medication and fentanyl test strips into the hands of schools, bars, restaurants and partner agencies.
Fentanyl is a synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine, according to the U.S. Centers for Disease Control and Prevention. Its use has become a nationwide epidemic, according to the CDC.
Other drugs are cut with the cheaper and stronger fentanyl and its analogs, such as acetylfentanyl, furanylfentanyl and carfentanil. These drugs have a chemical structure like fentanyl but they require specialized toxicology testing and aren't routinely detected. Some of these analogs are less potent, but some are stronger than fentanyl; carfentanil can be thousands of times stronger than morphine, according to the CDC.
Accidental fentanyl overdoses in the county have reached every community and every socioeconomic group. Males and females from 12 to 70 years old in nearly every city in the county have died from accidental overdoses. In the north county, fentanyl's victims included residents of Los Altos, Mountain View and Palo Alto. In April, a Los Altos High School student died from a "potential fentanyl poisoning," according to Mountain View police; fentanyl claimed the life of a 12-year-old San Jose girl in 2020.
A Stanford University student died in January 2020 from accidental fentanyl toxicity after taking counterfeit Percocet, which contained fentanyl. Counterfeit prescription pills containing fentanyl were being smuggled into the U.S. from Mexico, the university warned the campus community later that same day.
The overall number of Santa Clara County deaths caused by opioids has increased 2.5 times since 2018, when 62 people died; in 2021, that figure spiked to 163. Fentanyl-related overdoses are responsible for the precipitous rise. Fentanyl deaths as a percentage of all opioid-related deaths have quadrupled in four years. In 2018, only 11 out of the 62 opioid-related deaths were due to fentanyl, or 18%. In 2021, fentanyl accounted for 132 of the 163 deaths or 81%, according to the coroner's reports.
So far in 2022, 52 of 67 opioid deaths have been related to fentanyl; just 15 were caused by other opioids.
Alarmed by the rising numbers, on June 28, Chavez introduced a referral to the Board of Supervisors on behalf of the Fentanyl Working Group to direct county administrators to identify possible funding sources for Narcan and fentanyl test strips. Narcan is a prescription drug that can rapidly reverse an opioid overdose in an emergency. Fentanyl test strips can detect the presence of the drug in pills, powder and injectables.
If funded, Narcan and the test strips would be made available to any local school, bar, restaurant or nonprofit and community organization that would like to have them on hand and could be distributed to anyone who wants them.
By making these life-saving products broadly available, the working group hopes to turn the tide against overdoses and deaths, said Bruce Copley, director at the county Department of Alcohol and Drug Services, during a June 27 press conference.
Ed Liang, a lead investigator on fentanyl with the Santa Clara County District Attorney's Office, said during the press conference that the prevalence of mixing fentanyl with street drugs is "a time bomb." But it's known that a large number of overdoses have been saved with Narcan.
"Ultimately, it's about access and making it available" along with the educational and informational work the county is doing in the schools, he said.
Young adults ages 18 to 25 as well as middle- and high-school-aged children are the group most affected by fentanyl, according to county data. Because of the prevalence of overdoses among younger people, the County Office of Education is currently developing policies for Narcan kits and fentanyl strips in the schools, Chavez said. Stocking Narcan and test strips would be decided on by the schools and it would not be required, she added.
Some parents might feel that making these tools available would encourage drug use, Chavez conceded. But the reality is that people are using illegal drugs, and they are overdosing in increasing numbers, she said.
"While we're waiting for an ambulance, we don't want to lose a child. Timing matters," Chavez said.
On June 28, the supervisors unanimously approved the referral, which directs county administrators to return with their funding report on Aug. 16.
County Superintendent of Schools Mary Ann Dewan lauded the decision in a June 28 statement.
"We are pleased that the County Board of Supervisors unanimously approved the funding for the increased purchase and distribution of Narcan and for the ongoing Fentanyl prevention programming. The rise of opioid use in our county is alarming," she said.
"Knowing that there will be resources available to help save a life gives me hope. The Santa Clara County Office of Education will continue to work in partnership with both the Fentanyl Working Group as well as with the schools in our county to ensure information, resources, and support are readily available," she said.
The county has also embarked on community and school educational programs to raise awareness about fentanyl. In May, it launched a pilot program of discussions with county leaders to be hosted at high schools to raise awareness. The Office of Education put out a flyer with vignettes from parents of students who died from fentanyl and opioid overdoses.
This year, the District Attorney's Office's annual poster contest focused on the question, "What is the Face of Fentanyl?" and asked students to illustrate how the fentanyl-overdose epidemic is affecting them and their community. Winners were awarded on July 18.
Santa Clara County isn't alone in dealing with the rising problem. San Mateo County Health said it is also seeing a concerning increase in both fentanyl and overdose deaths.
On June 22, the San Mateo County Public Health, Policy and Planning Department issued an alert regarding an increase in overdoses after a spike in drug overdoses and deaths during the weekend of June 17 to June 20.
The suspected drugs included fentanyl and a combination of fentanyl and stimulants. The patients' ages ranged from 23 years old to 44 years old. About 70% were male and 30% were female. Fifty percent of patients died at the scene. Fifty percent of cases occurred in the north county, 30% in the mid-county, and 20% in the south county. Half of the deaths were outdoors or in a vehicle and 50% occurred in a residence.
In 2020, the county had 118 overdose deaths, representing a more than 20% increase from 2019 when there were 98. Of the 118 overdoses, 81 cases tested positive for opioids; of those, 63 of cases tested positive for fentanyl, according to a 2020 San Mateo County Coroner's report.