The Ripple Effect, Part Six: The Illicit Fentanyl Crisis Sweeping Sacramento County

Oct 11

Drug overdose is now the leading cause of death for Californians ages 15-44 and kills twice as many people statewide as car accidents. Fentanyl, the powerful synthetic opioid that has rapidly created a significant public health and safety crisis across the nation, is involved in at least 55% of all overdose deaths. One of the key dangers of illicit fentanyl is that it is often mixed with other drugs without the user's knowledge or is the primary ingredient in counterfeit pills. Many fentanyl-related deaths occur because individuals are unaware they are consuming it, leading to fatal accidental poisonings. In all of California, fentanyl-related deaths have increased 1,027% since 2017. Numbers have increased across nearly all ages, races, ethnicities, and genders, with the sharpest increase for males, ages 18-44. Notably, in 2021, Blacks/African Americans were the most overrepresented among general overdose fatalities, representing 6% of the population but 13% of all overdose deaths, as the fatal overdose rate rises fastest among Black/African Americans, Hispanics/Latinos, and Native Americans.

The Scope of the Crisis

Sacramento County’s statistics look equally dismal: According to Sacramento County Opioid Coalition, first responders treated over 3,000 opioid overdoses in 2023 – not counting opioid overdose cases that were treated only in an emergency department – and the majority of the cases involved illicit fentanyl. Between 2017 and 2023, Sacramento County experienced over a 2,000% increase in fentanyl-related overdose deaths with 17 recorded deaths in 2017 and over 400 in 2023. This rise in fentanyl-related overdose deaths has reached alarming levels, prompting urgent calls for action from public health officials, community leaders, and law enforcement.

Chart: Phillip Reese, The Sacramento Bee | Source: Sacramento County Coroner's Office | U.S. Census Bureau

Sacramento, which includes seven incorporated cities, is one of the most diverse cities in the United States, and this surge in fentanyl-related deaths is not limited to any specific demographic group. While opioid addiction traditionally affected White rural populations, the fentanyl crisis has significantly impacted younger populations – particularly individuals aged 18-35 – and vulnerable communities such as communities of color and the unhoused. Death rates in Sacramento are highest in the midtown and downtown area, which see a higher rate of unhoused populations, and although the unhoused make up less than 1% of the total population in Sacramento, they accounted for 20% of all fentanyl-related overdose deaths. Black individuals, particularly men, in Sacramento are also significantly overrepresented in the number of related deaths, as compared to their overall percentage of the population.

Learn more about illicit fentanyl’s fatal grip on vulnerable communities

The Role of Counterfeit Pills

One of the most troubling aspects of the fentanyl crisis in Sacramento County is the proliferation of counterfeit pills. These pills are often made to look like legitimate prescription medications, such as oxycodone, Xanax, Aderrall, and Percocet but contain lethal doses of fentanyl. According to the Drug Enforcement Administration (DEA), as many as 7 out of every 10 counterfeit pills seized in the United States contain potentially lethal doses of fentanyl. In Sacramento County, law enforcement agencies have reported a significant increase in the seizure of counterfeit pills laced with fentanyl. From January to April 2024, law enforcement agencies, in partnership with California’s Counterdrug Task Force, seized more than 5.8 million pills containing fentanyl across California. Despite these efforts, the availability of these dangerous pills remains a significant public health threat.

Read about countermeasures against illicit fentanyl

Factors Contributing to the Fentanyl Crisis

Several factors have contributed to the rapid escalation of the fentanyl crisis in Sacramento County. Understanding these factors is essential for developing effective strategies to combat the epidemic.

COVID-19 Pandemic

The COVID-19 pandemic and its lingering impacts have played a significant role in exacerbating the fentanyl crisis. During the pandemic, many individuals experienced increased stress, anxiety, and isolation, leading to higher rates of substance use. In California, overdose deaths were steadily rising during the decade prior to the pandemic and then rose sharply from 63.1% to 82.7% during the pandemic period.The pandemic also disrupted traditional support systems, such as addiction treatment programs and mental health services, making it more difficult for individuals struggling with addiction to access the help they needed.

In Sacramento County, the pandemic coincided with a marked increase in fentanyl-related overdose deaths. Public health officials have noted that the pandemic’s impact on mental health and social services likely contributed to this surge. The Sacramento County Department of Health Services has reported that many of the individuals who died from fentanyl-related overdoses during the pandemic had a history of mental health issues or substance use disorders.

Availability and Spread of Fentanyl

The Sacramento County Sheriff’s Department has reported a significant increase in the amount of fentanyl being trafficked through the county, much of it originating from international sources, and the availability of fentanyl on the black market has increased substantially in recent years. Fentanyl is relatively cheap to produce and highly potent, making it an attractive option for drug traffickers. Additionally, the rise of the dark web and social media platforms as channels for drug sales has made it easier for individuals to access fentanyl and other dangerous substances. Law enforcement agencies in Sacramento County have noted that many young people are purchasing drugs online, often without knowing that the substances they are buying contain fentanyl.

While counterfeit pills containing lethal amounts of fentanyl are a serious cause for concern, so too is the increase in the powder methamphetamine and cocaine that also contain fentanyl. In Sacramento, many of the recorded cause of death stats suggest individuals who are dying from drug overdoses have a combination of substances in their bodies. This polydrug use can complicate emergency and long-term treatment.

Learn more about the complexity of polysubstance use

Lack of Awareness and Education

Despite the growing crisis, there remains a lack of awareness about the dangers of fentanyl among the general public, though efforts to educate are having an impact. Many individuals, particularly young people, do not fully understand the risks associated with fentanyl or the prevalence of fentanyl-laced street drugs.

We must continue to emphasize the need for increased education and awareness to inform our community about the dangers of illicit fentanyl. Schools, government and community organizations, law enforcement agencies, and healthcare providers all have a role to play in spreading this critical information. In our next blogs, we will discuss the impact of illicit fentanyl on our youth and what is currently being done to combat fentanyl nationally and locally.

Learn more

References

California Department of Public Health. (2024). California state of public health: Full report 2024. https://www.cdph.ca.gov/Programs/OPP/CDPH%20Document%20Library/California-State-of-Public-Health-Full-Report-2024.pdf
California Health Policy Strategies, L.L.C. (2023). Policy brief fatal overdoses in california. https://calhps.com/wp-content/uploads/2023/04/2023-04_CalHPS_CA_Overdose_Report_Final.pdf
DEA. (2023). One pill can kill. Www.dea.gov. https://www.dea.gov/onepill
Reese, P. (2024, September 3). Fentanyl-related deaths have jumped in Sacramento County. See where they are most common. The Sacramento Bee. https://www.google.com/url?q=https://www.sacbee.com/news/local/article291569480.html&sa=D&source=docs&ust=1726505632839338&usg=AOvVaw2o1Q8eXrUQxMIFrMtdjxgh
Sacramento County Coroner. (2024). Fentanyl deaths, Sacramento county. ArcGIS Dashboards. https://www.arcgis.com/apps/dashboards/0661fb44435b4611bf52be84708c4591
Sacramento County Opioid Coalition. (2024). Sacramento county opioid coalition data dashboard. Arcgis.com. https://experience.arcgis.com/experience/96fe1c89f2324013a58b80e147bc47a8/page/Demographic-data/
Thompson, D. (2023, May 22). California’s fentanyl problem is getting worse. Nobody is sure what to do. San Francisco Chronicle. https://www.sfchronicle.com/health/article/california-fentanyl-overdose-drug-18109374.php?sid=5eee736a5ed310415b371d22&ss=A&st_rid=8cdc1e97-999a-4414-a3aa-2df70fdcbdb1&utm_source=newsletter&utm_medium=email&utm_term=headlines&utm_campaign=sfc_morningfix
United States Drug Enforcement Administration. (2021, April 29). Facts about fentanyl. Www.dea.gov. https://www.dea.gov/resources/facts-about-fentanyl
Wagner, K. D., Fiuty, P., Page, K., Tracy, E. C., Nocera, M., Miller, C. W., Tarhuni, L. J., & Dasgupta, N. (2023). Prevalence of fentanyl in methamphetamine and cocaine samples collected by community-based drug checking services. Drug and Alcohol Dependence, 252, 110985. https://doi.org/10.1016/j.drugalcdep.2023.110985

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