.Fentanyl Deaths Rise

Vicki Dowell remembers hearing a loud noise on the steps outside her condo, where son Jake, 26, had gone downstairs to help a friend change a tire. It was Dec. 3, and he had just finished putting up holiday lights.

Jake had grown up in San Jose, was getting certified to be a mechanic and making plans to marry his girlfriend. “He fell and he hit the back of his head on a railing,” Dowell says. “He wasn’t responsive at all. I dragged him in the house and started performing CPR.”

“I was on hold with 911. We’d get a pulse, then he would fade away. I worked on him for 40 minutes,” she says. The memories of just a few weeks ago are still fresh and raw, but she wants to share the story so that lives can be saved.

“He tested positive for fentanyl. The ER doctor told me. He had done what he thought was cocaine, but it was laced. He spent two weeks on life support. He eventually gave out. It was two weeks exactly.

“He was so strong and healthy. My son did a one-off decision. He made a bad decision, and it cost him his life.”

“I lost my best friend. I’m never going to experience being a grandmother. My lifeline is gone.”

The Bay Area, like the rest of the United States, is experiencing a dramatic surge in drug overdoses. San Francisco is the region’s overdose hotspot, with 435 deaths in 2021.

Sonoma County is another, with someone dying every two days from an overdose, according to the Sonoma County Department of Health. Deaths there involving fentanyl increased by 2,550% between 2016 and 2021.

Though Alameda and Santa Clara counties have less than half San Francisco’s number of fatal overdoses, the poorest neighborhoods have been hit hard. In urban Alameda, overdoses are concentrated in five Oakland ZIP codes that appear on lists of the Bay Area’s ten poorest areas. And while rates in Silicon Valley—Santa Clara County and the southern parts of Alameda and San Mateo County—are lower than in surrounding regions, synthetic opium use has surged in San Jose’s central, east and south neighborhoods.

California’s rural counties of Mendocino, Humboldt, Lake, Trinity, Shasta, Tuolumne, Yuba, Butte, Kern and Inyo have also been plagued by overdoses.

No demographic is immune. In 2016, Gabriel Tramiel, 32, was found dead in his Manhattan apartment a day after he met up with childhood friend Avinoam Luzon of Mountain View on Manhattan’s Upper West Side. Luzon sold Tramiel what the medical school student later told police was morphine but was, in fact, pure fentanyl. Prosecutors said Tramiel paid $1,200 for the drug, which he ingested with a nasal sprayer.

Tramiel grew up in Los Altos Hills as part of one of Silicon Valley’s most famous dynasties; he was the son of former Atari president Sam Tramiel and the grandson of a personal computer industry pioneer—Commodore International founder Jack Tramiel.

Between March 2020 and February 2021, Gilroy residents Fernando Sanchez, 17, Jacob Vasquez, 24, and Joseph Saavedra, 26, all died by overdosing on fentanyl. Each got drugs from the streets they thought were Xanax or another less harmful substance. Their mothers believe all three acquired the fatal doses from the same small-time dealer, who they believe should face homicide charges. (Luzon received a nine-year sentence in New York in connection with the Tramiel case.)

“It is important to bring awareness because there is a lot of this happening,” said Eleanor Saavedra, Joseph’s mother. “These kids came from good homes.”

It’s not just the young and adventurous either. Just this month, on Feb. 6, three men were found dead of suspected fentanyl overdoses in a home near Gilroy, authorities said; a fourth was revived by Santa Clara County sheriff’s deputies. All were in their 50s. First responders said the patients received doses of Narcan, a branded naloxone product.

Even though California’s overdose rate is lower than almost two-thirds of U.S. states, it has the most overall casualties due to the sheer number of people who live here. The California Department of Public Health reported 5,961 fentanyl deaths in 2021, accounting for more than three-quarters of all fatalities from opioid substances. The death rate jumped 70 percent during the pandemic, with racial and ethnic minorities hit hardest.

Locally, there were 154 opioid deaths in Santa Clara County, with the highest number—24—occurring among 20- to 24-year-olds. White and Latinx communities experienced around 11 deaths per 100,000 residents, while the rate was nearly double that for African Americans. Asians and Pacific Islanders were found to have died from an overdose at around one-fifth the rate of white and Hispanic/Latino residents.

In December, Sen. Dave Cortese of San Jose introduced a bill that would require public school staff to undergo training in how to treat overdoses of opiates and synthetic opioids, such as fentanyl. Schools would keep naloxone on hand and incorporate opioid overdose response in their mandated school safety plans.

Cortese says the state will include funding in its budget “to provide resources so that counties don’t see it as an unfunded mandate.” This is particularly important in smaller counties with tight budgets, he says.

Cortese says he introduced the bill after a sitting through committee hearings on an unsuccessful bill last year in which family members called in with a succession of similar stories about Californians who “got spiked and stopped breathing.”

“It stuck in my head,” Cortese said. “We need to do something about this.”

Trevor Leopold would have turned 22 on Jan. 30. Instead, he’s “forever 18,” his mother says.

When Michelle Leopold received the news that her 18-year-old son had died in his dorm room, she didn’t need to wait for the coroner’s report to know what killed him.

Although it was November 2019—before many parents had heard of the fentanyl crisis—there was no doubt in Michelle’s mind that this powerful synthetic opioid was the culprit. The drug had claimed her son’s close friend the previous year. Toxicology results confirmed that Trevor died after ingesting a pill laced with fentanyl. One pill.

He thought he was taking the prescription drug oxycodone, Leopold said. As it turned out, the laced pill contained no oxycodone at all. Public health officials say it’s common for fentanyl victims to believe that they’re taking another, more benign, drug.

Exactly how did fentanyl, a powerful legal synthetic opioid developed in 1959, cause this nationwide crisis? Fentanyl, used as an analgesic during surgery and as a prescription drug to treat severe pain, is easily produced and affordable.

Unfortunately, its characteristics also make it attractive to the illicit drug market. In recent years, the supply of fentanyl has grown swiftly, with most of it manufactured outside of the United States. The drug’s effect is similar to heroin, and it’s extremely addictive.

“Fentanyl is up to 100 times more potent than morphine,” said Melissa Struzzo, the program manager for Sonoma County’s Substance Use Disorder Services.

Drug dealers bank on fentanyl’s addictive quality to keep their customers coming back for more. But just two milligrams of fentanyl—a few grains—can kill a person, according to the Drug Enforcement Administration. It issued this urgent health alert: “One pill can kill.”

Without access to the sophisticated and expensive scientific weights and measures used by pharmaceutical companies, it’s almost impossible for dealers to calculate how much fentanyl they’re putting into a pill or powder. 

And with pill-pressing machines available at a variety of price points—and just a few keystrokes away on Amazon—it could be someone living next door who’s concocting drugs that look almost identical to the Ritalin, Adderall or oxycodone you might get from your doctor.

“Fentanyl is now present in most illicit pills and powders,” said Dr. Matt Willis, Marin County’s public health director. “People overdose from the presence of fentanyl in what’s sold on social media as prescription pills, cocaine or other powders.”

Local health agencies have been promoting a “harm reduction” approach and are pushing for more organizations to keep Narcan on hand. The Santa Clara County Opioid Overdose Prevention Project offers free Narcan training and kits, from 1-2pm every day, at two San Jose clinics and one in the South Valley. Because you spray it into someone’s nose, there’s no need to worry about having to reenact the classic John Travolta and Uma Thurman scene in Pulp Fiction, where Thurman’s character receives a shot of adrenaline in her chest following a heroin overdose.

District 5 Supervisor Joseph Simitian, who chairs the Board of Supervisors’ Health and Hospital Committee, says this laser focus on combating the fentanyl crisis is quite new here. Though school systems are now frantically stocking up on naloxone and other supplies, his overtures were spurned, at first. “There wasn’t initially any sense of urgency, quite frankly,” he said. “I think people were perhaps lulled into a false sense of security.”

Less than 10 Santa Clara County deaths were attributed to fentanyl in 2015. But around that time, Simitian had taken a trip out east, and began hearing horrific stories about overdoses. He met with a firefighter who was also a mayor of a small town who gave him a dark forecast of the storm clouds on Silicon Valley’s horizon.

Within six years, Santa Clara County had experienced a more than 10-fold jump in fentanyl deaths. “Fortunately, my board colleagues kept pressing on the issue after we had this initial lack of response,” he said. “I would say middle of last year…was when we—as a county and a board of supervisors—made the commitment to step up our efforts to push back.”

In September, the Board of Supervisors voted to put $135,000 in state funds toward placing Narcan kits in high schools. Now, they’re expanding the drive to get the fentanyl antidote into middle schools. But Simitian says there’s another prong of their strategy that’s key—public awareness. “Even as the problem began to grow, I think there was a sense in many of the suburban communities that I represent that this could be a problem in other parts of the county,” he said. “This was a problem that was happening ‘somewhere else.’”

In the summer of 2020—in the midst of the pandemic—star wrestler Linus Blom was facing academic pressure ahead of his senior year, as his parents brought him back from Finland to Los Gatos.

He’d begun experimenting with drugs and had become addicted. He ended up purchasing what he thought was a Percocet pill, but, in fact, it contained a lethal dose of fentanyl. “We found him when it was too late,” his father, Jan, said as part of an informative event in October. “We were not aware of the fentanyl issue.”

Jan Blom has since joined a Santa Clara County task force to help root out the problem, but says he still has trouble figuring out how to discuss drug risks with his surviving teenager. “It’s so hard,” he said. “Talking about this—I know it’s really hard—but, I think awareness is the first step.”

Simitian, who also spoke as part of the panel, says he was moved by Linus’s story. “That young man was a victim of the fentanyl epidemic,” he said. “I think it’s too easy to dismiss this as a set of statistics. When we hear from the parents, (we see) it’s all too human.”

Another event to educate students about the risks of fentanyl is being organized for March 22 in Palo Alto.

Meanwhile, police and prosecutors have been targeting dealers.

In December, a San Jose man was charged with felony drug sales after a group of Los Gatos High School students overdosed on fentanyl-laced pills they bought from him, the District Attorney’s Office said. According to prosecutors, 23-year-old Simon Jose Armendariz’s student buyers were so painfully aware of the dangers of the pills in his inventory that they’d carry Narcan in case they overdosed. Deputy District Attorney Eunice Lee argued letting him out on bail would put the public at risk. In December, a judge agreed. And on Jan. 23, Armendariz lost another bid for pretrial freedom as the DA’s Office urged the judge to consider the grim reality of the fentanyl crisis. “The court agreed with my position,” Lee said. “There is not sufficient means to protect the public” if he were released.

When “one pill can kill,” you don’t have the “safety net” of experimentation like you might expect with other drugs, Lee said. “We now understand that this can affect people from all walks of life,” she said. “We have to respond.”

Despite the prioritization of such cases, experts say social media can make it easy for dealers to hide. And given how lucrative the market is, there’s always another ready to fill the void if one is arrested, according to Dr. Willis.

“Public health and law enforcement agree that we aren’t going to arrest our way out of this problem,” Willis said. “Instead, we partner with the justice system using all of the tools at our disposal, including diverting people with low-level drug offenses to assessment and ensuring people who are incarcerated have access to addiction treatment.”

Trevor Leopold’s mom plans on educating as many people as possible about what happened to her son, with the goal of preventing fentanyl deaths. “People just don’t know,” she said. Last year, Leopold and her husband hosted Narcan training sessions at the six Ace Hardware stores they own. Although Leopold admits it’s not easy, she makes herself available to the media and speaks at numerous public forums.

“When we got the phone calls about Trevor, I turned to my husband and said, ‘We can’t be quiet about this,’” Leopold said. “There are a lot of us speaking out on behalf of our dead, poisoned children. Hopefully, it’s making a difference.”