National alarm about growing, widespread abuse of the synthetic opiate fentanyl has risen sharply in recent months. Millions of fentanyl pills of indeterminate potency have been flooding into the U.S. from drug labs in Mexico. Overdose deaths broke U.S. records in 2020 and again in 2021. In August the federal government warned parents that school age children were being lured into drug abuse by new, rainbow colored fentanyl candies.
“Fentanyl is the single deadliest drug threat our nation has ever encountered,” said Drug Enforcement Agency administrator Anne Milgram. ”From large metropolitan areas to rural America, no community is safe from this poison.”
Last month, the PRT looked into how Santa Cruz County is facing up to the fentanyl menace in our communities. We were encouraged by what we found.
High Drug Trafficking But Low Drug Consumption
From January to December of 2021, the DEA Phoenix Field Division seized over 9.5 million counterfeit fentanyl-laced pills. The number of pills seized per week is rising.
Earlier this year Colonel Heston Silbert, Director of the AZ Department of Public Safety, told the Arizona House Health Committee that fentanyl-laced pills are manufactured by Mexican criminal drug networks using precursor chemicals purchased primarily from Chinese suppliers. These pills are then smuggled into the United States, often through Southern Arizona, which is now designated as one of 33 nationwide High Intensity Drug Trafficking Areas by the DEA.
According to Border Patrol officials, most fentanyl that is seized entering the United States from Mexico is intercepted at ports of entry and is smuggled primarily by U.S. citizens.
Santa Cruz County Sheriff David Hathaway told the PRT that although Nogales has become known as a trans-shipment point for fentanyl, Santa Cruz County (SCC) itself has a very low drug consumer problem for drugs, including fentanyl.
“For all types of drugs, we have a very low consumer problem compared to some of the big metropolitan areas like Tucson or Phoenix,” Hathaway said.
Statistics from the Arizona Dept. of Health Services bear this out. While the rate of opioid deaths has increased statewide each year since 2017, SCC opioid deaths peaked in 2020 with 16 deaths and actually declined to less than ten deaths in 2021. Data for 2022 is incomplete. For the five-year period from June 2017 to July 2022, SCC recorded 48 fatal opioid overdoses and 348 suspected non-fatal opioid overdoses. Over 87% of deaths were Hispanic/Latino. Seventy-five percent were men, 25% women.
Combating Overdoses and Addiction
Accidental overdoses involving fentanyl are not uncommon. Fortunately, they can be reversed if an adequate dose of Narcan – usually administered as a nasal spray – is given right away when symptoms appear. The nasal spray is safe, and available from pharmacies without a prescription. Across SCC, emergency medical personnel administered 70% of Narcan and law enforcement 25%
Sheriff Hathaway said that all County officers carry Narcan and are trained to identify overdose symptoms and administer the drug. Narcan usually works quickly to reverse an opioid overdose in a matter of minutes, but more than one dose may be required.
Patagonia Fire Chief Ike Isakson said his department has administered Narcan once, but it was too late to remedy the overdose and the person died.
Sonoita-Elgin Fire Department Chief Marc Meredith said his department has administered Narcan for a small number of overdoses. He added that Narcan kits are available at all Fire Departments in the county free of cost.
Sheriff Hathaway said that since fentanyl pills are not produced in a regular and recognized pharmaceutical lab, users don’t know the strength they are ingesting, whether it’s by swallowing pills, vaping, injecting, or laced into marijuana cigarettes. Small disparities in strength can mean the difference between a drug user’s usual dose and one that proves deadly. In recent tests conducted by DEA, six out of ten fentanyl-laced, fake prescription pills contained at least two milligrams of fentanyl – an amount considered to be a lethal dose.
Fentanyl overdose symptoms include pupil constriction; becoming dazed or nearly unconscious; cold and clammy skin; pale completion; stiff or limp body; blue or purple tint to skin, lips or fingernails; vomiting; gurgling sounds; frothing at the mouth; slowed or absent breathing; coma; inability to speak; and, slow or stopped heartbeat.
Opiates like fentanyl are also highly addictive, creating a euphoric effect that causes users to crave rising amounts of fentanyl to avoid feeling ill or “dopesick,” Hathaway said. Use can easily turn to addiction.
There are many options for treating opiate addictions to help users regain control of their lives. Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid agency that offers health care programs to serve Arizona residents. For questions on AHCCCS eligibility, call 1-855-432-7587. Individuals must meet certain income and other requirements to obtain services. Also, for help finding treatment, go to findtreatment.gov or call 1-800-662-4357.
Rehabilitating Drug Offenders
Hathaway said there are two options for dealing with illegal drug use in a community: put users in jail, or try to encourage them to not use drugs in the first place. The County has focused on demand reduction. “It costs taxpayers a lot of money to put somebody in jail,” Hathaway said. The Sheriff’s Office has a grant from Mariposa Community Health Center for the purposes of allowing officers to identify people who need help.
If drug users do get into the criminal justice system, they have access to SCC diversion programs to avoid incarceration. Using grant funding from the Department of Justice, SCC Justice of the Peace Emilio Velasquez has spearheaded a substance abuse diversion program called Recovery Court, the first of its kind in Arizona. Velasquez has also established a Behavioral Empowerment Court to address mental health issues. There are currently eight people enrolled in Recovery Court and four in Behavioral Empowerment Court.
Sheriff Hathaway said if people have been arrested for substance abuse or sales of drugs in small quantities, these programs can help rehabilitate offenders, get them back with their families and keep them employed and productive members of the community.
In 2019, Judge Velasquez also created the Substance Abuse Community Coalition, which includes Circles of Peace, Hope Incorporated (formerly Wellness Connection), and Mariposa Community Health Center, all collaborating to address substance abuse mental health solutions. Part of this grant funds SCC Jail Liaison Martin Felix, a former addict and convicted felon, who helps inmates find and maintain supportive community connections when they are released from prison.
“Without this assistance, users are likely to fall right back to the same people they were hanging out with before,” said Sheriff Hathaway. “Felix is trying to create something along the lines of a half-way house by providing contacts for various services within the community.”
Hathaway said that the Sheriff’s Office is available to speak at community forums and encourages groups and organizations to reach out where needed to enhance awareness. He recommends that everyone be able to identify fentanyl, understand the potency, and realize that young and healthy people are dying from overdoses.
Hathaway also identified Drug Abuse Resistance Education (D.A.R.E.) as a key program in reducing drug demand amongst youth. D.A.R.E. is an officer-led series of classroom lessons that teach children from kindergarten through Grade 12 how to resist peer pressure and live productive drug and violence-free lives. Hathaway’s office provides officers for all county schools, with the Nogales Police Department covering schools in the city. Over 400 5th graders graduate from the program each year, but officer interaction occurs at all grade levels and includes parents, teachers, and students.
The social isolation and economic dislocation widespread during the pandemic may have caused relapses in drug use and contributed to rising overdoses, but Sheriff Hathaway is hopeful that as we get back to normal, the demand for fentanyl will decline.
In the meantime, SCC Detective Joe Bunting recommended that parents educate their children about “stranger danger” – don’t take something from a stranger. Also know who your children are talking to, which includes monitoring their cell phones.
DEA Administrator Milgram said, “This holiday season, every parent, family member and friend should take a few minutes to share a simple message: One Pill Can Kill.” For more information, visit dea.gov/onepill.
In the January issue, the PRT will examine how one local nonprofit is helping people with recovery.