Fentanyl deaths hit new peak in 2022 in Ventura County

Deaths by drug overdose were down slightly in Ventura County in 2022, but fentanyl, heroin, methamphetamines, alcohol and other drugs still claimed 278 lives last year, with fentanyl involved in nearly two-thirds of those deaths.

The death toll was down 4% from 2021, according to the annual report on fatal overdoses from the Ventura County Medical Examiner's Office, released Monday.

However, the long-term trend is still bleak: Overdose deaths nearly doubled between 2019 and 2021 before that small decline in 2022. And the latest statistics represent the biggest-ever death tolls attributed to the powerful synthetic opioid fentanyl, and for opioids in general.

"A few years ago, I thought we were getting a handle on it, but I've been telling anyone who will listen: It's hitting a different level now," said Pat Montoya, the president of the national and Simi Valley chapters of Not One More, a nonprofit that promotes education and treatment to combat the opioid epidemic.

Montoya thinks it's going to get worse before it gets better, based on what he's seen through Not One More and what he's heard from law enforcement and drug treatment professionals.

"I think we're going to see those deaths going up," he said. "If you're already an addict, the switch to fentanyl is going on now. I talk to a lot of people in recovery and rehab, and that's their drug of choice. ... I've been following this from my other chapters in New York and Pennsylvania, and fentanyl has been there for about five years, on an illicit basis. We've been waiting for this wave to get here, and now it's splashing on our side of the country, but I don't think it's fully hit yet."

The Ventura County Medical Examiner's Office investigates all deaths in the county that appear to be suspicious, unusual or unexpected, and all natural deaths that occur outside of the care of a doctor. In 2022, it investigated 1,090 of those deaths and performed autopsies in 799 cases. Of those deaths, 253 were determined to be accidental drug overdoses, and 18 to be suicide by drug overdose.

For a death to be ruled a drug overdose, the victim must have the drug in question in their system when they die, and their death must appear attributable to the substance, said Dr. Christopher Young, Ventura County's chief medical examiner. So a person who dies of a heart attack with high levels of methamphetamine in their system would likely be classified as a methamphetamine overdose, while someone who suffers a fatal heart attack but doesn't have the drug in their system would not be classified as an overdose, even if decades of drug abuse contributed to the heart attack.

"It's not always cut and dry," Young said. "Sometimes when you see a death, it's a clear-cut overdose, say from fentanyl, but in the majority of cases it's more than one substance."

More than one drug was involved in 67% of fatal overdoses in 2022, and the medical examiner concludes only that a specific drug contributed to a death, not whether it was solely or primarily responsible.

Men accounted for 74% of the overdose deaths in Ventura County in 2022, and 68% of the people who died were between the ages of 31 and 60. Three of the Ventura County residents who died in 2022 were under the age of 18, and another 44 were between the ages of 18 and 30.

Fentanyl has become by far the deadliest drug in Ventura County. In 2022, it was a factor in 181 overdose deaths. That total was up 10% from 2021, and represents more than an eight-fold increase since 2017, when the county had 22 fatal overdoses involving fentanyl.

"In order to save lives you have to know what’s killing people," Young said. "The public needs to know this so they can know how risky and dangerous it is to use anything that could potentially contain fentanyl, and anything that you buy on the street could potentially contain fentanyl."

Opioids — including fentanyl, heroin and prescription medications — were present in 211 overdose deaths in 2022, up from 196 the year before.

As fentanyl has become more prevalent, heroin has faded as a factor in fatal overdoses. In 2022, there were 10 fatal heroin overdoses in Ventura County, down from 40 in 2018.

"We're seeing heroin go down and fentanyl go up," said Montoya, whose nonprofit was founded in 2012 in response to a growing heroin problem in Simi Valley. "It's cheaper to get fentanyl than to get heroin, and that comes from the cost to manufacture it being so much lower."

After fentanyl, the drug connected to the most overdose deaths in Ventura County last year was methamphetamine. There were 125 fatal overdoses involving meth in 2022, more than double the total from 2019.

Meth itself is more likely to kill through years of abuse than through a single acute dosage, but it's often found in combination with fentanyl in overdose victims in Ventura County, Young said. Addicts appear to be using stimulants like meth to come off of the depressive effects of opioids, he said.

"I liken it to, if you drove around in a car and you were holding your foot on the brake pedal whole you're holding down the gas, something is going to break," Young said. "It's not a good combination."

Benzodiazepines, a class of drug that includes Xanax, Klonopin and Valium, contributed to 46 overdose deaths in 2022, and alcohol contributed to 33 deaths. Those substances are both depressants and can be especially deadly together, Young said — a seemingly moderate amount of alcohol can kill when combined with a few anti-anxiety pills.

Deaths connected to alcohol overdoses spiked during the pandemic, from 20 in 2019 to 58 in 2021, before dropping in 2022.

"I think COVID had a great effect on alcohol and drug use," Montoya said. "I think with alcohol, it is waning away now, but the drug use is still going up."

Deaths from cocaine overdose remain relatively rare in Ventura County. In 2022, cocaine was a factor in 10 overdose deaths. That was down from 22 the year before, and was in line with the totals from 2017 through 2019.

Young said he draws hope from the efforts in Ventura County to treat addicts and to help people survive overdoses. The drug naloxone — its brand name is Narcan — can save lives by immediately reversing the effects of an opioid overdose. It can be administered through a nasal spray and is available through public health and medical providers.

The Ventura County Public Health Department, the Sheriff's Office, the Medical Examiner's Office and other agencies have formed an opioid task force, and its website has information on where to get Narcan kits and fentanyl test strips.

Between 2014 and 2021, naloxone was used 1,457 to save someone in the throes of an overdose in Ventura County, according to the task force's website.

"The number of saves from Narcan distribution, that’s what allows me to sleep at night," Young said. "I shudder to think what the numbers would be if our county wasn’t responding the way it was."

Tony Biasotti is an investigative and watchdog reporter for the Ventura County Star. Reach him at tbiasotti@vcstar.com. This story was made possible by a grant from the Ventura County Community Foundation's Fund to Support Local Journalism.

This article originally appeared on Ventura County Star: Opioid overdoses killed more than 200 people in Ventura County in 2022