What the numbers, including ZIP codes, reveal about the fentanyl crisis in Stanislaus County

The most deaths due to illegal fentanyl occurred in the 35 to 39 age group last year in Stanislaus County. The deadly street drug claimed the lives of young and old, from a child less than 5 years old to adults older than 65.

Four times more males than females were killed by the illegally made synthetic opioid, which is mixed with pills to look like prescription drugs and also is combined with substances like methamphetamine and cocaine.

The fentanyl death rate in the 95354 ZIP code has been 2 1/2 times higher than the countywide rate. That ZIP code includes Modesto’s airport neighborhood, one of the poorest areas of the county.

County and state data on overdoses, deaths, emergency room visits and other metrics reveal how Stanislaus and other California counties are struggling with the nation’s opioid epidemic, including fentanyl, a relatively newer public health threat foisted on communities by drug traffickers.

There were 5,961 fentanyl deaths in California in 2021. That’s more than the number of people killed in auto accidents and homicides combined.

“I would argue fentanyl is definitely the dominant drug,” Stanislaus County Sheriff Jeff Dirkse said. “We have seen methamphetamine drop off in the last year or two. It is still there, but fentanyl is the main issue now.”

Dirkse said street fentanyl is cheap and easy for users to obtain. And it “provides a high that drug users are looking for,” he said.

The sheriff said the vast majority of overdoses recorded by the Coroner’s Office are caused by fentanyl. “So many kids or people who are new to drugs have no resistance to opioids and one use can kill them,” Dirkse said.

One theory to explain the prevalence of methamphetamine in cities and towns in the San Joaquin Valley is that Highway 99 and Interstate 5 serve as major conduits for trafficking in California. That also is a factor with the spread of illegal fentanyl, the sheriff said.

When did fentanyl start to take a toll here?

The fentanyl crisis grew out of the nation’s opioid epidemic, which started in the late 1990s with the overprescribing of pain medication. Patients became addicted to the medications, causing thousands of overdose deaths. In the second phase of the epidemic, a larger heroin market was spawned in the United States for addicted patients who no longer could afford their pain meds or were cut off by doctors.

Fentanyl is a synthetic opioid, up to 100 times more potent than morphine, and is given to surgical patients to control pain. Drug cartels import cheaply made fentanyl powder from China and combine it with illegal drugs sold across the U.S. Illegal fentanyl caused more than 70,000 overdose deaths nationwide in 2021, according to the National Institute on Drug Abuse.

Only five years ago, in 2018, other opioid drugs caused four times as many deaths (43) as fentanyl (10) in Stanislaus County. As the drug surfaced on the streets of Modesto and other cities, the county’s fentanyl death rate increased from almost nil in 2019 to more than 20 per 100,000 by the fourth quarter of 2022.

According to the county, 73% of the 176 overdose deaths last year were due to fentanyl. Deaths from methamphetamine overdoses were 10% of the total. Another 10% were caused by other drugs, and 8% by other opioids.

Is the problem worse in Stanislaus than in other counties?

The preliminary numbers on fatal fentanyl overdoses in 2022, posted on the California Overdose Surveillance Dashboard, show Stanislaus ranks 15th among the 58 counties, with a rate of 22.37 deaths per 100,000 residents. That is much higher than the statewide rate of 15.62 deaths per 100,000.

People are dying from illegal fentanyl in neighboring San Joaquin and Merced counties, but those counties are below the statewide rate, according to the data.

Hospital emergency rooms in Stanislaus County regularly see people come in with opioid overdoses, including those caused by fentanyl. According to the 2022 numbers, opioid ODs accounted for 330 ER visits in the county, almost one per day. Hospitals in Santa Clara, a Bay Area county with a population 3 1/2 times that of Stanislaus, had 319 of those same visits last year.

Stanislaus County’s rate of opioid overdose emergency room visits (60.6 per 100,000) is close to that of San Francisco, one of the cities hardest hit by fentanyl deaths. San Francisco’s rate is 62.2 ER visits per 100,000.

In the Valley, San Joaquin County had 315 emergency room visits for opioid overdoses, a rate of 40.6 per 100,000, and Fresno County had 272 visits, or 27.8 per 100,000.

Similar numbers on ER visits in Stanislaus were posted for 2021. The newer data show the overdose visits peaking in the first quarter of 2022 and coming down somewhat by the fourth quarter of 2022.

What are the impacts by ethnicity, race and ZIP codes?

The county’s snapshot indicates Native Americans with the highest opioid overdose death rate: 68.8 per 100,000. Black people are next at 54 per 100,000, whites at 35.4 per 100,000 and Asians at 19.3 per 100,000. Latinos in Stanislaus County had the lowest mortality rate: 14.4 per 100,000.

Besides southeast Modesto and the airport area, eight other local ZIP codes in 2021 had opioid overdose death rates above the statewide rate, including the central Modesto neighborhoods west and east of McHenry Avenue (95350 and 95355); west and south Turlock (95380); Patterson (95363); Ceres (95307); northwest Modesto (95356); rural areas west of Modesto (95358); and west and south Modesto (95351).

Other ZIP codes in the county were below California’s opioid death rate. Median incomes were significantly higher in ZIP codes with lower fatal overdose rates.

Fatal overdoses by age group

In Stanislaus County, people in their 30s accounted for one-third of the fentanyl deaths in 2022. In addition, 21 victims in their late 20s didn’t see their 30th birthday and six young adults killed by fentanyl were between 20 and 24 years old.

The state did not reveal the actual number of deaths among teenagers or children in the county, because of confidentiality considerations, but the dashboard shows fewer than six deaths among ages 15 to 19 and newborn to 5.

Fentanyl claimed the lives of 38 people ages 40 to 59 last year.

Are county residents getting treatment for substance use?

The state surveillance dashboard says Stanislaus County had 345,215 prescriptions for opioid drugs in 2021, which was an 18% decrease in prescribing of the pain meds compared to 2019.

Medication-assisted treatment for opioid addiction, using drugs like suboxone or methadone, climbed by 63% in the county from 2019 to 2021. The county’s prescription rate for buprenorphine (another name for suboxone) was 21.81 per 100,000 in 2021 and continued to rise in the first quarter of 2022, according to preliminary data.