In recent years, the U.S. has been experiencing a fentanyl crisis that has only continued to worsen.

The Centers for Disease Control and Prevention (CDC) have estimated that the crisis is claiming at least 250 American lives daily, and as of January 2022, over 71,400 Americans have died from illegally-made fentanyl. This crisis has also made its way down to Orange County, which saw an increase in deaths among youth and young adults.

According to the “2022 Drug and Alcohol Deaths Among Youths and Young Adults: The Impact of Synthetic Opioids During the Pandemic” report published by the Orange County Health Care Agency, between 2017 and 2021, the number of overdose deaths related to fentanyl among youth and young adults in OC saw an increase after 2020.

In 2020, there were 78 fentanyl-related deaths, which increased to 97 for 2021. Both 2020 and 2021 saw the increase specifically among youth between the ages of 10 and 17.

Meanwhile, the percentage of fentanyl involved in opioid-related deaths among youth and young adults between 2017 and 2021 also saw an increase. In 2017, 30.8% of opioid-related deaths involved fentanyl. However, after 2019, the percentage increased to 71.4%, with 2021 having 98% of opioid-related deaths involving fentanyl.

In regards to age, 18 to 24 year olds made up the largest amount of deaths at 261 total, with 2020 and 2021 reporting the highest amounts at 76 and 80, respectively. Individuals 10 to 17 year olds totaled 28 deaths, with 2021 seeing 19, up 12 from 2020. Within the span of five years, only one death was reported for an individual aged between zero and nine years old in 2020.

Fentanyl is a synthetic opioid, meaning that it is made by scientists in a lab. The opioid is obtained with a doctor’s prescription, but it can also be made, distributed and used illegally via illegal drug markets, since its effects are similar to heroin.

Doctors tend to use this opioid whenever they are treating patients who are suffering from severe pain, especially for those who are going into or have just had surgery and for those with advanced-stage cancer. According to the CDC, fentanyl is 50 times more potent than heroin and 100 times more potent than morphine.

The recent increases in overdose deaths caused by synthetic opioids, including fentanyl, can be attributed to the ones that are illegally manufactured, making them dangerous since they aren’t being produced in a lab. The deaths are also being attributed to the fact that fentanyl is being added to other drugs like cocaine and heroin, and some of the individuals who have died were unaware that fentanyl had been in the drug they took.

Kavita Babu, the chief of medical toxicology at UMass Chan Medical School, explained in an article that fentanyl is created in China, Mexico and India, and it is later distributed to the U.S. in the form of powder or pressed pills.

The Drug Enforcement Administration (DEA) put out a warning Aug. 30 surrounding a growing trend of brightly-colored fentanyl and fentanyl pills, also called “rainbow fentanyl,” which they had been seizing in 26 states since August 2022.

“Rainbow fentanyl — fentanyl pills and powder that come in a variety of bright colors, shapes and sizes — is a deliberate effort by drug traffickers to drive addiction amongst kids and young adults,” DEA Administrator Anne Milgram stated in the press release.

In Orange County, opioids and opiates consistently held higher percentage rates of deaths caused by substances present at the time of death among 18 to 24 year olds between 2017 and 2021. These rates have fluctuated between 79% and 94%.

Within the same timespan, cannabis has also seen an increase caused by substances present at the time of death, going from 8.5% in 2017 to 25.9% in 2021.

What is being done nationally?

One action being taken to address the fentanyl crisis is the Drug Cartel Terrorist Designation Act, which calls for the Reynosa/Los Metros faction of the Gulf Cartel and the Cartel Del Noreste faction of Los Zetas to be designated as “foreign terrorist organizations.” The act was introduced in the House of Representatives in April 2021 and has been spearheaded by Sen. Roger Marshall (R-KS), who was later joined by Sen. Rick Scott (R-FL).

“As these cartels continue to invade our porous southern border in an increasingly militarized approach, this designation is needed to ramp up our efforts to combat them,” Marshall wrote in a Sept. 21 Instagram post. “We will not rest in our fight to stop fentanyl’s terrible scourge wreaking havoc in Kansas and across the U.S.”

The act has been met with mixed views.

While some like Don Barnes, the Sheriff-Coroner of OC’s Sheriff Department have voiced their support, critics argue that the pharmaceutical industry has also helped play a role, especially in the overall opioid crisis.

In a Q&A article by the Harvard T.H. Chan School of Public Health, Howard Koh, a professor of the practice of public health leadership at Harvard University, explained that when the drug oxycontin was trying to get approval, Purdue Pharma falsely stated the drug was less addictive compared to other opioids.

The drug was originally considered a “breakthrough treatment” for chronic pain, but after the drug was approved, some users began crushing the pills to snort or inject them as this allowed them to gain effects similar to those of heroin. Later on, a multitude of lawsuits were filed against the pharmaceutical company, and in February 2018, the company stated they wouldn’t sell it to doctors anymore.

Also in April 2021, the U.S. Attorney’s Office in the U.S. Department of Justice announced they were pursuing seven criminal cases against drug dealers who sold narcotics contaminated with fentanyl that resulted in fatal overdoses in OC.

What are Orange County and California doing?

Barnes shared a copy of a letter he wrote in an Oct. 11 Instagram post voicing his support for the Drug Cartel Terrorist Designation Act.

“Classifying the cartels specified in your legislation as terrorists will increase the tools available to combat these organizations that have destroyed the lives of so many people on both sides of our southern border,” Barnes wrote in the letter.

OC District Attorney Todd Spitzer has also announced new campaigns and policies in an effort to curb the county’s fentanyl crisis. An anti-fentanyl ad campaign announced after Oct. 14 on Orange County Transit Authority (OCTA) buses featured slogans like “FENTANYL ENDS LIFE IN A SNAP — WILL YOU BURY YOUR CHILD?” And “ONE PILL WILL KILL — FENTANYL MURDERS OUR KIDS EVERY DAY.”

The prior November, Spitzer announced a new policy relating to convicted drug dealers. According to the policy, convicted drug dealers will be charged with murder if they manufacture or sell drugs, including fentanyl, after being “advised of the dangers of controlled substances” and someone consequently dies from the sold drug.

This policy is similar to the “Watson admonition” warning in California. This warning is given to drivers convicted of driving under the influence, in which they are informed of the dangers to human life and that getting another conviction can result in a murder charge as well.

The OC Board of Supervisors endorsed three bipartisan state legislations pertaining to fentanyl earlier this March: Assembly Bills (AB) 1673, 1628 and 1598. The endorsement came a week after Supervisor Katrina Foley held a public hearing featuring guests including Barnes, Spitzer, OCHCA Director & County Health Officer Clayton Chau and CA State Assemblywoman Cottie Petrie-Norris.

AB 1673 calls for the creation of the Anti-Fentanyl Abuse Task Force, which would work to figure out how to increase public awareness of fentanyl abuse, review the effectiveness of current state criminal statutes and collect data on statewide abuse.

AB 1628 pertains to online platforms, in which they would have to include a policy statement informing users that a controlled substance can’t be illegally distributed online and how the platform itself would regulate this.

AB 1598 calls for the use of fentanyl testing equipment, which would allow buyers to perform a chemical analysis of their drugs in order to help prevent individuals from accidentally ingesting them.

Additionally in March, Gov. Gavin Newsom signed AB 2365, which would allow educational agencies, public health agencies and law enforcement to have the opportunity to apply for grant funds that they could use to “increase awareness and education about the dangers of fentanyl.

“When I found out what our community partners were already doing out of their own department budgets to educate teens and parents about fentanyl, it was clear the state needed to pitch in, not just to help Fresno County, but to make sure other counties have funding to do what we’ve done here,” Assembly member Jim Patterson (R-Fresno), the bill’s author, wrote in a statement released upon the creation of the bill.