‘We are not trying to scare you.’ In California, fentanyl now behind 1 out every 5 youth deaths

SAN JOSE, Calif. – Jan Blom knew little about fentanyl when his 17-year-old son, Linus, went to take a nap in their Los Gatos home in July 2020.

By midmorning, Blom discovered Linus’ lifeless body in bed. The cause of death? A Percocet pill laced with the powerful synthetic opioid that has fueled an unprecedented rise in drug-related deaths across California, and now is targeting its young people. Last year, fentanyl was responsible for an astounding one-fifth of the deaths in the 15-to-24 age group, with a total more than six times the number it killed a mere three years earlier.

For most of his life, Linus had been a stellar student and avid high school wrestler who aspired to compete for the national team in his native Finland. But he started taking pills he found online, his father believes, as a way to handle the intense pressure to succeed academically in Silicon Valley.

Suddenly, Linus had become a casualty of a drug 50 times stronger than heroin that has exploded across the country in the last half-decade but largely spared the West Coast during its initial surge.

“It’s hard to realize that your own son has become a data point,” Blom said.

Fentanyl overdoses are leaving their toll not only in tragically familiar places like San Francisco’s gritty Tenderloin district but also inside teenagers’ bedrooms in some of the Bay Area’s most upscale neighborhoods. More and more often, users have no idea the drugs they are taking include fentanyl.

As a precaution, schools are stocking up on medication that reverses the effects of overdoses, and experts are recommending teens shopping for illicit painkillers and study drugs also buy test strips that detect if the pills are mixed with fentanyl.

“We are not trying to scare you,” said Chelsea Shover, an assistant professor of epidemiology and health services research at UCLA, who co-authored a 2020 study on fentanyl’s spread to the West Coast. “But we are trying to tell you what’s happening now, and it is different than what was happening a few years ago.”

The scourge of fentanyl’s dramatic rise in California shows up in 2020 as a startling spike in the state’s death records alongside another now-familiar entry: COVID-19.

Fentanyl overdoses killed about 4,000 people in California in 2020 – more than double the previous year – as trafficking routes from Mexico hardened and the unusually cheap drug began penetrating local drug markets.

And last year, for the first time, California’s death rate from all drug overdoses surpassed that of lung cancer and ranked just below hypertensive heart disease. The increase was due almost entirely to fentanyl. It killed a record 5,722 Californians in 2021, according to preliminary data from the California Department of Vital Statistics. That’s more than the estimated 4,258 people who died in auto accidents on California roads and more than double the 2,548 killed in homicides.

For teenagers between the ages of 15 and 19, the opioid death rate increased more than fourfold from 2018 to 2021. For 20- to 24-year-olds, the rate shot up nearly seven times. The spikes in death have occurred even as the overall drug use rate among teenagers has remained stable, experts say.

But here’s what’s really telling: Prior to fentanyl’s rise, the total number of yearly deaths for Californians ages 15 to 24 typically hovered around 3,000. Since 2020, that number has skyrocketed to nearly 4,000 deaths per year. And fentanyl accounted for more than 750 of those deaths in each of the past two years.

“This is going to keep happening until we actually respond,” Shover said. “The idea that one pill can kill, now that’s true … that changes what we need to be telling kids.”

Some counties have begun taking action as the fentanyl crisis deepens throughout the Bay Area.

In September, Santa Clara County stocked up on Narcan, an over-the-counter nasal spray, which can prevent a serious fentanyl overdose from becoming a death. The kits are being dispatched to schools throughout the county and teachers are being trained on how to administer Narcan.

“We don’t want to have a situation where we have an unresponsive student … and we don’t have the tools to save that person’s life,” said Santa Clara County Superintendent of Schools Dr. Mary Dewan.

She said that students are consuming study drugs like Adderall and common painkillers like Percocet, which they purchase from unlicensed dealers on the internet. They have no idea these pills are now often laced with fentanyl.

“If you are buying a pill off the street, yeah, it’s probably fentanyl,” said Shover. “Fentanyl until proven otherwise.”

That’s why Shover and other experts are recommending fentanyl test strips, which can be bought on Amazon for less than $10 a kit, to detect if fentanyl is laced in other types of illegally sold drugs. Sales of fentanyl test strips were only legalized in California this August when Gov. Gavin Newsom signed a bill authored by Orange County Republican Assembly member Laurie Davies. Previously, the test strips were classified as drug paraphernalia and some states still ban them.

Teenagers are far from the only ones suffering from fentanyl’s deadly toll. The opioid death rate for adults between the ages of 30 and 34 reached a record high in California of about 33 per 100,000 in 2021, the highest of any age group.

Every Bay Area county is seeing a rise in overdoses, too. San Francisco remains ground zero with close to double the opioid death rate of the next most heavily impacted Bay Area county – Sonoma.

In Contra Costa and Santa Clara counties, the opioid death rate more than doubled from 2018 to 2021 as fentanyl entered the market. In Alameda, it more than tripled. In Marin, it nearly quintupled.

Edward Liang, who supervises the Major Crimes and Drug Trafficking Team of the Santa Clara County District Attorney’s Office, says that Interstate 5 has become a fentanyl trafficking route for Mexican cartels who bring fentanyl-laced pills and raw materials up through Mexico and to the Bay Area.

The cartels have been using some of the raw materials trafficked over the border to produce fentanyl pills in the Bay Area.

Liang says that the reason the cartels are so interested in tapping into the fentanyl market is that the costs associated with producing fentanyl are low compared to other drugs like heroin, which require poppy plants and ample resources to produce. Since fentanyl is so much more potent than other drugs, dealers also earn more off small doses.

“They target schoolchildren and the homeless,” Blom said. “Everyone is a target.”

Law enforcement is trying to catch up. On Oct. 12, Attorney General Rob Bonta announced a fentanyl task force has seized more than 4 million pills and nearly 900 pounds of fentanyl powder since April 2021. And federal prosecutors in San Jose this summer took down a drug ring, including a Mexican pharmacist, connected to the overdose death of a Monterey County man.

But the sale of fentanyl is turning up in even the most guarded places: Inmates from Riverside County to Mendocino have overdosed on fentanyl-laced pills smuggled into prisons.

Most teenagers only need to search on apps like Instagram and Snapchat.

By the start of 2020, the Bloms were worried enough by Linus’ drug use that they sent him abroad to an international school in Finland where they hoped he would break his pill habit.

But the COVID-19 pandemic upended everything. Linus’ school went entirely online, and his favorite sport of wrestling was banned as a COVID-19 precaution.

As a result, Linus just kept self-medicating, Blom said.

He ultimately moved back in with his family in Los Gatos. They tried to get him outpatient care to treat his addiction. But everything, they were told, was full. The COVID-19 pandemic had forced some clinics to shut down temporarily or reduce services, Blom said, creating a backlog of patients.

One clinic, which placed Linus on a waiting list, called months after his death to offer him a spot.

After Linus’ death, Blom became active in pushing the county to take the threat of fentanyl more seriously. He joined Santa Clara County’s fentanyl working group and has been speaking out about his son’s death.

He says he would be satisfied if all his activism stops just one death. Now, he knows more than any parent should know about fentanyl.

“It’s so tragic,” Blom said, as Linus’ 6-year-old brother, Lucas, fidgeted nearby. “We thought he was safe at home.”