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Annette Fouche, left, and Alexia Fouche Gilliam both died of fentanyl overdoses in 2020, and their cremated remains are at Santa Rosa Memorial Park cemetery. Photo taken Thursday, June 3, 2021. (Kent Porter / The Press Democrat) 2021

Fentanyl overdose deaths surge in Sonoma County

On a sunny spring afternoon, Annie Fouche flips through printed photo collages and scrolls through pictures on her phone, images that captured special moments she’s shared with her sister and mom.

One shows Fouche’s sister as a teen, smiling at Santa Rosa City Hall while receiving an award for being at the top of her class.

In another photo, taken when Fouche was a child, the three pose for a formal portrait. Fouche’s mother has her hair neatly combed back and wears an elegant flower print dress. Her two daughters stand in front of her.

Alexia Fouche Gillam, 37, right, and Annette Fouche, 58, left, died on April 2, 2020, at their Sonoma Avenue apartment in Santa Rosa of fentanyl overdoses. (Annie Fouche)
Alexia Fouche Gillam, 37, right, and Annette Fouche, 58, left, died on April 2, 2020, at their Sonoma Avenue apartment in Santa Rosa of fentanyl overdoses. (Annie Fouche)

Fouche looked back on those memories while at the Santa Rosa Memorial Park cemetery during one of her regular visits.

A granite niche that held their cremated remains was surrounded by flowers and metallic butterflies, and was adorned with an oval photograph of the pair, Alexia Fouche Gillam, 37, and Annette Fouche, 58, smiling and hugging one another.

Alexia, a former longtime employee of the Sole Desire shoe retailer, was known for her bubbly personality, Fouche said. The two had teamed up to raise Fouche’s daughters.

The women’s mother, Annette, had juggled several jobs as a single mom and struggled with alcohol and drug addiction throughout her life, Fouche said. But she showed her love through small gestures, such as doing Fouche’s laundry or teaching her how to make waffles.

On April 2, 2020, the bodies of Fouche’s mom and sister would be found apart at their Sonoma Avenue apartment in Santa Rosa. Alexia had lived at the apartment complex, a cluster of gray and white homes near Howarth Park, for several years.

Fouche’s older sister by five years, Alexia was found in her front yard. Her body lay curled in the fetal position, a cup of red Jell-O near her body.

Hours later after police had left, Fouche went to her sister’s apartment. Unaware that her mother had also died, she would enter the home alone and discover her mother had died in the kitchen under a pile of appliances and trash.

Nearby was a pan of red Jell-O that had only a small portion scooped out. Next to it sat a bag filled with a white powdery substance authorities warned Fouche was fentanyl, a synthetic opioid 100 times more potent than morphine.

“(My sister) is going to miss out on my daughter’s graduation. She’s going to miss out on all these things we live for.” ― Annie Fouche

The Sonoma County Coroner’s Office ruled a mix of drugs caused their death. Toxicology reports provided by Fouche for both her mother and sister showed that fentanyl had been in their system, as was methamphetamine and amphetamine.

Their deaths were part of a larger spike in fatal fentanyl-driven overdoses recorded by the coroner’s office in 2020, when such deaths more than doubled compared to the year prior and have steadily increased since 2017. From a statewide perspective, Sonoma County had among the highest rates of fentanyl-related overdose deaths per capita just two years ago.

Fentanyl use in Sonoma County

Data from the Sonoma County Coroner’s Office shows local fentanyl-related overdose deaths have skyrocketed.

Here is how many people have died of overdoses involving fentanyl and other substances since 2017:

2017: 12 people

2018: 29 people

2019: 37 people

2020: 80 people

Deadly overdoses in which fentanyl was the only drug detected were less common, though those figures also spiked in 2020.

2017: 2 people

2018: 2 people

2019: 6 people

2020: 29 people

Source: Sonoma County Coroner’s Office

Fouche said she was unsure exactly when or how her mother and sister were exposed to the drugs. She had stopped talking to the pair after her mother relapsed in February of that year and her sister continued to let their mother live with her.

“It sucks,” Fouche said. “(My sister) is going to miss out on my daughter’s graduation. She’s going to miss out on all these things we live for.”

Fatal overdoses on the rise

Though it’s hard to say how many people are using fentanyl in Sonoma County, data from the Sonoma County Coroner’s Office shows local fentanyl-related overdose deaths have skyrocketed in the past five years.

Public reporting of those cases show the drug is killing people of all ages throughout Sonoma County.

Those deaths include Yadhira Carrillo Mendoza, a 14-year-old girl from Guerneville whose body was found in the back of a car after a minor crash in Santa Rosa in December. A mix of fentanyl and alcohol intoxication caused her death, the coroner’s office said.

California counties with the highest rates of fentanyl overdose-related deaths per capita

1. San Francisco

Rate: 19.07

Total deaths: 196

2. Mendocino

Rate: 11.14

Total deaths: 9

3. Sonoma

Rate: 8.52

Total deaths: 41

4. Lassen

Rate: 7.54

Total deaths: 2

5. Inyo

Rate: 6.93

Total deaths: 1

6. Humboldt

Rate: 6.52

Total deaths: 8

7. Kern

Rate:5.77

Total deaths: 54

8. Riverside

Rate: 5.42

Total deaths: 134

9. Lake

Rate: 5.41

Total deaths: 4

10. Marin

Rate: 5.25; Total deaths: 11

Source: California Opioid Overdose Surveillance Dashboard, 2019

No arrests, other than the minor who drove the car Carrillo Mendoza was in, and who officers suspect was intoxicated at the time of the crash, have been made, Santa Rosa police said.

In December 2019, federal prosecutors filed charges against three Santa Rosa residents they suspect of supplying Patrick O’Neill, also of Santa Rosa, with a dose of fentanyl that killed him and his 13-month old son, Liam Richard Savoy-O'Neill, three months earlier.

The defendants, Leanna Zamora, Shane Cratty and Lindsay Williams, have each entered guilty pleas and are scheduled to appear for sentencing in August and late September, court records show.

The U.S. Attorney’s Office made the largest federal seizure of fentanyl in Northern California last month when it raided multiple East Bay stash houses and found more than 40 pounds of the drug, leading to the arrest of seven people, the agency announced on Tuesday.

Investigators allege the suspects behind the drug trafficking organization filled over 100 orders of suspected fentanyl in just over a month earlier this year and are responsible for distributing fentanyl throughout Northern California and beyond.

The rise in deaths comes as local law enforcement officials say fentanyl has come to dominate the local illicit drug market and workers at a Santa Rosa methadone clinic say most of their clients are trying to kick the drug.

When prescribed by a doctor, fentanyl can be given as a shot, a skin patch or a dissolvable oral tablet to treat patients with severe pain. Illegally manufactured fentanyl can come in a white powder, pressed into pills or mixed with heroin, among other forms.

Both legally and illicitly made versions of the drug are extremely potent, making it an attractive option to people with opioid use disorder. It also delivers a greater high for less money when bought off the street, experts say.

“When I first started working here, it was all heroin,” said Jesse Collins, a counseling supervisor who started working for the Santa Rosa Treatment Program, which treats people with opioid use disorder, over five years ago.

“Then it was red rock … which is heroin mixed with fentanyl. Now it’s just fentanyl.”

The combination of fentanyl and other substances led to 80 deaths in Sonoma County last year, a 116% increase from 2019, when 37 of those deaths were reported.

The difference is even greater when compared to 2018 and 2017, when 29 and 12 people, respectively, died of overdoses involving a mixture of fentanyl and some other drug.

Deadly overdoses in which fentanyl was the only drug detected were less common in Sonoma County, though those figures also spiked in 2020.

Under those circumstances, 29 people lost their lives last year compared to six in 2019. There were two such deaths in 2018 and again in 2017 countywide, the Coroner’s Office data showed.

“When I first started working here, it was all heroin. Then it was red rock … which is heroin mixed with fentanyl. Now it’s just fentanyl.” ― Jesse Collins, Santa Rosa Treatment Program counseling supervisor

The proliferation of fentanyl has had a deadly effect elsewhere in the state, ranging from San Francisco to the Central Valley’s Kern County, areas with some of the state’s highest rates of fentanyl-related overdose deaths per capita in 2019, the most recent data from the California Opioid Overdose Surveillance Dashboard shows.

Sonoma County ranked third on that list.

The number of overdose deaths in California related to fentanyl rose 541% in the past three years, according to a report by the California Health Policy Strategies, a Sacramento-based consulting firm.

When looking at all fatal overdoses of any type of drug, the substance was involved in more than a third of all overdose deaths in the Golden State, the report said.

In Sonoma County, it was involved in half of all drug overdoses from 2018 through July 1, 2020, according to county data.

“It’s a concern,” Melissa Struzzo, the program manager for Sonoma County’s Substance Use Disorder Services, said of fentanyl. “As a counselor, I’ve seen people that are returning to use.”

Focal point for drug teams

Two local narcotics sergeants say the rise of fentanyl overdose deaths coincides with the steady increase in the quantity and frequency their officers and deputies encounter the drug, which filters from the U.S.-Mexico border to San Francisco and Oakland before landing in the hands of Sonoma County drug dealers.

Sgt. Dan Ager, who oversees the Sonoma County Sheriff’s Office’s hybrid narcotics and property crimes unit, said his investigators expect fentanyl “almost everywhere we go.”

Sgt. Brain Boettger, who oversees Santa Rosa Police Department’s narcotics team, estimates about 90% of his unit’s investigations involve fentanyl. These days they’re seizing the substance by the pound, though just a few years ago it was rare for the department to retrieve more than an ounce or two at a time.

Santa Rosa police in August 2020 arrested four men suspected of being part of a Bay Area drug ring that’s responsible for a large portion of fentanyl in circulation in Sonoma County. (Santa Rosa Police Department)
Santa Rosa police in August 2020 arrested four men suspected of being part of a Bay Area drug ring that’s responsible for a large portion of fentanyl in circulation in Sonoma County. (Santa Rosa Police Department)

“We’ve seen over the last 18 months those numbers go up and up,” Boettger said.

Both sergeants say fentanyl’s increased presence in Sonoma County mirrors its broader infusion into the U.S. in recent years. Mexican cartels have learned to manufacture the substance, which is easier to make than other drugs and results in a greater high, they said.

Fentanyl seizures by U.S. Customs and Border Protection agents may be one marker of the increase. The agency reported seizing 6,500 pounds of fentanyl this year as of May 4, surpassing the almost 4,800 pounds it collected for all of 2020, Department of Homeland Security data shows.

Those figures hovered at around 2,300 pounds in 2018 and 2,800 pounds in 2019.

“It’s gripped this country,” Boettger said. “It’s the focal point of most of our investigations. That’s the trend we’re seeing now.”

Fentanyl has also changed how officers do their jobs, with law enforcement agencies throughout the county equipping their employees with doses of Narcan.

The drug can reverse the effects of opioid overdoses for civilians or officers who may become inadvertently exposed to fentanyl and begin to feel ill.

Fentanyl can be absorbed through the skin or inhaled when in a powder, and according to the U.S. Drug Enforcement Administration, only a couple milligrams of the drug can be lethal depending on the person’s size, past usage and tolerance.

To minimize accidental fentanyl exposures, both Santa Rosa officers and the Sheriff’s Office have also stopped doing field drug tests, which can quickly detect illegal drugs, both sergeants said.

“Pretty much, departmentwide, we’re not testing any narcotics,” Ager said. “We’re starting to see fentanyl mixed with heroin, methamphetamine and cocaine also.”

Stephen Bussell, a field training officer with the Santa Rosa Police Department, displays Narcan, which is often used by police and rescue personnel for treatment in fentanyl overdoses. Photo taken Wednesday, June 2, 2021. (Kent Porter / The Press Democrat)
Stephen Bussell, a field training officer with the Santa Rosa Police Department, displays Narcan, which is often used by police and rescue personnel for treatment in fentanyl overdoses. Photo taken Wednesday, June 2, 2021. (Kent Porter / The Press Democrat)

Like they’re trying heroin for the first time’

Just as local officers have seen a surge of fentanyl in Sonoma County’s illicit drug market, two employees at the Santa Rosa Treatment Program, a clinic that pairs methadone and counseling services to treat opioid use disorder, say their clients have reported using the drug in greater numbers.

Melissa Nelson, the center’s Systems Coordinator and Community Liaison, said that’s a shift from what she saw when she started working as a counselor there seven years ago.

Clients were predominantly misusing prescription medication or taking heroin. Encountering clients who were using fentanyl, which is cheaper to buy and more potent, was rare, she said.

“Then you introduce something like fentanyl in the mix, somebody that has a high tolerance of abusing this (other) medication over here, it takes it up a notch,” Nelson said. “It’s now like they’re trying heroin for the first time.”

Melissa Nelson, left, the systems coordinator  and Jesse Collins, a counseling supervisor at Santa Rosa Treatment Program in Santa Rosa, Friday, May 14, 2021. (Kent Porter / The Press Democrat)
Melissa Nelson, left, the systems coordinator and Jesse Collins, a counseling supervisor at Santa Rosa Treatment Program in Santa Rosa, Friday, May 14, 2021. (Kent Porter / The Press Democrat)

Most of the program’s 370 clients, who range from working professionals to people experiencing homelessness, are part of the methadone maintenance program, said Collins, the counseling supervisor.

The methadone, if given in the right amount for each individual, works by stopping one’s cravings for drugs and blocking the effects of such opiates as heroin and fentanyl, Nelson said.

The medication is part of a treatment regiment that includes weekly counseling sessions, in which staff address other parts of a client’s life that might contribute to opioid dependence, such as mental health issues or unhealthy environments, Nelson said.

Though the program puts no limit on how long the methadone treatment can last, most clients need about a year before counselors can recommend that they gradually reduce their daily methadone intake.

“The best situation would be that they come in and get stable and taper off (the methadone),” Collins said. “But not everyone can do that.”

For many clients who are dependent on fentanyl, staff at the program find it difficult to reach a “therapeutic dose” of methadone that will curb cravings and block the effects of the drug given the high tolerance those patients tend to develop.

Those factors make the danger of relapse higher, she said.

“We know that opiate disorder is a complex disease,” Collins said.

“However, the first time that someone chooses to pick up a drug like fentanyl … they need to understand that it has the potential to be a life sentence or a death sentence.”

At Santa Rosa Treatment Program in Santa Rosa, clients drink methadone, a treatment to stem the tide of fentanyl addiction, Wednesday, June 2, 2021. (Kent Porter / The Press Democrat)
At Santa Rosa Treatment Program in Santa Rosa, clients drink methadone, a treatment to stem the tide of fentanyl addiction, Wednesday, June 2, 2021. (Kent Porter / The Press Democrat)

Sonoma County’s approach

The spike in fentanyl-driven overdoses and the growing availability of fentanyl has sounded an alarm among county substance abuse counselors and behavioral health professionals, said Struzzo, the program manager of Sonoma County’s Substance Use Disorder and Recovery Services.

Through Sonoma County’s Alcohol and Other Drug Prevention Team, a coalition that’s been in place for 15 years, county staff are working with local hospital workers, doctors and primary care clinics, among other groups, to identify strategies that will reduce fentanyl use locally, Struzzo said.

Among those tactics is raising the public’s awareness of Narcan. State-sponsored distribution programs allow law enforcement agencies, community organizations, libraries and schools to apply for free doses, Struzzo said.

Several local universities already have Narcan giveaway programs, though the coalition is in touch with the schools to find out what additional resources or information students need, she said.

One group in the coalition is charting which pharmacies can provide Narcan without a prescription, she added.

A broader goal is normalizing conversations around substance abuse disorder to reduce the stigma people face when considering seeking help, Struzzo said.

“It’s not a moral failure, it’s a chronic disease,” Struzzo said.

“Once we help remove that stigma, we’ll be able to help the people seeking treatment.”

You can reach Staff Writer Nashelly Chavez at 707-521-5203 or nashelly.chavez@pressdemocrat.com. On Twitter @nashellytweets.

Nashelly Chavez

Diversity, Equity and Inclusion, The Press Democrat 

Who calls the North Bay home and how do their backgrounds, socioeconomic status and other factors shape their experiences? What cultures, traditions and religions are celebrated where we live? These are the questions that drive me as I cover diversity, equity and inclusion in Sonoma County and beyond.   

 

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