In my last column, I shared Tim’s story — a 31-year-old unhoused man lost to what I believe was a fentanyl overdose.

His death represents one face of a crisis that is reshaping our community. Now it’s time to understand what we’re up against and what we can do about it.

Numbers Tell a Devastating Story

Santa Barbara County saw 112 fentanyl deaths in 2023, up from just 12 in 2017.

To put this in perspective: our county lost 493 people in all wars and conflicts over 163 years, yet 539 residents died from drug overdoses in just the last three years.

While 2024 showed a 47% decline in fentanyl deaths compared to 2023, we cannot become complacent.

At least once a week, someone in Santa Barbara County still dies from an overdose involving opioids.

Young people remain particularly vulnerable — deaths among 15-19 year olds rose to 4 in 2024 from 1 in 2023.

What Makes Fentanyl So Deadly?

Fentanyl is not just another opioid. It is approximately 100 times more potent than morphine and 50 times more potent than heroin.

Even in small doses, it can be deadly — as little as 2 milligrams of fentanyl, the amount of a few grains of salt, can be fatal.

Unlike heroin, which is derived from opium poppies, fentanyl is synthetic and made entirely in laboratories with no natural ingredients.

This makes it cheaper and easier to produce than heroin, which is why drug dealers increasingly use it as a cutting agent.

Fentanyl gets to the brain faster than morphine and binds more tightly to opioid receptors, which is why such a tiny amount can trigger a fatal overdose.

The real danger: powdered fentanyl looks just like many other drugs, and it is nearly impossible to tell if drugs have been mixed with fentanyl unless you test them with fentanyl test strips.

People using what they believe is heroin, cocaine or even prescription pills may unknowingly consume a lethal dose.

Signs Someone May Be Using Fentanyl

Recognizing fentanyl intoxication can save a life. Look for extreme drowsiness or inability to stay awake; slow, shallow or stopped breathing; pinpoint pupils; cold, clammy skin; disorientation or confusion; and blue or grayish lips and fingernails.

If someone exhibits these signs, call 9-1-1 immediately and administer naloxone if available.

Local Resources

Santa Barbara County has several treatment options, among them:

• CADA’s Adult Residential Treatment Services (ARTS) operates a 12-bed facility in downtown Santa Barbara that provides 24-hour withdrawal management and up to 90 days of inpatient treatment. CADA offers medication-assisted treatment (MAT) and has an on-site addiction specialist. Their success speaks volumes: 90% of ARTS graduates were engaged in ongoing treatment within 14 days of discharge.
• Pacific Pride Foundation runs the county’s only syringe services program, operating out of locations in Santa Barbara and Santa Maria. Beyond syringe exchange, it provides harm reduction education, overdose prevention training and distributes naloxone. Pacific Pride distributes more than 4,000 doses of naloxone annually.

Beyond Abstinence

Not everyone who uses drugs is ready or able to stop immediately. That’s where harm reduction becomes critical.

Harm reduction is a set of practical strategies aimed at reducing negative consequences associated with drug use, meeting people who use drugs “where they’re at.”

Medication-assisted treatment combines Food & Drug Administration-approved medications like Suboxone or methadone with counseling.

Studies show that only 10% of patients not using MAT are drug-free one month after detox, while 50% to 80% of patients are no longer using opioids after six to 12 months of treatment with medications.

What Ordinary People Can Do

• Get Naloxone (Narcan). This opioid overdose-reversing medication is available free at sheriff’s stations countywide, Pacific Pride Foundation and many pharmacies. The Sheriff’s Department has distributed more than 1,790 doses to community members since its program began. Learn how to use it — it could save your child, your neighbor, your co-worker.
• Educate yourself and others. Talk to young people about the dangers of counterfeit pills. Pills made to look like prescription pain medicines or ADHD medications are often sold through social media and can contain fentanyl in deadly doses.
• Support harm reduction. Syringe services and naloxone distribution prevent deaths and disease transmission. These aren’t endorsements of drug use — they’re recognition that people who use drugs are still human beings worth saving.
• Advocate for systemic change. Our county went from 27 narcotics investigators in 2007 to just five today, while fentanyl deaths have soared. We need more treatment beds, more outreach workers, more mental health services, and a system that doesn’t criminalize addiction while failing to provide adequate care.

System We Have vs. System We Need

Our current system expects a person in active addiction — often homeless, mentally ill, malnourished and traumatized — to navigate complex bureaucratic processes.

We ask them to fill out 15-page applications, attend phone appointments when they have no phone, and provide addresses they don’t have.

We release them from jail with three days of Suboxone and no follow-up support.

An ideal system would provide immediate access to low-barrier treatment that doesn’t require sobriety as a prerequisite; integrated services that address mental health, substance use and housing simultaneously; medication-assisted treatment available in jails, emergency rooms and on the streets; peer support from people in recovery; and long-term residential treatment with adequate bed capacity.

We need a system that recognizes addiction as a medical condition, not a moral failing, and that meets people where they are with compassion rather than judgment.

Massive Psychoeducation Needed

This crisis demands community-wide education.

Parents need to understand that one counterfeit pill can kill their teenager. Employers need to train staff to recognize overdoses and administer naloxone.

Schools need evidence-based prevention programs. Health-care providers need to screen for substance use and offer MAT without stigma.

The fentanyl crisis isn’t someone else’s problem. It’s our sons, our daughters, our neighbors, our coworkers.

Tim was someone’s child. He mattered. And there are hundreds more like him in Santa Barbara County right now, fighting the same battle.

Tomorrow, I’ll go back out. Someone else will need help. And I’ll keep showing up — because that’s the only way we survive this.