The San Joaquin Valley is in crisis due to overdoses of fentanyl and other opioids

Opioid and fentanyl use has caused a crisis in various regions of California, such as Fresno County, because overdose deaths continue and have a significant impact on families and public health.

Unfortunately, many people who use drugs do not even know they are using fentanyl.

Daniela Rodríguez, a UC Berkeley fellow and reporter for Radio Bilingüe, prepared this information.

In the San Joaquin Valley, in the southern part of California’s Central Valley, the opioid crisis continues to affect many people who fall into addiction and families who are sometimes devastated after the death of a loved one.

Dr. Marlon Echaverry, an academic and health professional in the family medicine residency program at the University of California, San Francisco, Fresno campus, explains how prevalent the opioid crisis is in the region.

“The problem started a long time ago, but it’s still going on. What puts us in real danger is that these days it’s not just opioids like heroin, but also fentanyl. Unfortunately, fentanyl is very potent. And what happens is that if a person takes fentanyl, thinking it’s heroin, they can easily kill themselves with an overdose.”

In Fresno County alone, the number of opioid deaths remains alarming. Dr. Echaverry points out that in 2023, the county recorded rates higher than the state average, although the rates in Kern and Tulare counties were even higher.

“In Fresno County, there were nearly 267 patients who died from opioids in 2023, which is more than before, in 2022. We have seen it stabilize somewhat, but the problem remains very critical.”

In California, preliminary data from the Department of Public Health show that 2023 saw the highest level of opioid deaths, but in 2024 the numbers declined. Dr. Marlon Echaverry warns that it is not just people who are homeless or chronic users, as young people and adults who do not know that the pills are contaminated with fentanyl are also losing their lives.

So, because people often think that it is only people on the street who are using fentanyl, and that they are the only ones who are dying, that is really not the case. What we see from time to time are young people experimenting with drugs, occasionally people who do not use drugs in any form, but receive a pill from a neighbor or a friend at a party, for whatever reason, and do not know that there is fentanyl in it.”

Dr. Echaverry, who also runs Harm Reduction clinics in downtown Fresno and elsewhere in the Central Valley, warns that even more potent types of fentanyl are being detected. Still, he believes that opioid deaths have been declining thanks to access to available help.

“And we’re seeing that when we improve people’s ability to get treatment, their ability to access mental health programs, the numbers are improving. When access and government funding improve, the problem starts to get better little by little.”

In response to this crisis, local organizations have expanded prevention and treatment programs. Dr. Echeverry points out that there are still few harm reduction clinics in the Central Valley, but in the ones he runs, the goal is to understand the patient and their illness holistically.

“But most importantly, I explain to them that it is treatable. There are medications for every ‘chemico’ in these clinics that we give them.”

However, he also says that these medications are not always effective, and patients must be ready to give up those chemicals. That is why he asserts that one of the most effective resources for opioid use is buprenorphine.

“Every time we prescribe this medication, we know that it will save a life every three times we prescribe it. That’s a very high number. Buprenorphine is one of the safest medications that helps save the most lives.”

Another key resource is Narcan, an antidote to overdose that is now distributed in places such as clinics, hospitals, community events, and even restaurants.

“If a family is unfortunately suffering from addiction, they should have Narcan in their kitchen. At the very least, they will have the medication and can use it easily.”

In closing, Dr. Marlon Echaverry warns of a significant danger currently facing families in California’s Central Valley.

“We are in an era of fentanyl contamination. What I tell all my patients is to be very careful.”

Many thanks to Daniela Rodríguez, a UC Berkeley fellow and reporter for Radio Bilingüe.

This report is part of the Closing the Gap series and is partially funded by The Sierra Health Foundation.