When prices drop and supply increases, even in the face of steady demand, the consumer benefits.
There are exceptions to the rule, of course. One is when the commodity in question is killing people.
Just such a bonanza of availability, however, could soon be the case with illicitly manufactured street opioids, which, like opioids in general, present a persistent threat to the health and well-being of communities across the country. That's particularly the case in Kern County, where overdose rates are a staggering 50 percent above the state average and quadruple in two specific pockets of despair.
Kern County's opioid overdose rate of 8.5 per 100,000 population dwarfs the state rate of 5.2, according to the California Opioid Overdose Surveillance Dashboard, a collaboration of four state agencies and nonprofits. Two areas of the county — a portion of the poverty-afflicted Kern River Valley and the section of east Bakersfield roughly between Bakersfield College and Old Town Kern — exceed 22 per 100,000. Overdose rates in the Latino-majority farm town of Lamont are more than 20 per 100,000, and central-south Bakersfield (93304) and working-class Oildale are not far behind.
Poverty is a predictive indicator but not an infallible one: The overdose rate in the relatively affluent southwest Bakersfield ZIP code of 93309 is more than double the state average.
And now a new threat looms — fentanyl, reportedly manufactured in China, packaged for distribution in Mexico and mixed, often unadvertised, with other street drugs.
It's not that local law enforcement agencies are being deluged with fentanyl at the moment. They're not. Drugs are flowing through Kern County — just Friday, an interagency task force arrested two men in south Bakersfield in possession of 5 pounds of cocaine and almost 2 pounds of heroin with a combined street value of nearly a quarter-million dollars — but fentanyl has been identified only a few times in such busts. It's just that the stuff is among the deadliest substances out there. A little goes a long way when it comes to overdose statistics.
Fentanyl is turning up in combination with other drugs — and killing people who may not even know it's present in the pill they're swallowing, the powder they're snorting or the vial they're injecting. The pain-numbing drug is administered to cancer patients by way of a prescription patch, but the illicit street version is so strong it can grab an arresting deputy who gets too close and knock him off his feet.
Across the U.S., opioids kill 130 people day, some of them right here. Local numbers are tough to come by because the most recent figures are for all drug overdoses, not just for opioids like heroin and prescription painkillers. But we know this: 75 people died from opioid deaths in Kern County in 2017, and 251 died from all drug overdoses in 2018.
In 2017, opioids sent 165 people to Kern County emergency centers and 101 to local hospitals.
Local programs have sometimes struggled to keep up with addiction levels, and law enforcement is challenged as well.
The Kern County Sheriff’s Office has been distributing the opioid-overdose prevention drug Narcan (naloxone) to deputies since 2016, and Sheriff Donny Youngblood reports they’ve saved at least seven lives by administering the potent nasal spray. The Arvin Police Department now carries Narcan, as well; the Bakersfield Police Department does not, although agency officials have researched the possibility.
The county oversees a program that administers the synthetic opioid methadone, which tamps down withdrawal symptoms, to addicts trying to kick; the drug is formulated to block rather than engage the pleasure centers that other opiates activate. Four licensed methadone clinics — three in Bakersfield and one in Delano — treat local patients through two state-licensed, state-certified contracted providers, Aegis Treatment Centers of Canoga Park and American Health Services of Santa Clarita. (It bears noting that the communities of the Kern River Valley, including Lake Isabella, Weldon and Wofford Heights — which has the highest per capita addiction rate in Kern County — do not have a clinic.)
Between those four locations, the county can treat up to 1,605 patients at a time. As of Thursday, 1,510 slots were filled with recovering addicts who receive regular, mandatory counseling and a daily cup of liquid methadone.
"We currently don't have a waitlist but it varies daily," said Ana Olvera, a licensed marriage and family therapist who serves as the program administrator for Kern Behavioral Health and Recovery Services' substance use disorder division. "People show up at the door and say, 'I need this.' Ten people might want to start on the same day and if we're full, we may tell five to come back the next day. We've had that happen."
People may need treatment because of addiction to any number of opioids, illicitly manufactured, illegally obtained or legally prescribed, including Vicodin, codeine, heroin, morphine, Percocet and OxyContin.
Perhaps surprisingly, the age groups suffering the highest rates of overdoses in Kern County are 50-54 and 55-59, possibly suggesting that legally prescribed opioids are killing people as effectively as illegally manufactured opioids — or, more likely, prescription opioids are creating addictions that street opioids must eventually satisfy.
Legally prescribed drugs, said Sgt. Mark Warren of the Sheriff’s Office narcotics investigations division, are also paving the road for younger addicts-in-waiting.
"One path to addiction starts in high school, where kids are getting exposed to their parents' pills, or someone who has had a surgery is prescribed these pills," he said. "But it's very expensive to buy hydrocodone on the street, and so they're going to get it however they can get it — and it's usually like this."
By "this," Warren means criminal operations like the one he helped bust near Delano last October as part of that same multiagency task force: In addition to 40 pounds of methamphetamine and a quarter-pound of cocaine, they seized 1,000 counterfeit oxycodone pills produced with fentanyl. Four men were arrested.
Yes, fentanyl cases are still somewhat rare. Over the past 12 months, fentanyl has turned up in only about 10 cases analyzed by the Kern Regional Crime Laboratory — in counterfeit pharmaceuticals, variously colored powders and sticky, brown substances similar to tar heroin. That's just a fraction of the crime lab's 1,300 drug screenings over that period, according to crime lab supervisor Tammi Noe.
But the incidence of fentanyl-spiked street opioids is most likely to go up before it goes down.
"The potency is increasing," Warren said. "And drug prices have really dropped. More are readily available."
Is Kern County as prepared as it ought to be? Certainly people like Warren and Olvera are working to make it so. But if an onslaught is coming, we need to be ready for it.
Know someone — perhaps yourself — with a dependency issue? Call the Kern Behavioral Health and Recovery Services Crisis Hotline at 866-266-4898. Suspect someone of trafficking in opioids? Call 661-392-6003 or visit wetip.com.