These days, even what counts as positive local news about fentanyl is pretty grim.

For example: Last year, 555 people died in Orange County after ingesting the powerful, synthetic opiate, some after they knowingly took a drug they’d been told was fentanyl and many others because they took a street version of a different drug – anything from Adderall to Xanax – that happened to have a lethal amount of fentanyl in it.

The positive spin? The 2022 death count was about 14% less than the 647 people who died locally of fentanyl in 2021. That was the first year-to-year decline in the nine years that fentanyl deaths have been tracked locally; in the four years prior to 2021, the county saw a five-fold jump in fentanyl deaths.

Such numbers – and a collective belief that even after the recent dip fentanyl is likely to keep killing locals of all ages races and ethnic backgrounds – have prompted Orange County to join a public awareness campaign called “Fentanyl is Forever.” All five county supervisors and several county health officials gathered in a conference center at the Santa Ana Civic Center on Tuesday, Oct. 10, to talk up the campaign, which includes a multilingual website, live town halls and efforts to boost availability of different versions of the anti-overdose drug naloxone.

Some also offered increasingly personal messages about their contact – and frustration – with the scourge posed by illicit fentanyl.

“The entire board is deeply troubled by the threat fentanyl poses,” said Third District Supervisor Don Wagner.

“The attraction… to users is because it is cheaper,” said First District Supervisor Andrew Do.

“Among Latinos, in California, there was an 85% increase in overdose deaths in 2021 from the year before, and it was the same in 2022,” said Second District Supervisor Vicente Sarmiento. “We know the impacts fall heaviest on people of color.”

“Fentanyl has, forever, taken one of my son’s friends,” said Fifth District Supervisor Katrina Foley. “He and his girlfriend took a Xanax. But one pill can kill and, forever, we no longer have those two with us.”

And Dr. Veronica Kelley, who oversees the county’s mental health and recovery services, noted that the drug has, literally, touched home.

“As a clinician, I know how important is to get the word out,” Kelley said. “And as a mom, who has used Narcan to reverse an overdose of my own child in my home, I know how important it is to have that drug on hand.”

The push is the latest step in what has become a long-running public health battle against fentanyl, which now accounts for roughly nine out of every 10 opioid deaths in the county.

Last month, the county authorized the purchase of 250,000 doses of different versions of naloxone, the drug that can revive people from opioid overdoses. One of those versions, sold under the brand name Kloxxado, is twice as powerful as Narcan and is specifically crafted to take on the chemistry of fentanyl. County officials handed out boxes of Kloxxado at Thursday’s event.

But officials were less specific about how the “Fentanyl is Forever” campaign will affect fentanyl use in the county. Anti-drug campaigns have a mixed history nationally, with once-popular ideas like “Just Say No” and “D.A.R.E.” eventually producing poor to mixed results in actually driving down drug use. And overdose data in counties where the “Fentanyl is Forever” campaign already is in use don’t yet point to big success. In Ventura County, fentanyl overdoses were up 10% last year. In San Joaquin County, the fentanyl death rate was up by about 8% in 2021, the last year records are available. And in Santa Barbara County, where the “Fentanyl is Forever” campaign includes a website, videos and testimonials that are identical to those on the Orange County version of the site (fentanylisforeveroc.org), 114 of the 122 people who died of opioid use last year were felled by fentanyl.

Still, until last year’s downturn in fentanyl deaths, other trend lines suggested local anti-fentanyl strategies weren’t working.

For example, public health data shows that even as fentanyl awareness has been a discussion point in public schools, opioid overdose deaths (about 90% of which now are connected to fentanyl) are shifting younger. Since 2017, people ages 25-to-44 have replaced people ages 45-to-64 as the group most likely to die of fentanyl or any other type of opioid.

Also, even though fentanyl is cheaper than heroin and other opioids, the communities with the highest overdose rates continue to be wealthy areas near the coast and in south Orange County.

The county also has yet to pinpoint data related to some elements of the fentanyl boom. For example, county data doesn’t differentiate overdoses connected to people knowingly taking fentanyl and people dying because a lethal amount of fentanyl was mixed into the drug they were using.

Kelley, the county health official, suggested such data isn’t tracked, but it also isn’t the point of the current public information campaign.

“I would just respond by saying dead is dead,” Kelley said. “We aren’t looking to see if they were trying to get high or not. The important thing to know is treatment works, recovery happens and Narcan can save a life.”

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