Addiction Counselors Say Fentanyl Is Now In Most Drugs. It’s Replacing Heroin in Stanislaus Region

The New Hope Recovery House in Modesto used to treat heroin addicts, including people who first got hooked on prescription narcotic painkillers and then sought heroin to prevent withdrawal pains. That was a syndrome of the earlier stages of the nation’s opioid epidemic. Now, heroin has disappeared. And many are seeking treatment for addiction to fentanyl, said an intake counselor at New Hope. “No heroin addicts are coming in,” Counselor Theresa Frassrand said. “You can’t find heroin because the fentanyl is so prevalent.” Staff members at New Hope on East Orangeburg Avenue were among the first to alert media, in June 2020, that fentanyl had arrived on Modesto’s streets. Illegal fentanyl resulted in 5,961 overdose deaths in California in 2021. In the past three years, co-owner Shawna Phillips and substance use counselors have watched the highly lethal fentanyl become widespread in Stanislaus County. The synthetic opioid powder is combined with most illegal drugs including methamphetamine, cocaine, pills and any available heroin, supposedly to enhance the high and reduce the cost.

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“Marijuana is testing positive for fentanyl,” Phillips said. Only about 2 milligrams of fentanyl is lethal, which accounts for the 366 fentanyl overdose deaths in Stanislaus County since 2020, including more than 80 since January. Total overdose deaths are expected to exceed 200 in 2023, or four to five per week. New Hope Recovery has residential care for 30 people, outpatient counseling and detox service, and stresses one-on-one counseling that gets to the root of substance use. About 70% of the clientele suffer from alcohol dependence. Of those addicted to drugs, staff said, half were taking methamphetamine and half were on fentanyl, whether they knew it or not. Frassrand said some people who come through her intake office don’t know the drugs they were taking contained fentanyl, until they test positive for it. LAB COULD NOT TEST FOR ‘TRANQ’ Phillips was preparing last week for the latest scourge of the Central Valley fentanyl crisis. The lab used by New Hope could not test for “tranq”, which surfaced in Stanislaus County two months ago, but Phillips arranged for a Southern California lab to test clients’ urine samples for the drug. Xylazine combined with fentanyl, also known as tranq, causes skin lesions and severe infections in those that inject the drug. Users suffer the loss of mental function, and xylazine, a horse tranquilizer, does not respond to overdose-reversing Narcan nasal spray. Phillips said she hasn’t seen anyone who has used tranq come to the center for help. “It’s limited now, but I think it’s coming,” she said. Phillips said some clients have knowingly used deadly street fentanyl and are trying to break the addiction. “I ask them ‘does it not terrify you?’” Phillips said. “What they say is it lasts longer and is so much cheaper. A lot of them are injecting it. When they are knowingly using fentanyl, they are usually IV users.” FENTANYL USERS MUST OVERCOME INTENSE CRAVINGS Clients hoping to get clean struggle with the intense cravings of fentanyl use. Phillips said those going through detox have agonizing withdrawal symptoms, and staff need to give them stronger medication to treat the effects. People who leave treatment prematurely run a high risk of using again, so the center works harder to motivate them to stay in treatment, Phillips added. Amy Northern, 42, of Modesto, who’s in counseling at New Hope, said she didn’t have a choice in switching from heroin to fentanyl. The heroin supply dried up. And she didn’t want to suffer severe withdrawal pains, she said. Northern said she overdosed on fentanyl a number of times and was taken by ambulance to hospitals. She has been clean since January and gets support from outpatient classes at the center. “If I go back on it again, it will kill me,” Northern said.

The staff at the community-oriented treatment center are well aware of tragedies of former fentanyl-addicted clients who relapse. “We stay connected with patients and their families and we have been invited to more funerals or received phone calls about people we know who passed away,” Phillips said. Many people working in the addiction field, who often have a substance use background, have lost family members to fentanyl, she said. FENTANYL COMBINED WITH MANY DRUGS Stanislaus County recorded some fentanyl deaths before 2020, including 16 in 2019 and 10 in 2018. Illegal manufacturing of the synthetic opioid was a later development of the national opioid crisis that sprang from over-prescribing of narcotic pain medication. Fentanyl became more prevalent here in 2020 with fake pills made by drug traffickers to look like oxycodone, Xanax and other prescription drugs. The county’s 60 fentanyl overdose deaths in 2020 grew to 97 in 2021 and 128 in 2022. Drug traffickers are now combining fentanyl with many other drugs and don’t have standards to keep the fentanyl content within safe limits. As fentanyl continues to run rampant, the New Hope staff are trying to maintain the center’s success rate, which they boast is well above the national average. Phillips said there are substance use resources in the community but not enough coordination to help people find those services. Recovery services run into problems in getting private insurance to cover treatment for addiction. “A lot of people can’t stay clean on their own,” Phillips said. “They need to learn abstinence and need a period of time to stay clean. Insurance usually covers 30 days of residential care before it steps down to outpatient classes. Longer treatment has been proven (to achieve) better outcomes.”

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