In a hearing room in the California State Capitol, tears flowed as tribal leaders shared stories of the family members they’d lost to fentanyl overdoses in the past few years.
Angela Elliot Santos is the Chairperson of the Manzanita Band of the Kumeyaay Nation, near the state’s border with Mexico. The tribe is small — only 155 people. Since 2021, she’s lost two nephews and a first cousin to accidental fentanyl overdoses. She said she’s haunted by the guilt of not being able to help them.
Santos said she asked her niece to describe one of the nephews who’d died and read her words to the assembled legislators.
“Hours before he passed, we were talking about his love for the culture — that he wanted to teach all his nephews to sing and teach all the kids to play our hand game peon,” she read. “He had the passion to keep our traditions alive.”
Santos added: “Unfortunately, the baggage of intergenerational traumas, along with stigmas attached to seeking help for mental health and substance use disorder, have brought us to a place where unnecessary deaths happen far too often.”
During a recent 2 and 1/2 hour round table discussion at the Capitol, Native American leaders pleaded to state lawmakers for help with combatting the fentanyl crisis on tribal lands: Asking specifically for more consistent funding, regional treatment centers, widespread education about fentanyl and other new drugs, and better cooperation from law enforcement to stem the tide of drugs and respond to overdoses. The round table was hosted by the California Native American Legislative Caucus, led by Assembly member James Ramos, a Democrat who represents the Highland area and the first California Indian to be elected to the State Assembly.
“Native American overdose deaths are above the national average and [Native people] are disproportionately impacted, per capita-wise,” said Ramos. “Drug related activity in Indian Country is a major contributor to violent crime and imposes serious health and economic hardships on tribal communities.”
Fentanyl is an extremely powerful synthetic opioid that is normally prescribed to people after major surgery or during advanced-stage cancer. However, for the past decade, illicitly manufactured fentanyl, which is often combined with heroin or cocaine, has fueled a surge in the opioid epidemic and in related overdoses and deaths.
According to data from the California Department of Public Health, there were 7,175 opioid-related overdose deaths in the state in 2021; 5,961 of these deaths were related to fentanyl. In 2020, American Indian and Alaska Native people were the demographic with the highest opioid-related overdoses, with 26.2 people overdosing per 100,000. Although the state doesn’t have complete data from 2022 or 2023, information shared by some counties during the roundtable showed fentanyl usage has surged even higher in some tribal regions over the past year.
Ami Admire has been teaching on the Rincon Indian Reservation in San Diego County for decades. She said she’s seen a worrying trend she’s dubbed the “school-to-addiction pipeline” where discrimination at school leads to kids dropping out and turning to drugs.
“We have eighth graders with opioid problems exacerbated by the pandemic,” she said. “We know they're not returning to school.”
There are nearly 100 separate reservations or rancherias in California and many are in very rural areas. Santos said, on her reservation in southeastern San Diego County, they need quicker emergency response for people in crisis or experiencing overdoses.
“If you call and it's in the night, no one comes for two or three hours. There are no [Psychiatric Emergency Response Team] teams, there are no mental health crisis teams. But maybe through collaboration in those rural areas, we could serve not only our people but the other people who are also suffering in that area,” she said.
Representatives from the Yurok tribe in northwestern Del Norte county also expressed a desire for collaboration and coordinated response in rural areas.
“We need regional treatment centers, not treatment centers that we have to go hundreds of miles to that may not have room for us,” said Yurok Tribal Court Chief Judge Abby Abinanti. “This is not right. This is a state that can do better and needs to do better.”
The highest rates of opioid-related deaths in California are in the northwest coastal region: An area where many Native American tribes are located, including the Yurok, Hoopa and Karuk people. Where the Yurok people live, in the upper west corner of the state, tribal police collaborate with the County Sheriff.
Del Norte County Sheriff Garrett Scott spoke, sharing that the death rate in the county has been “sickening.” Last year, of a population of 28,000 people, there were 33 drug related deaths, of which 19 were fentanyl overdoses. Native people make up the vast majority of overdoses in that county.
Yurok Tribal Police Chief Greg O’Rourke said his attitude about fentanyl has changed over the past two years. “I am ashamed to admit that even seeing the impacts of fentanyl and opioid use within my career, I still had that stigma attached to it of, ‘well, they shouldn't have started using,’” he said. “And it wasn't until my sister died of an overdose when that shift of perspective became very personal and very relevant.”
O’Rourke also shared that tribal police have been worried seeing the proliferation of the drug “tranq,” the street name for the animal tranquilizer xylazine, which lawmakers in Congress are now moving to crack down on. He said they’re finding that when fentanyl is combined with "tranq," responders cannot reverse overdoses with the opioid reversal drug Naloxone, known as Narcan.
As far as solutions go, Scott said he is in favor of a measure Ramos has introduced, Assembly Bill 462, which would provide money for law enforcement to better respond to overdose incidents. The bill would allow sheriff’s departments in three counties in Southern California to create response teams that would investigate overdose incidents involving adolescents and groups, with a focus on fentanyl overdoses.
Ramos has also authored Assembly Bill 461, which would require that public institutions of higher education in the state stock and notify students about the location of fentanyl test strips. The Centers for Disease Control and Prevention say fentanyl test strips are an effective harm reduction strategy, where people using other illicit drugs (like cocaine, methamphetamine and heroin) can test their supply to see if it is laced with fentanyl. The CDC says this is important, because drugs with even an extremely small amount of fentanyl in them can kill you.
