In 2022, at least 877 people died from drug overdoses in Riverside County—with 519 caused by fentanyl.
Through May 31 of this year, there have already been 329 overdose deaths recorded, 208 of which resulted from fentanyl—and a disproportionate number of those deaths have occurred in the Coachella Valley.
In other words, our area has a significant drug-overdose problem.
All of these statistics come from the Riverside County Overdose Dashboard, designed and maintained by the Riverside County Department of Public Health (RCDPH), with Wendy Hetherington, chief of epidemiology, program evaluation and vital records, supervising the effort.
The dashboard was developed after the RCDPH received an Overdose Data to Action grant from the United States Centers for Disease Control and Prevention in 2019, Hetherington said during a recent interview.
“The primary purpose of that grant was to enhance our collection and analysis and reporting of overdose data, and then to use that data to guide the development and implementation of prevention programs related to overdose,” Hetherington said.
I asked Hetherington if she agreed that fentanyl and other opioid overdoses were on the rise in our region.
“I wouldn’t say that,” she said. “Overdose deaths have been increasing pretty much regularly for a while, and then in 2020, they went up by a lot. The difference between 2021 and 2022—although we still increased in 2022—wasn’t as big of an increase, so I would say that we’re stabilizing.
“In particular populations, we look at a lot of demographic data. For instance, we’re noticing an increase in (overdose incidents in) the Native American population, the Latinx population, the African-American population, and different cohorts within that.”
The biggest increase, she said, has been among the unhoused population.
“Overdose deaths in the homeless population have tripled over the last three to four years,” Hetherington said. “It’s something that’s really concerning. A lot of times on the news, you hear about the younger population and people in school. That’s really important. … But when you look at the absolute numbers and the rates of overdoses, it’s people who are homeless, people who are middle age or older, and people who have addiction issues” who need the most help.
However, Riverside County does not have one tool being used in some communities to ascertain where overdose prevention resources should be concentrated: wastewater testing.
“When you look at the absolute numbers and the rates of overdoses, it’s people who are homeless, people who are middle age or older, and people who have addiction issues.”
Wendy Hetherington, county chief of epidemiology, program evaluation and vital records
Testing a community’s wastewater to watch for trends was widely adopted in response to the onset of the COVID-19 pandemic. Not only can municipalities test for the presence of a virus; they can test for the presence of drugs, like fentanyl,
A July 24 article on the website of WUSA9 in Washington, D.C., examined a regional program being run New Castle, Del. “Everybody poops; it’s not a biased sample,” New Castle County Executive Matt Meyer said. “It enables us to look in an unbiased way and say, ‘Hey, in this neighborhood where we never thought there were spikes in cocaine use and fentanyl use, we need to pay more attention.’ … So it allows us, as policymakers, to make decisions without traditional biases.”
Here in California, Marin County health officials in February instituted a pilot wastewater-testing regimen for methamphetamine, fentanyl, nicotine and cocaine. Government Technology in May quoted Haylea Hannah, senior department analyst for the county of Marin Department of Health and Human Services: “We were really interested in piloting (this technology) and seeing if it was a tool that could help fill in some of the gaps that we know we have in our existing drug surveillance overall, and if it could help at all with overdose prevention.”
Both of these communities have partnered with BioBot, a company in Massachusetts, to conduct the tests
“Wastewater data might be able to provide warning signs of increased use that we can address and provide services for, before we see them downstream as fatal or nonfatal overdoses,” Hannah told Government Technology.
The Independent reached out to two wastewater-treatment departments in the Coachella Valley—both of which have been testing for the presence of the virus that causes COVID-19—to ask if they were considering testing for drugs.
The answer: Nope.
In Palm Springs, we were referred to Amy Blaisdell, the city’s communications director. In an email response, Blaisdell wrote, “The city does not test for narcotics in its wastewater. The city does the federally required testing—and is continuing to do COVID and monkeypox testing at the request of Riverside County Public Health and the California Department of Public Health. The city does not analyze the data. Staff forwards it to Riverside County who handles public health issues.”
In the east valley, we spoke with Jason Dafforn, general manager for the Valley Sanitary District, which treats wastewater in Indio and some surrounding areas.
“We have a permit issued by the state of California which regulates our operations here in Southern California,” Dafforn said. “That permit clearly identifies the discharge requirements and really lays out what (our) district here is required to test for. As part of our program, which is similar to all of the wastewater agencies in the state, we do not, and are not required to, test for these specific types of pharmaceutical (substances) or opioids, if you will.”
Dafforn said he wasn’t surprised that wastewater was being tested for drug levels in other parts of the country. “But currently, we are not. I’m hoping it’s a good thing that we’re not doing that, because maybe it’s not a prevalent issue. I know that fentanyl is a scary and very ugly drug, so hopefully it doesn’t become an issue in our area, but I know it’s spreading throughout the U.S.”
The California Department of Public Health’s email response read: “The CDPH Wastewater Surveillance Team is not involved with any localized wastewater testing for opiates, and therefore cannot comment on this.”
The Independent emailed the California Department of Public Health’s communications department in Sacramento and requested an interview to discuss the possibility of Coachella Valley’s wastewater-treatment organizations implementing drug-level-testing programs. Their email response read: “The CDPH Wastewater Surveillance Team is not involved with any localized wastewater testing for opiates, and therefore cannot comment on this.”
We asked Riverside County’s Hetherington whether she saw value in such wastewater testing.
“Any avenue, in terms of surveillance work to know what’s really going on, could be helpful, and maybe wastewater data would be able to tell us (where there’s a) prevalence of people who use fentanyl or other opioids, because that would be captured in wastewater data,” Hetherington said. “From a public-health perspective, we have data related to people who overdose—either 911-EMS data or emergency department data, or, unfortunately if they pass away, we have a record of their death—but we really don’t have accurate numbers about how many people actually use opioids or fentanyl on a regular basis, and wastewater data probably could help with that.
“Of course, if it were countywide, then (it would be helpful) for sure. But even a sub-local like Indio wastewater might be a good representation of a general community, and what their use of opioids is.”
