The Abridged version:
- The fentanyl overdose death count is declining in Sacramento, El Dorado and Placer counties.
- The decline in Sacramento County is especially apparent in Del Paso Heights and Old North Sacramento.
- Public health officials say the recent decline in overdose deaths could be the result of increased efforts related to prevention, particularly distribution of Narcan.
More than one death a day.
That’s how many people were killed by fentanyl-related overdoses in Sacramento County, on average, during an ugly, record-breaking 2023.
Now, the death count has finally begun to decline.
Fentanyl contributed to about 280 deaths in Sacramento County in 2024, down by about 125, or 31%, from 2023, according to provisional data from the Sacramento County Coroner’s Office.
A separate dataset from the California Department of Public Health also shows apparent declines in opioid-related overdose deaths through September of last year in Placer and El Dorado counties, as well as across the state. The number of deaths in Yolo County held relatively steady.
The downward trend may be continuing. The Sacramento County Coroner’s Office reported 76 fentanyl-related deaths in the first four months of 2025, compared to 112 deaths in the first four months of 2024. Those numbers could change, though, because it can take several months to determine whether drugs contributed to a death.
The decline has been especially profound in Del Paso Heights and Old North Sacramento, two hotspots of the local fentanyl crisis. Fentanyl-related deaths in the 95838 ZIP code covering Del Paso Heights fell from 12 in 2023 to six in 2024, and deaths in the 95815 ZIP code covering Old North Sacramento fell from 28 in 2023 to eight in 2024.
Despite the respite, fentanyl-related overdoses remain a crisis. The number of deaths in 2024 can only be viewed favorably when compared to the unprecedented spike in 2023. For historical context, Sacramento County saw 33 fentanyl-related deaths in 2019 and about 110 in 2020.
Drug dealers continue to prey on the vulnerable. “When you’re concentrated in an area like ours, where the poverty is so high, where the trauma is so high, which is associated with poverty, then you’ve got folks who come into the neighborhoods like that,” said Gina Warren, founder and CEO of Sacramento’s Neighborhood Wellness Foundation, which serves Del Paso Heights and North Sacramento. “It’s easy. It’s easy to find somebody who’s in need. It’s supply and demand.”
Public health officials and experts said the recent decline in overdose deaths could be the result of increased efforts related to prevention, enforcement and treatment.
Over the last few years, officials have made a huge push to make Narcan readily available to anyone who might encounter someone experiencing an opioid overdose. Narcan is a nasal spray that can quickly counteract the effects of an overdose, saving lives.
For example, a consortium of drug treatment officials and experts offers free training on the proper use of Narcan. The Sacramento LGBT Community Center even created a ” naloxone newsstand that allowed people passing by its midtown location to obtain the spray at any hour, though they recently removed it following vandalism.
Neighborhood Wellness is one of the organizations on the front lines distributing Narcan. Warren said staff members at her organization started by reaching out to people along a bike trail in their community, and the need was intense.
“We were on that trail twice a week, sometimes three,” Warren said. “We had 220 encounters a week.
“We wanted to save lives and also to connect them to resources that they can address their trauma and address their substance use challenges.”
Officials have also made a comprehensive effort to distribute strips that test for fentanyl. Local colleges in the area, for instance, have been giving out the strips, along with Narcan and tests to detect drink spiking, to students.
State and county officials have embarked on public awareness campaigns detailing the dangers of fentanyl. Flyers, billboards and public service announcements all discuss how only a tiny amount of fentanyl can be fatal.
The campaign included media ads, a website, personal stories, and partnerships with impacted families, community events and “distribution of Narcan everywhere,” said Lori Miller, division manager at Sacramento County’s Substance Use Prevention and Treatment Services.
Federal, state and county law enforcement officials have beefed up enforcement efforts and publicized prison convictions for dealers convicted of distributing fentanyl.
Those prosecutions include a 27-year-old Sacramento man sentenced in federal court to 16 years in prison for conspiring to distribute fentanyl and methamphetamine; murder charges filed in late 2024 in Placer County against a 34-year-old Sacramento County man accused in relation to a fentanyl overdose; and a regionwide law enforcement operation in February that resulted in 51 felony arrests related to illicit drugs sales online.
“In the last two years, you saw counties like Sacramento, like Placer, like Fresno, really taking this seriously, knowing that if drug dealers are not held accountable, we’re going to continue to see this issue,” Miller said.
The county also funded more treatment for people addicted to drugs, trying to get to the root of the problem, Miller said. Mobile medical teams staffed with paramedics, physicians or substance use professionals were dispatched across the area. Officials added scores of treatment beds, reducing wait times for addiction treatment.
“We’re getting people into treatment within a 10-day period,” Miller said.
Warren and her team at Neighborhood Wellness also focused on underlying causes of the crisis, providing healing circles — group therapy and support —to assuage the trauma and pain that causes people to look for a quick fix.
“We tell people, ‘you gotta go get a physical release. You gotta talk, first of all,’” Warren said. “Acknowledge it, then talk, and then go for a walk. Find your safe space. Find your safe community that will help you stay where you are, instead of adding gasoline to your fire.”
While the gains achieved are tangible, it will take continued focus and more resources to keep drug overdose numbers down, Warren said.
“These are our people,” she said. “These are our community folks that we want to save, and so we are emotionally invested we are invested, period, because we want to see people reach their potential.”
Phillip Reese is a regular contributor, writing Numbers Matter for Abridged.