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Opioid Use: The New Public Health Crisis

Published on Aug. 30, 2021

A guest post by Fresno County District Attorney Lisa Smittcamp

Fentanyl has long been used by licensed professionals for pain management in hospital and medical settings. Today, it has become a common street drug in the United States, sold as counterfeit pills, that is causing addiction, overdoses and overdose deaths in skyrocketing numbers.

In 2018, there were two fentanyl-related deaths in Fresno County. In 2020, that number jumped to 40. This crisis is running rampant in our own community, especially with our youth and young adults. 

The majority of counterfeit drug production occurs in other countries, mainly China, Mexico and India. However, we are also starting to see production in the United States.

Transnational drug organizations, otherwise known as drug cartels, make the pills in clandestine manufacturing facilities in Mexico for distribution all over the world. California is particularly vulnerable to drug traffickers because of our close proximity to the Mexican border. The majority of the counterfeit pills resemble blue 30mg Oxycodone pills (M30s). However, they are also sold in other forms and mimic actual Vicodin, Adderall and Xanax, among others.

Many teenagers and young adults continue to struggle with anxiety as the COVID-19 pandemic continues, and many seek out these drugs to cope. Very quickly, they find themselves addicted and facing life-threatening risks every time they purchase a counterfeit pill. 

High school and college students purchase counterfeit pills from dark web drug markets and via social media. Cash apps are used to pay for the transactions, and oftentimes the people dealing the drugs to the user are addicts or peers of the user. They deliver the drugs at a meeting place, or even bring the pills to the home of the user, much like a food delivery service.

With the weakening of the drug laws in the State of California, locally we have to rely on two things to help us battle this crisis: 1) our sound partnerships with federal agencies such as the United States Attorney’s Office, Drug Enforcement Administration and Homeland Security Investigations; and 2) education and awareness within the community.

We cannot investigate or prosecute our way out of this crisis that is killing our young people. This poison is present in every city in the state of California, and all young people are susceptible to the ills of the drug. It is my hope that the more aware we can make the community about the presence of the lethal counterfeit pills, the more lives we can save.

To learn more about fentanyl and the impact on our youth, visit Fresno County Department of Behavioral Health or Fresno County Law Enforcement. For information on substance abuse and prevention resources, visit

About the Author: Lisa Smittcamp is the Fresno County District Attorney and is also a member of Valley Children's Hospital Board of Trustees.

About Valley Children’s Take-Back Initiative

Valley Children's Medication Take Back Initiative BinValley Children’s Hospital has a medication disposal bin designated by the United States Drug Enforcement Agency (DEA) to keep harmful and unused medications out of reach for children. The Valley Children’s pharmacy team announced the safe collection of more than 128 pounds of discarded drugs in just over a year. Valley Children’s reminds the community to check frequently for unused, expired prescription drugs in their home and to dispose of them properly.


The medication disposal bin is located at the Imaging entrance of the hospital and is accessible to the public during normal business hours. Valley Children’s security personnel monitor the bin, which the community can use to safely dispose of prescription medications, liquids with tight caps, ointments/lotions, pet medications, prescription patches and over-the-counter medicine.


To find more medication disposal bin locations near you, visit