The Opioid Crisis in San Bernardino County: Data, Impact, and Solutions

The Scope of the Opioid Crisis in San Bernardino County

The opioid crisis in San Bernardino County represents one of the most urgent public health emergencies facing the Inland Empire. Overdose deaths in the county have climbed steadily since 2015, with a dramatic acceleration beginning in 2020 driven by the proliferation of illicitly manufactured fentanyl in the regional drug supply.

San Bernardino County recorded over 900 overdose deaths in 2023, a figure that represents a more than twofold increase from 2019 levels. Fentanyl was detected in the majority of these deaths, often in combination with methamphetamine, heroin, or counterfeit pharmaceutical pills. The geographic scope of the crisis spans the entire county, from the densely populated western corridor to the High Desert and mountain communities.

These numbers reflect a crisis that affects every demographic group and every community within the county. While certain populations face elevated risk, including individuals with prior opioid prescriptions, those experiencing homelessness, and formerly incarcerated persons, the indiscriminate contamination of the drug supply with fentanyl has expanded the at-risk population dramatically.

How Fentanyl Changed the Epidemic

Illicitly manufactured fentanyl has fundamentally changed the nature of the opioid crisis in San Bernardino County. Unlike pharmaceutical opioids or heroin, fentanyl is cheap to produce, extraordinarily potent, and easily concealed in other substances. A lethal dose of fentanyl can be as small as two milligrams, roughly the size of a few grains of salt.

Fentanyl has been detected in counterfeit pills made to resemble pharmaceutical medications like oxycodone and Xanax, in heroin, in methamphetamine, and in cocaine. Many individuals who die of fentanyl overdose were unaware they were consuming the substance. This contamination of the broader drug supply means that risk extends far beyond individuals who intentionally use opioids.

The introduction of fentanyl analogs, synthetic variants with unpredictable potency, has further complicated the crisis. Some analogs are resistant to standard naloxone dosing, requiring multiple administrations to reverse an overdose. Law enforcement and public health officials in San Bernardino County continue to identify new analogs in the local drug supply.

Communities Most Affected

While the opioid crisis touches every community in San Bernardino County, certain areas have experienced disproportionate impact. The city of San Bernardino, with its concentrated poverty, limited healthcare access, and high rates of homelessness, has some of the highest overdose rates in the county.

The High Desert communities of Victorville, Hesperia, and Adelanto have also seen sharp increases in opioid-related deaths. Geographic isolation, limited treatment infrastructure, and economic challenges contribute to the vulnerability of these communities. The distance from specialized treatment centers in the valley creates additional barriers to care.

Even more affluent communities in the western corridor, including Rancho Cucamonga, Upland, and Claremont, are not immune. Prescription opioid dependence that began with legitimate pain management has led many individuals in these communities to illicit opioids as prescribing guidelines tightened and pharmaceutical supplies decreased.

Evidence-Based Treatment Solutions

Addressing the opioid crisis requires a multi-pronged approach that includes prevention, harm reduction, treatment, and recovery support. At the treatment level, medication-assisted treatment combining FDA-approved medications with behavioral therapy represents the evidence-based standard of care.

Buprenorphine, available as Suboxone and other formulations, is the most widely prescribed medication for opioid use disorder. It can be prescribed by qualified physicians in office-based settings, expanding access beyond specialized opioid treatment programs. Methadone, available through licensed clinics, provides another effective option for individuals who benefit from daily supervised dosing.

Naltrexone, administered as a monthly injection under the brand name Vivitrol, blocks opioid receptors and eliminates the ability to experience opioid effects. This medication is particularly effective for highly motivated individuals and those in criminal justice settings where compliance monitoring is available.

• Buprenorphine: Partial opioid agonist available through office-based prescribing, reduces cravings and withdrawal
• Methadone: Full agonist administered at licensed clinics, daily supervised dosing provides structure
• Naltrexone: Opioid antagonist as monthly injection, blocks opioid effects entirely
• Cognitive Behavioral Therapy: Evidence-based therapy addressing thought patterns and coping strategies
• Contingency Management: Motivational incentives for maintaining abstinence and treatment engagement

Naloxone Access and Harm Reduction

Naloxone, marketed as Narcan, is an opioid antagonist that rapidly reverses opioid overdoses. In San Bernardino County, naloxone is available without a prescription at most pharmacies and is distributed free of charge by community organizations, harm reduction programs, and county health initiatives.

Fentanyl test strips, which allow individuals to detect the presence of fentanyl in their drug supply before use, are another harm reduction tool gaining acceptance in San Bernardino County. While not foolproof, these strips can prevent unintentional fentanyl exposure and prompt individuals to seek help.

Good Samaritan laws in California protect individuals who call 911 to report an overdose from prosecution for minor drug offenses. This legal protection is designed to encourage bystanders to seek emergency help without fear of criminal consequences, potentially saving lives during overdose events.

Getting Help for Opioid Addiction in San Bernardino County

Recovery from opioid addiction is possible with appropriate treatment. San Bernardino County residents can access help through the county behavioral health access line at (888) 743-1478, the SAMHSA helpline at 1-800-662-4357, or by contacting treatment providers directly.

Trust SoCal in Fountain Valley provides comprehensive opioid addiction treatment including medical detox, medication-assisted treatment, residential care, and outpatient programming. The facility's medical team specializes in managing opioid withdrawal and optimizing medication-assisted treatment protocols for long-term success.

Call Trust SoCal at (949) 280-8360 for a free, confidential assessment. The admissions team is available around the clock to answer questions, verify insurance, and coordinate intake for San Bernardino County residents ready to begin recovery.