Santa Cruz County Overdose Deaths Fall for Third Consecutive Year

Drug overdose deaths in Santa Cruz County, California, have fallen sharply for the third consecutive year, reversing a grim trend that peaked in 2023 when more than 130 people died. Twenty fatalities were recorded in the first six months of 2026, down from 36 during the same period last year, according to data from the Santa Cruz County Sheriff's Office.

If the current pace continues, the county could record fewer than 50 deaths this year—its lowest total in more than five years. The turnaround follows years of increasingly deadly overdoses driven largely by fentanyl, a powerful synthetic opioid that has been involved in close to 70 percent of overdose deaths since 2022.

A coordinated response

The decline reflects a broad expansion of treatment, prevention, and law-enforcement efforts that began after the 2023 peak. "It's really taken all of us," said Marni R. Sandoval, the county's Health Services Agency behavioral health director, who oversees substance-use services.

At the suggestion of Sheriff-Coroner Chris Clark, former sheriff Jim Hart established a multidisciplinary team in 2023 to review every overdose death each month. "We had folks from the state come sit with us because they hadn't seen it done," Clark said. That review process helped lead to the formation of the Fentanyl Crisis Response Team in 2024, which focused on high-volume dealers typically selling at least a pound of drugs at a time.

"We made short work of a lot of those dealers," Clark said, noting that much of the dealing and deaths happen near the San Lorenzo River levee and Costco.

Public health approach

Law enforcement has increasingly embraced a public-health approach to drugs rather than a purely criminal one. In 2015, the sheriff's office was among the first in the nation to set up a sobering center, where people arrested for public intoxication can be taken for treatment instead of jail. The Santa Cruz County Sobering Center, a 24/7 treatment facility near the county jail, reopened in 2024 after being shut down in 2020 due to the coronavirus pandemic and budget cuts.

"It's no surprise that overdose deaths began coming down the same year the sobering center reopened," said Amber Williams, chief executive of Janus of Santa Cruz, the nonprofit that runs the facility. "We rallied around each other and saw what challenges were happening post-COVID in overdose death rates and focused on how we could get medication to the population."

At its 18 locations and through mobile vans, Janus distributes naloxone to help prevent opioid deaths. Police officers also carry the life-saving medicine, delivered by nasal spray, and provide it freely to people in custody.

Opioid settlement funds at work

The county has leveraged millions of dollars in opioid settlement funds—payments from drugmakers, distributors, and pharmacies to state and local governments following lawsuits over the opioid epidemic. Santa Cruz County has awarded more than $1.6 million since 2024, with a second round of funds announced this March.

Among the recipients is New Life Community Services, which received $201,358 this year to support a 14-bed addiction-treatment facility in Watsonville.

"What we're doing and investing in and committed to is working," Sandoval said. "And we can't stop now."

Fentanyl, typically sold in powder form, poses a particularly lethal threat because people who use other drugs, including cocaine and methamphetamine, can unknowingly consume it when it is mixed into these substances. The county's approach combines law enforcement targeting of high-volume dealers with expanded access to medication-assisted treatment and harm reduction services.

The Santa Cruz County model demonstrates how local jurisdictions can achieve significant reductions in overdose mortality through coordinated investment in treatment infrastructure, harm reduction tools like naloxone, and strategic deployment of opioid settlement funds to expand access to care.