San Diego Man Who Sold Deadly Fentanyl Gets 15 Year Sentence

fentanyl case 15 years san diego

Saul Caro, a San Diego resident, convicted of selling fentanyl to a man who subsequently overdosed, pleaded guilty to providing the fentanyl on June 1, 2022. At his sentencing hearing, more details of the case were revealed, showing that he was worried about the potency of the fentanyl he had acquired. The jury gave him 15 years.

Caro Knew Fentanyl He Sold Was Deadly

When Caro pleaded guilty on June 1, 2022, he admitted that he sold the highly potent fentanyl to a man the court recorder identified only as MS. Two days later, M.S. was dead. The victim, investigators discovered, had been worried about the potency of the drugs he had previously acquired from Caro. Not only did he think the fentanyl was too potent, but he told Caro that he needed to warn people about it. Caro lied, telling the victim he was. “Yeah thanks otherwise would have been bad news for me lol” (sic) the victim replied.

In November of that same year, the victim again contacted Caro and told him he was worried that the drugs had been altered somehow. The side effect, according to the texts from M.S., said it made his heart “slam.” “Ugh why the hell did they have to put that sh-- in here and ruin it!” he texted Caro. “He told me to be careful cuz its strong,” Caro replied.

Caro continued to supply drugs to the victim and others for months before M.S.’s death. The text messages showed that other drugs could have been mixed into the fentanyl. MS, an experienced opioid user, was uncomfortable with the side effects. Yet the victim has an opioid use disorder and continued buying drugs. Caro continued to sell the drugs even though he likely knew they could be deadly.

“The defendant chose to disregard the significant risk associated with selling fentanyl and other drugs,” said U.S. Attorney Randy Grossman. “His choices had severe consequences for a family that lost a beloved son and brother. The driving factor for all of us in law enforcement is the human toll that fentanyl is taking. We see the grief and destruction in person every day. We will continue to seek justice for every victim.”

Evidence In Fentanyl Overdose Case

The prosecution had much tangible evidence, enough that Caro pleaded guilty on June 1, 2022. He agreed that he sold powdered fentanyl, which led to the death of one of his customers. When they arrested Caro, he had a bag of powder with a greenish tint in his pants, which tested positive for fentanyl. In addition, when they searched his house, they found several guns, ammunition, other drugs, and drug paraphernalia.

Many cases like this have been going forward across the country, and the U.S. continues to battle the opioid epidemic. Opioids have been a leading cause of death in the United States in recent years. Over 100,000 people died from opioid-related overdoses last year, with most of the deaths involving fentanyl.

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Medication-Assisted Treatment is considered the gold standard of treatment for opioid use disorder. Experts say the medication, alongside appropriate treatment, and peer support groups is backed by science. MAT can help individuals begin to live substance-free while quelling withdrawal symptoms and cravings. But how well does it work for people who use fentanyl, a drug that is 50 to 100 times the potency of morphine?

Opioid Use Disorder and Fentanyl

Fentanyl is a highly potent drug that is typically used by experienced drug users. Many people who are exposed to drugs in a medical setting end up misusing them. Some people misuse prescription drugs after surgery. Others start out with recreational opioid use, such as OxyContin pills sold online or on the street. Eventually, addiction becomes costly, and people may move up to more potent drugs. Many people who use heroin, Oxycontin and other opioids decide to try fentanyl, a much more potent drug.

Fentanyl addiction is dangerous and deadly. People can quickly become physically addicted, experiencing intense withdrawal symptoms if they cannot use an opioid. Withdrawal is the top reason many people resist getting sober from opioids. People who use fentanyl will have stronger withdrawal symptoms than those using a less potent drug.

Deciding on MAT Dosage For Fentanyl Users

When a person gets sober from opioids and enters a detox program, they are assessed by a clinician for detox symptoms.  Yes, MAT can be successful for people addicted to higher-dose opioids.  People who have used high doses of drugs such as heroin have still found relief and freedom from cravings using treatment drugs such as methadone, Suboxone or Naltrexone.

A doctor or nurse practitioner will help administer MAT and assess a patient for symptoms after they’ve been sober for 24 hours. There may need to be adjustments to the initial dose. All dosage decisions are made between the healthcare provider and the patient. Some patients will stay on MAT for the duration of their inpatient treatment. Others will stay on it indefinitely. The CDC has said MAT is safe to use for years. For this reason, most sober housing programs treat MAT like they do most medications.

Sober Housing and MAT

People who are sober and meet the requirements of sober housing programs often are on medication. MAT isn’t a big deal; programs are more about focusing on recovery. If you’re interested in sober housing, our program offers community, safety, and recovery in a serene and vibrant environment. Give us a

In May 2022, a three-year-old child died from fentanyl ingestion in a home in San Luis Obispo.  Like many California overdoses, it took months to conduct a full medical examination. Police now say they have enough information on the child’s death to charge the mother criminally. Authorities have announced they plan to charge the child’s mother, 30-year-old Jennifer Mae Niemann, with reckless endangerment.

Fentanyl Overdose Incidents Among Children Becoming Common

On May 4, 2022, police responded to a phone call about a child that was turning blue and not breathing. Emergency personnel arrived and found the unresponsive child. EMTs from the fire department began lifesaving efforts and took the child to the hospital. However, all lifesaving efforts failed. He was pronounced dead later in the day. Toxicology results later showed the child had died from a fentanyl overdose.

Ms. Niemann, the child’s mother, was apparently careless with fentanyl, and due to her actions, the child got ahold of it, resulting in his death. So far, the police have not explained how the child got ahold of the fentanyl. It will likely come up at trial.

Drug overdose deaths involving children aren’t rare. They happen nationwide. They are almost always accidental. States as far away as Kansas had record overdoses for minors in 2020, with 16 teen deaths. Last September, a mother in Iowa was charged with murder when her 22-month-old child died of an overdose.

Ms. Niemann, the mother whose child died in her care in San Luis Obispo, is being held in county jail on four criminal charges. She is being charged with “child endangerment with great bodily injury, enhancement for causing great bodily injury during a commission of a felony, possession of a controlled substance (methamphetamine) and possession of a controlled substance (fentanyl).”  Her bail has been set at half a million dollars.

Fentanyl Is a Deadly Drug

Fentanyl is one of the most potent pain medications in the medical industry. Yet it’s becoming more commonly used as a pain medication, party drug, or adulterant. Many people who ingest fentanyl don’t know that they’re taking it. Fentanyl has become a common adulterant among street drugs, especially drugs sold through anonymous apps. Fentanyl in California has been found in a myriad of drugs seized by police, including cocaine and Molly.

People have accidentally overdosed on fentanyl when they thought they were taking Molly, cocaine, and club drugs. For people who don’t use opioids, this can cause trouble breathing and can make their heart stop. Over 100,000 people died from opioid use disorder in 2021. The majority of these overdoses involved fentanyl. Many of them may have had fentanyl as a contaminant.

People who use opioids are at high risk for overdoses. Fentanyl is a potent drug and can cause significant withdrawal symptoms that make going “cold turkey” nearly impossible. A clinical detox, and treatment, including Medication-Assisted Treatment can help with these issues when a person first gets sober.

Getting Help, And Sober Housing

If you or somebody you love is addicted to fentanyl or other opioids, help is available. Treatment and detox can help you reclaim your life, and sober housing can give you stability.

Many people who go to drug detox and treatment choose sober housing as the next step in recovery. We offer safety, security, and community for you as you begin your journey in recovery. Give us a call at 760-216-2077 to learn more about our programs.

Fentanyl seizures at border continue to spike, according to the U.S. Department of Justice making San Diego a national epicenter for fentanyl trafficking. According to the DOJ release, more deadly fentanyl is being seized by border officials in San Diego and Imperial counties than at any of the nation’s 300-plus ports of entry, making this federal district an epicenter for fentanyl trafficking into the United States.

High Schools are Reporting Ever-Increasing Fentanyl Deaths

The San Diego Union Tribune reported recently about a California high school that made arrests after a student overdosed on fentanyl pills on campus during school. Notably the perpetrator used social media to market the pills.  Using social media channels (like Snapchat) to market fentanyl laced pills is increasingly common, especially among teens, and often with predictably tragic effects

Fentanyl is Hyper-Potent and Deadly

Researchers have sounded an alarm for the past few years about the rise in overdose deaths involving fentanyl. The majority of overdoses now involve the drug, which is 50-100 times as powerful as Morphine. Overdoses that involve fentanyl are usually deadlier because of the potency of the drug.

For people who have an opioid use disorder, there are many risks to take when buying drugs. Regular drug supply chains are strained, and China has outlawed the manufacture of oxycodone (aka Oxycontin) and fentanyl. Because of this, chemists that rely on illicit drug sales have been offering fentanyl either as an adulterant or alternative to other opioids. Chinese drugmakers funnel fentanyl through the Mexico border, and from there, it makes its way into heroin, Oxy, and other street (and internet) drug dealers.

FENTANYL OVERDOSES ARE GETTING YOUNGER

Roneet Lev, an emergency room physician at Scripps Mercy Hospital in San Diego, California, told Bloomberg that most of the overdose deaths she’s seen in teens are accidental overdoses. One of her young patients, 14 years old, died from a fentanyl overdose.

“The problem is both supply and demand,” she said. “There’s already a lot of fentanyl coming into our market, and now we have a pandemic where people are isolated and not working, or not in school. These teenagers probably don’t have a substance use disorder, they’re experimenting, making a bad choice, and they end up dead.”

EDUCATION AND PREVENTION EFFORTS

Many cities and nonprofits say that harm reduction is an integral part of tackling the opioid epidemic. After all, many of the young people who are dying don’t even mean to take fentanyl. They often believe they’re taking a pill such as Percocet, Adderall, Ecstacy, etc. It may be the first time they have ever taken a drug at all.

Many law enforcement agencies are trying to get the word out about counterfeit pills and the dangers of fentanyl.

Some nonprofits offer fentanyl testing strips as a harm reduction measure that can test drugs for the presence of fentanyl. Then, the user can decide if they want to take it or flush it. Narcan, an overdose reversal drug, is also available to people who use opioids and other concerned community members. Carrying this drug can help reverse fatal overdoses, but when it’s a drug like fentanyl, reversal may require multiple doses of Narcan.

STAYING SOBER IN SOBER HOUSING

If you or somebody you love needs a safe living space to continue their recovery journey, sober housing may be the answer. We have an excellent, enthusiastic, peaceful environment where you can learn to live life on its terms, substance-free. Call us to learn more about our programs at 760-216-2077. Our treatment team is also very familiar with recovery from fentanyl and other opioids.

Addiction is a problem throughout the country, and California is no exception. Much of the focus around the country has been placed on fentanyl use. After all, fentanyl overdoses outrank all other drug addiction deaths. However, meth addiction has been rising steadily in the past several years. As a result, overdoses have been increasing as well.

Meth’s Growing Popularity

Pop culture such as the popular show Breaking Bad has helped glorify meth use even as it portrayed characters stuck in horrific cycles of addiction. As pop culture brought a resurgence of popularity to meth, cartels have created more pure products as a result. This has made meth more addictive and more likely to cause an overdose.

According to the California Overdose Dashboard, deaths from illicit psychostimulants such as methamphetamine increased more than 250 percent between 2008 and 2015. California is, after all, a popular state to traffic drugs through. The Central Valley is considered one of the most active meth markets in the US. Some of the meth is manufactured in California, but now it is often more likely to have been made in Mexico and distributed through trafficking networks.

Meth and Fentanyl: A Fatal Combination

Drug dealers often use fentanyl as an adulterant to other drugs to make it more addictive or more potent. For inexperienced opioid users, this can be a fatal decision. It’s caused people to overdose on drugs like meth or cocaine more often. Combining uppers with downers is also more likely to cause a heart attack.

Many people who take meth with fentanyl don’t know that they’re doing it. However, some meth users also use other hard drugs like heroin or fentanyl.

Many harm reduction proponents recommend all drugs users consider acquiring Naloxone, an opioid reversal drug. Some people even use fentanyl testing strips to test for the presence of fentanyl in other drugs.

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Young people in San Diego County, like around the US, have a problem with fentanyl. They’re not using it on purpose but instead are experimenting with drugs that somehow contain it. This is one reason younger people, including teenagers, are now dying at record numbers from overdose deaths.

Fentanyl is a drug typically used for people in severe pain, such as stage 4 cancer. It is also used as a sedative for surgeries. According to the CDC, the drug itself is 100 times more potent than morphine and 50 times stronger than heroin.

And now America has a fentanyl problem – not large amounts of people addicted to it, but large amounts of people dying after accidentally using it.

Fentanyl Overdoses Are Getting Younger

Roneet Lev, an emergency room physician at Scripps Mercy Hospital in San Diego, California, told Bloomberg that most of the overdose deaths she’s seen in teens are accidental overdoses. One of her young patients, 14 years old, died from a fentanyl overdose.

“The problem is both supply and demand,” she said. “There’s already a lot of fentanyl coming into our market, and now we have a pandemic where people are isolated and not working, or not in school. These teenagers probably don’t have a substance use disorder, they’re experimenting, making a bad choice, and they end up dead.”

Education And Prevention Efforts

Many cities and nonprofits say that harm reduction is an integral part of tackling the opioid epidemic. After all, many of the young people who are dying don’t even mean to take fentanyl. They often believe they’re taking a pill such as Percocet, Adderall, Ecstacy, etc. It may be the first time they have ever taken a drug at all.

Many law enforcement agencies are trying to get the word out about counterfeit pills and the dangers of fentanyl.

Some nonprofits offer fentanyl testing strips as a harm reduction measure that can test drugs for the presence of fentanyl. Then, the user can decide if they want to take it or flush it. Narcan, an overdose reversal drug, is also available to people who use opioids and other concerned community members. Carrying this drug can help reverse fatal overdoses, but when it’s a drug like fentanyl, reversal may require multiple doses of Narcan.

Staying Sober in Sober Housing

If you or somebody you love needs a safe living space to continue their recovery journey, sober housing may be the answer. We have an excellent, enthusiastic, peaceful environment where you can learn to live life on its terms, substance-free. Call us to learn more about our programs at 760-216-2077.

A recent letter to the Acting Director of Health and Human Services in the Biden administration urged action for expanding the availability of Medication-Assisted Treatment through the Office of National Drug Control Policy. This comes on the heels of Biden suspending the former administration's OUD (opioid use disorder) guidelines.

Who Sent the Letter on OUD Treatment?

In response to a recent retraction of Trump guidelines, the letter announced on January 27, 2021, was written by the American Academy of Addiction Psychiatry (AAAP) and signed by representatives from seven representatives with over 150,000 members and 2200 treatment centers. The Biden administration recently decided to withdraw the previous administration's Practicing Guidelines for Administration of Buprenorphine for Treating Opioid Use Disorder to update them and provide better access.

Medication-Assisted Treatment: Science-Based OUD Tools

The letter from AAAP implored the Biden administration to expand access to science-based medication. Buprenorphine, methadone and naltrexone are all medications that have been proven to help people get and stay sober.

Medications that help people addicted to opioids are crucial in assisting them to avoid the compulsion to use. Buprenorphine and methadone help people prevent painful and challenging withdrawal symptoms.

For many treatment programs, the idea of medication carries a stigma. Because of this, it's vitally important that more doctors are educated about how MAT works and how it should be administered. Many medical professionals have felt uncomfortable prescribing it because of a lack of education.

Opioids are notoriously tricky to cease using due to the problematic withdrawal symptoms they cause when a person quits using.

Opioid Prescribing Education and Guidance

The letter for AAAP also says that the Biden administration needs to begin a focus on opioid addiction prevention. They say that this means requiring all prescribers of opioids to be taught about opioids dependence, addiction, and withdrawal.

Preventing opioid addiction is the best long-term strategy for ending the opioid epidemic. It's unclear what path the Biden administration will decide to take regarding new addiction recovery health policies.

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- By Philip, Milgram, MD

Worry, fear, boredom, anxiety, loneliness, escapism, insomnia; these are the emotions that plague our society. The plague that is COVID is making these human imperfections more frequent and more pronounced. There are healthy effective ways we can not only deal with these feelings and situations. But it is human tendency to take an immediate and effective way to escape: The Devil’s Drugs. They are readily (too readily) available. There is easy access to someone who can promise you the gates of heaven. You are invincible. And you want it now. From a friend or family member who has some. Or from a prescriber who will prescribe, sometimes inadvertently but often as a legitimate dealer. Hey, maybe it‘s even covered by your insurance. Maybe you know somebody who knows someone who can get it for you in a park or a parking lot. Trust me. You are not invincible. These are not your grandparent’s drugs. These synthetic drugs have a high addiction potential. I don’t think they should have ever been released to the public, like Quaaludes. You give these drugs to a thousand white mice…and a thousand whit mice will be pushing that button for more. Physiologically, we are not dissimilar from a white mouse. They use these same white mice to test the drugs and extrapolate to human consumption. WE WANT MORE OF THAT!!

These drugs cause what is known as hyperalgesia. Let’s say you stroke the hairs on your arm with a feather. These drugs make a stimulus that would be a tickle or an unpleasurable event and convert it to pain. What do you do? I WANT MORE OF THAT!!

Then you develop tolerance to the drug. Until you rapidly, sometimes within days, need more to get you to that place where you want to be. And you then know. I NEED MORE OF THAT!!

We have been very successful treating alcoholism and drug addiction to heroin, opiates with our innovative and experienced team and the magical molecule of NAD+ (Nicotinamide Adenine Dinucleotide), which detoxifies and fixes your brain, relieving withdrawal symptoms and cravings with much greater regularity than your neighborhood rehab center. But these are The Devil’s Drugs. And they require an all out and effective therapeutic approach to avoid the gates of hell; loss of you job, your family, your money, your home. And finally you lose yourself and then you lose hope. Benzodiazepines (Xanax, Klonipen, Ativan, Ambien and the sort) are not a good solution. You solve a problem by creating another problem. But prescribers too readily whip out their prescription pads to give you a stopgap that may be as bad or worse than the original problem. Please don’t take Kratom either. Often the addiction to Kratom is worse than heroin. Unfortunately, it is readily available and touted as “natural”. When you are addicted to Kratom, you may be suffering such terrible withdrawals that you have to use through the night every two hours.

The best way to avoid this whole situation is to not allow these drugs into your body. Avoid them all-knowingly because I have here told you of their power, their danger, and the high percentage for your physiologic tendency as a normal human being to succumb to the power of these drugs. But it is human tendency to think you are different, stronger, better, even invincible. I WANT TO FEEL IT, NOW!!

We have an alternative therapy here in Carlsbad, with the magic molecule (NAD+) that is already present in every living animal and plant cell. And that the body naturally uses to detoxify, heal, pump up immunity, and create new neural pathways that results in less cravings, less withdrawal symptoms and a high degree of long-lasting sobriety, health, longevity and wellness. We help restore restful sleep, use additional therapies, and get you on the road to a new life free from the influence of these drugs.

NAD+ is the magic. There is an art to the administration of it—starting with the best NAD+. Then there are therapies that enhance and propagate the NAD+ effect. Then, once off the drugs, you need to deal with the emotional, physical, depression, anxiety, any underlying mental disease, situation, and establish an ongoing program of healthy nurturing lifestyle.

There is such a thing as recovery, let us show you.

Phillip Milgram MD

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