The rural Utah community at the crossroads of the fentanyl epidemic

PRICE, Utah — The highway headed into Price, Utah, has more roadkill on it than moving cars. Through the windy canyons, there is an abandoned, sunken ghost town and periods of time without cellphone reception. Highway 6 may seem out-of-sight and out-of-mind to northern city slickers, but it is one of the routes drug traffickers take to distribute fentanyl and heroin to dealers across the state.

Price, in the heart of Utah’s Carbon County, is at the crossroads of a growing, deadly drug problem in Utah.

With a population of just over 8,000 residents, this rural city has seen the devastation of opioid addiction and fentanyl use firsthand. Many residents work blue-collar jobs with a higher potential for on-the-job injuries and the county’s poverty rate exceeds what is typically seen on the Wasatch Front.

The rate of opioid-related deaths in Carbon County and its two neighboring counties, Grand and Emery, overwhelmingly exceeds the state’s death rate. Utah’s overall rate is 18.3 deaths per 100,000 people, but these counties on the highway from Mexico to Salt Lake City see a death rate of 42.7 per 100,000 people, according to the most recent data on the Utah Department of Health and Human Services from 2021. The rate of opioid prescriptions? It is also higher.

Numbers yet to be finalized for 2023 expected to be released in an analysis later this month show a dramatic rise.

Fentanyl has become “the most significant drug threat,” according to a recent report from the Rocky Mountain High Intensity Drug Trafficking Area, the group appointed by the White House to coordinate federal, state, and local response to violent drug trafficking organizations.

“Unprecedented levels of availability and demand have flooded the region with fentanyl pills, and increasingly, fentanyl powder,” the report read. “A significant decline in price, high potency, and common use in polydrug compounds which continues to drive fatal overdoses, elevates the threat of fentanyl throughout local communities in the Rocky Mountain region.”

To understand the fentanyl epidemic, the Deseret News searched through years of data and interviewed more than 20 people connected to the crisis, including those in recovery, former fentanyl distributors, law enforcement officials and recovery specialists. This is the first in a series of articles analyzing the problem and seeking potential solutions.

More potent than morphine, fentanyl has flooded the streets. According to the DEA, 7 out of every 10 fentanyl pills contain a lethal dose. And as fentanyl is on the rise, so are two other opioids — xylazine and carfentanil. Carfentanil is a synthetic opioid, like fentanyl, but stronger. It is used for tranquilizing elephants and other large mammals. It is 100 times more potent than fentanyl and can be lethal at a mere 2-milligrams (a fraction of a penny), said Bill Newell, coordinator for the Utah Crime Gun Intelligence Center. Xylazine, sometimes called tranq, is a sedative and muscle relaxer used on animals. On the streets, it is mixed with fentanyl. Naloxone, used to combat heroin, will not reverse an overdose.

The vast majority of fentanyl is manufactured outside the U.S., says Dustin Gillespie, the acting special agent in charge of the Drug Enforcement Administration’s Rocky Mountain Division. Fentanyl is made by the Sinaloa and Jalisco cartels in Mexico, said Gillespie, who along with other DEA agents, Enoch Smith and Brandon Scott, spoke to the Deseret News at the DEA’s Salt Lake City office.

“They need to get the precursor chemicals from somewhere and they don’t produce those in Mexico,” said Gillespie. “So, they have to get them from China, and to a lesser extent India.” Since those precursor chemicals have legitimate uses, it makes it difficult to monitor.

The chemicals are mislabeled when they are shipped from China to Mexico, and the cartels will acquire them at ports along the western seaboard, said Gillespie. The fentanyl drug market is decentralized because it does not take much equipment to make the drug.

“It’s all through extortion and violence. There is no retirement plan,” said Gillespie. People who make fentanyl often die due to exposure or are killed by the cartel, Gillespie explained.

The cartels have oversaturated the market with fentanyl and Price, seat of Carbon County, sits right on a highway drug traffickers use.

Jackson: ‘This is my opportunity to live the life I should have lived’

Price resident Allison Jackson is someone who knows firsthand the devastating impact opioids can have. After police arrested Jackson for drug distribution, she sat in the Emery County jail for two months wondering how she got there. Jackson’s drug addiction started when she was 28 years old after a doctor prescribed her pain medication.

Jackson said she experienced withdrawals after the pills were abruptly taken away. As a young mother of four children at the time, she said going through these withdrawals took away time from her children and she had the itch to find more pills. So she did.

And then she developed an addiction to opioids and eventually heroin.

“Continuing in my addiction instead of seeking help sooner means I walked away from my kids, my home, any relationship that was meaningful to me because my addiction had control,” Jackson said in an interview.

Life during addiction was misery, said Jackson. She and her husband — who also suffered from substance use disorder — fought with each other. Fearful of jobs that might drug test her, she worked under the table. She wasn’t able to see her children.

Going to jail was “very eye-opening.”

Jackson had two months to contemplate her life and started to realize why she used drugs to feel numb. As a child, she said she experienced abuse. Her sense of self-worth was obliterated and she didn’t have a vision of a better life for herself. Jail changed that. She connected with a jailer who was able to relate to her.

“I started praying again when I was in Emery County jail and that helped a lot,” said Jackson. “It was just asking for the strength to get through this, asking for the strength of knowing what to do and just having the feeling that I was on the right path.”

The path Jackson found was drug court, which she described as her “saving grace.”

Her road to recovery started because she said she wanted more out of life. She entered drug court in March 2023 and quit using for 4½ months. Her husband was considered “an association” due to his active use, so she had to cut contact with him. She had a relapse when they reconnected and she went to jail again.

The drug crisis in Price

“I think our fentanyl problem stems from prescription abuse and prescription addiction,” said Alyssa Potter, a prevention specialist in Carbon County, adding that coal miners and oil field workers sometimes get injured at work and are prescribed opioids to cope with the pain. Other recovery specialists said the same thing — and added that these workers often cannot afford to take off work due to the rising cost of living in the area.

“It starts at a basic level: a person gets injured, has to go to work, takes prescription opiates to combat pain,” said Carbon County Sheriff Jeff Wood while sitting in his office.

It is something Wood has become familiar with over the years. But fentanyl has added a more terrifying dynamic into the mix. Wood said on the streets, there are both “blues” — a term for fentanyl pills — and other drugs like heroin and cocaine laced with fentanyl.

“We’ve seen it really ramp up in the last couple of years,” said Wood. He said it has been scary for him and those in his office to see people come into jail addicted to opiates, get off their medication while incarcerated and then die of an overdose a few days after they leave.

“Everyone knows somebody that’s affected by this,” said Wood.

Carbon County is hit hard by fentanyl, but so is the rest of the state. It has surpassed methamphetamine as the No. 1 narcotic found in state lab testing of drugs in Utah. “I have a fear that fentanyl is going to be firmly entrenched in first place for a long time,” said Newell.

The most recent data shows 299 Utahns died in 2023 as the result of a fentanyl-involved overdose, according to the Utah Department of Health and Human Services. That is up from 182 deaths in 2022, 170 in 2021 and 125 in 2020.

Fentanyl accounted for over 43% of all drug overdose deaths in 2023.

“It’s a drug that reaches all classes of our society and it’s highly addictive,” said Tanner Jensen, director of the Department of Public Safety’s Statewide Information.

The number of fentanyl busts by police agencies has also steadily risen, said Jensen. Five years ago, task forces across the state seized close to zero pills and this year is shaping up to be the biggest year for fentanyl seizures yet. Now, driven by Mexican cartels, operations have seized more than 774,000 fentanyl pills, with nearly half a year remaining. In addition to seizing fentanyl pills, Jensen said the labs are seeing fentanyl mixed with other drugs.

Recovering in Price

Four Corners Community Behavioral Health social detox program manager Savannah Eley knows exactly what it is like to recover from an opioid use disorder. She took a Percocet after struggling with postpartum depression and eventually started using harder drugs.

Eley said she had to white-knuckle it during her recovery because there were not a lot of resources available.

“When I got sober, there wasn’t even a recovery meeting,” said Eley. Now seven years later, she helps people recover. There are different options for substance use recovery programs — but none are in-patient, the closest in-patient service is in Utah County. There are Narcotics Anonymous meetings and a syringe exchange program.

There is even a new crisis receiving center where Eley, Four Corners case worker and program director Cacilia Jensen works. The center is located near the Price downtown area and has a homey feel with a living room area for playing board games and watching movies.

It is the first crisis center for people experiencing substance use disorders or mental health crises in rural Utah. Eley said the center is important because it offers another option for people going through detox. Oftentimes, people in the area will go to the hospital to detox and rack up a $20,000 bill, but Eley said, social detox at the crisis center offers a more affordable option.

Both Jensen and Eley called the center a win for Utah, but also said people outside of rural Utah sometimes do not know how to best address the fentanyl and opioid crisis in these areas.

As an example, Jensen spoke about telehealth services like a virtual crisis outreach team. While in theory, telemedicine seems like it could be a boon for rural communities which struggle to attract people who are willing to work for a lower-paying salary in a remote area, in practice, success is elusive.

In addition to the isolation created just from having to drive through canyons to get to Price, Carbon County has unique struggles when it comes to recovery such as housing, transportation, staffing and stigma.

“Our cost of living within the last five to six years has skyrocketed,” said Jensen, adding that it mirrors urban centers, but wages have not kept up. There is no homeless shelter in the city and there are not many affordable options for housing.

“It’s not safe for individuals sometimes,” said Jensen, adding they have to refer out to urban areas, especially during the cold winters and hot summers, because it can be difficult to find a housing solution. Relocating for these individuals usually means losing their job because they have to relocate north.

As for transportation, if you do not have a car, Jensen said it is difficult to get around. “We don’t have a bus system, we don’t have taxis. There’s no Uber. There’s no Lyft.” So, if you live a couple towns over and Price is the closest area with a recovery center, it would not be safe or practical to travel over on foot.

Staffing recovery centers can also be difficult because it is a remote area and the salaries are lower.

“We’re a small community, so stigma plays a huge role in someone getting help, asking for help, admitting they need help,” said Eley. Being around the same people your whole life may make it harder to feel like you can admit you have a problem. And then, other times, the addiction is generational — it can be all you know.

“Just generation after generation, addiction is kind of the culture … in some families,” said Jensen. Eley remembered working at a detox facility and speaking with a young woman who had overdosed multiple times. The first time she used meth was when she was 11 years-old with her mother.

“You’re watching your parents cope with difficult days using substances or you’re using substances together with your parents,” said Eley. “You grow up, in a way, thinking this is normal.”

Just a couple minutes drive away, there is another recovery center called Life Balance Recovery. Susanna McGee said she ended up coming down here because of the lack of resources.

“In Salt Lake City, there’s AA meetings, 12-step meetings, every day — multiple ones a day. And down here, there’s one AA meeting a day, and two, three NA meetings a week,” said McGee. She also said there were issues with housing.

While people can couch surf or live in hotels when they are homeless, said McGee, that does not last long and it is hard for those individuals to stay sober.

Mersades Morgan, peer recovery coach at Utah Support Advocates for Recovery Awareness in Price, said there can be a “revolving door” of barriers individuals face when they are trying to get treatment. If they don’t have a car, they might not be able to maintain a job or go to doctor’s visits, which impacts their ability to recover.

Without a car, Morgan said a person in recovery might not be able to visit with their children.

“If you do have a criminal record, you have a hard time finding employment,” said Morgan. However, USARA has created a list of workplaces in the area that do allow people with criminal records a second chance to give people a starting point.

Morgan said the generational nature of substance use disorder can have ripple effects that might not be expected — like a person never getting their driver’s license and then having to do that later in life. “You don’t know what you don’t know.”

“Sometimes it’s just about sitting with someone and sitting in the dark if you need to — holding their hand through the process. We meet people where they’re at,” said Morgan. “We just don’t leave them there.”

There are also community efforts to prevent opioid and fentanyl addiction in the first place. Potter has worked on campaigns in the community to educate them about the impact of opioids. In addition to billboards, they wrapped 10 semi-trucks with messaging about the resources that are available to them.

“The public isn’t aware of the risks or things that are available for them, then that’s a huge barrier,” said Potter. She and other prevention specialists are laser-focused about getting the word out because, as she said, fentanyl is especially dangerous.

“Because of the high potency being found in fentanyl, a lot of the deaths we’re seeing from fentanyl overdose are just a one-time use and just that high risk of one time could be the time that takes your life,” said Potter.

How fentanyl gets to Utah

Nature is not involved in the production of fentanyl, said Newell. That is why Mexican cartels turned to manufacturing it as opposed to other drugs which come from natural substances.

Scott, who has worked at the southern border, said the most fentanyl comes into the U.S. from semitractor-trailers and passenger vehicles. The cartels will do this by hollowing out the floor of trailers and stuffing pills inside car engines.

“It’s just through sheer volume of the amount of vehicles that cross the border,” said Smith. “At any given time, they will often use tactics that are what they refer to as suicide loads where they’ll send a car over that will get intentionally stopped.” Then, when law enforcement stops this car and seizes fentanyl, other cars get through.

Once it crosses the border, Smith said it often comes up to Utah through I-15 out of Los Angeles or San Diego. Sometimes they will be driven straight up the highway to Salt Lake City and other times they will divert onto Highway 6 or Redwood Road.

Though the drug manufacturing process is decentralized, the transportation process is not, said Gillespie. Cartels know who is handling the product and where it is going. But once it is handed out to different distributors in a city, it comes decentralized.

“What’s made that even more difficult and challenging for law enforcement is the fact that with prices so low and availability of pills so high, those barriers to entry to becoming a distributor or becoming a low to mid-level distributor of pills are now gone,” said Gillespie.

With the prices so low, the availability of pills so high and 7 in 10 fentanyl pills containing a lethal dose, the influx of fentanyl has created a crisis in Utah and across the country. But what these three agents said the public does not understand is the cruelty that exists top to bottom.

Gillespie has listened to wiretaps of cartel members laughing about overdose deaths because for the cartel members, it means the demand for the product increases.

“I think that’s what people don’t realize is that the cartels, they don’t care. They don’t care about killing our kids,” said Scott. “They don’t care about more and more people developing substance use disorders.”

Fentanyl is connected to gang activity in Utah, said Scott, explaining drug trafficking, money laundering, extremism and violence go hand-in-hand. The people arrested for drug distribution often have extensive violent criminal histories, he said.

Even setting all that violence aside, Smith said fentanyl itself is still violent. It has a disastrous impact on families, society and personal relationships.

“It’s not a victimless crime,” said Smith.

Keeping the community safe

The relationship between law enforcement and recovery specialists is not adversarial.

McGee and another specialist go into the Carbon County jail once a week. They can only go see the women. She goes to show there is support in the town for the women struggling with addiction, but she laments that the men — who are more likely to struggle with opioid and fentanyl addiction — have a huge resource gap. Morgan called the Price City Police Department “one of our strongest partnerships” and “big advocates” for recovery work.

Law enforcement officials said the lack of resources in the immediate area pose an issue for them, too.

There are people who get arrested for possession while in active addiction — they are not in a place where they want to start treatment. “We find our jails get used a lot for that and it’s really not the place for those folks,” said Wood. “These folks probably ought to be in some kind of a structured treatment program like you would see on the Wasatch Front.”

Wood said he would also like to see a fast-track option for prosecutors to help people get into drug court sooner because right now prosecution is months behind on its caseload. “Here in Carbon County, we have an opening for a deputy county attorney that hasn’t been filled for quite a while and it’s just not being able to find an attorney that’ll work for the wage.”

“We want to protect our community and we want to make sure people are safe, but we also have empathy for folks that are struggling with addiction.” Wood said rural counties have fought for years for an in-patient facility, but there are not enough people in the area to sustain a business.

Brandon Ratcliffe, captain for the Price City Police Department, said the city does have a drug task force to try to identify the distributors in the area.

“It’s been difficult with that: our task force is made up of two people, and for the last two and a half years, we’ve only had one,” said Ratcliffe. “We have one guy trying to put out a fire with a garden hose.”

Ratcliffe said the price of fentanyl is around $5 a dose in the area. While it is higher than urban areas like Salt Lake City, it is a cheap drug on the market. Heroin costs around $20 to $25 a dose. But they have found fentanyl in just about every drug.

“We understand that every substance abuse issue is an issue, but we try to prioritize what’s most likely to have the greatest effect on our community,” said Ratcliffe. “And right now, it’s obviously a life you can’t put a price on. If we can prevent one overdose, then that’s what we’re going after.”

Before Ratcliffe was captain, he worked on the drug task force and arrested one of the most efficient dealers. After she got out of prison, she sent him a message of appreciation. Now she helps out with law enforcement training, has had a large amount of her record expunged and has received college degrees.

People like her made the job worth it, Ratcliffe said. Other officers in the department have forged similar relationships with the community. He said one of the biggest struggles they face is lack of funding. The cost of living has increased dramatically, but their wages have not — the city council did not deliver on a significant increase Ratcliffe thought they would give this year and also, decreased the typical 2% increase down to 1%.

“It’s a little disheartening and frustrating because we don’t want to leave,” said Ratcliffe. “We love our community, but ultimately, the community is going to feel it if we start losing our officers.”

Wood said illicit drugs come through Highway 10 off of the main pipeline of I-70 as well as Highway 6. “We have deputies that are involved in interdiction, but it’s on a smaller scale just because we don’t have the resources to assign somebody to only that,” he said, adding Utah Highway Patrol’s interdiction team is often helpful.

Drugs mostly move through the county, said Wood, and fentanyl in particular moves from Mexico through border states like California, Arizona and Texas up through Utah. Fentanyl has posed a safety concern for officers because if they get fentanyl on them, they can absorb it.

“The fentanyl dealers themselves probably never touch the stuff,” said Wood. “They’re just feeding it off to someone else. They’re addicted to money.”

Calling it a money-driven business, Wood said he wants to see the fentanyl stopped at the border before it even gets to Carbon County and impacts the people there.

“You may know somebody that lives on your block (in bigger cities), but you may not really know them,” said Wood. “And by that, I mean, you didn’t grow up with them. You didn’t know them from the time they were a kindergarten kid until the time they were an adult and that’s the people that live here.”

Jackson: Finding hope and recovery in Price

Since Jackson’s last stint in jail, she has lived a sober life and progressed to the third phase of drug court. She continues to receive counseling for past trauma, takes classes and now has a job she loves working at a local hotel. After four years without seeing her children, Jackson has reunited with them.

“It’s been phenomenal,” said Jackson beaming as she explained she has started to rebuild her relationship with her children. She said she has found happiness in everyday life. She deeply connects with people and has rekindled a love of reading as she now can concentrate on the pages better.

When Jackson was a kid, her grandmother told her to always choose love, no matter what happens to you. “Love is the light, and that is one of the ways I live now,” she said. Whether it’s checking a guest into the hotel or having a conversation with a loved one, Jackson said she is now the happiest she has ever been.

But tragedy and difficulties have also accompanied her recovery. Jackson lost her husband to a drug overdose — the same night she was reunited again with her children. She had dealt with heart problems stemming from a heart attack and complications from her addiction.

Still, Jackson now dreams of a future where she helps people who experience substance use disorder and has discovered qualities about herself that she loves like her newfound positive outlook on life and her problem-solving skills. She said she looks forward to phase five of drug court because she wants to do a community project. Her friend, a Price police officer, has encouraged her during her recovery and is helping her find a project.

“This is my opportunity to live the life I should have lived. That I’m going to live,” Jackson said.

The number of resources in Carbon and Emery counties for those wishing to recover has increased even just in the last couple years, said Jackson. Recovery center employees and law enforcement both echoed Jackson’s observations — the community has rallied together more resources — just not enough.