San Diego County leaders Friday announced plans to increase community distribution of naloxone — an overdose reversal medication — at several community-based locations and clinics throughout the region following a spike in overdose deaths.
In 2020, the county reported 457 fentanyl-related overdose deaths — a 202% increase compared to 2019, when 151 such deaths wsere recorded.
San Diego County Supervisor Nathan Fletcher, together with public health leaders, announced plans to increase community distribution of the medication — part of a harm reduction strategy that will be introduced during the June 8 Board of Supervisors meeting.
"We are stepping up our commitment to comprehensive harm reduction strategies," he said. "Making this life-saving medication more accessible helps to prevent overdose deaths and put San Diegans struggling with addiction on a better path to recovery."
Naloxone is a medication designed to rapidly reverse an opioid overdose and quickly restore normal respiration and alertness.
The county's public health officer, Dr. Wilma Wooten, signed a Naloxone Standing Order allowing community organizations to distribute nasal Naloxone. The overdose reversal drug will be available at no cost and without a prescription to any person at risk of an overdose or to a family member or friend willing to administer the drug.
"Opioids in large doses can cause breathing problems and a loss of responsiveness that can lead to death," Wooten said. "Naloxone saves lives by temporarily reversing those life-threatening effects until emergency medical help arrives."
The county made naloxone available to law enforcement years ago. Like CPR, time is critical as overdose patients need immediate intervention to improve their chances of survival. An overdose from opioids may take hours to cause death, but other drugs such as fentanyl can cause death in a matter of minutes.
Susan Monroe, a local paramedic, said readily available naloxone is needed.
“Unfortunately in the last three shifts, I've had three narcotic overdoses and one of them did not survive. Had the ordinance been signed and this be readily available, it might have made the difference in this person surviving,” she said.
According to the County’s Behavioral Health Services Director, Luke Bergmann, the pandemic has taken a toll on people struggling with substance abuse.
“August of 2020 alone, an average of four San Diegans died everyday as a result of drug overdose,” he said.
He said half of those were caused by fentanyl.
Fletcher said the biggest spikes in opioid overdoses are happening in North and East County.
“It is often perceived as an urban core type issue and it is not. The data will show this affects every community of every ideology,” he said.
Nasal naloxone is a prefilled, needle-free device that requires no assembly and is sprayed into one nostril while patients lay on their back.
The county has filed an application to receive a free supply of naloxone from the State Department of Health Care Services via its Naloxone Distribution Project. It is expected that the first shipment could be delivered in June, and it will be distributed to clients and patients through county clinics.
"The evidence is clear that harm reduction approaches lead to overwhelmingly positive outcomes, including reductions in overdose deaths and the spread of Hepatitis C and HIV, and greater engagement with treatment," said Luke Bergman, director of behavioral health services for the county.
"The broad expansion of naloxone distribution is a critical component of the comprehensive County Substance Use and Harm Reduction Strategy with the potential to have an immediate impact on the rise in overdose deaths throughout the region," he said.
The U.S. Centers for Disease Control and Prevention says to look for the following signs if you suspect someone is overdosing from heroin or prescription opioid pain medications:
— small, constricted "pinpoint pupils";
— limp body;
— pale, clammy skin;
— blue fingernails or lips;
— vomiting or gurgling sounds;
— inable to speak or be awakened, loss of consciousness; and
— slow breathing or slow heartbeat;
The county offers numerous prevention and treatment programs across the region. People seeking help should call the San Diego County Access and Crisis Line 888-724-7240 or 2-1-1 San Diego. The resources are available 24 hours a day, seven days a week.
