San Diego County To Make Overdose Reversing Drug Available In Community

Speaker 1: 00:00 San Diego county officials today signed a health order that will make the drug overdose reversal medication Naloxone more readily available without a prescription. This follows news that eight inmates at the George Bailey detention facility in OTI Mesa were hospitalized this week after overdosing on this synthetic opiate fentanyl, the powerful drug is responsible for a huge spike in accidental deaths over the last year. According to county medical examiner reports. And joining me now to talk about this is Luke Bergman director of behavioral health services for the county of San Diego. Luke, welcome. Speaker 2: 00:36 Thank you so much. Glad to be here. Speaker 1: 00:39 I want to start by talking about the prevalence of fentanyl in the county and its impact on the number of accidental deaths here. Can you put that prevalence into context for us? I mean, do we know how much fentanyl is circulating in the community? Speaker 2: 00:53 We unfortunately don't know precisely how much fentanyl is circulating in the community. And it's, it's a difficult thing to discern because fentanyl is so potent that very small amounts of it have very, um, significant impact. And it's very easy there for, for, uh, dealers of illicit drugs to spread it very far and wide. The best proxy that we have for determining its distribution is in, um, where we find it in overdose, mortality data and overdose death data. Um, and what we're seeing on that front, uh, as you suggest are enormous increases in the, in the, uh, total numbers and in the proportion of overdose deaths that have fentanyl involved. Speaker 1: 01:39 Okay. Will you remind us why fentanyl is so deadly, Speaker 2: 01:42 W it's extremely potent as an opioid. So fentanyl is a synthetic opioid, uh, and, uh, and so acts on the brain in ways that other opioids do like heroin, like oxycodone. Um, it just, uh, acts, uh, much more quickly, uh, and much more strongly just to give you some sense for those proportional numbers that I was mentioning, uh, before just this last, uh, February, uh, for example, we, we had around a hundred overdose deaths in San Diego county, two thirds of those involved fentanyl, uh, this past August, uh, August of 2020, which when we're looking at single months, uh, was the month, uh, where we had the most, uh, overdoses during this kind of most recent, uh, uh, uptick. It was around 60% of all overdose deaths involved fentanyl. So it really is having a significant impact. Speaker 1: 02:40 Hmm. You know, this announcement today by county officials to make Naloxone more readily available here. Uh, you know, how important could that be to slowing the number of accidental deaths caused by drugs like fentanyl? Speaker 2: 02:53 I think it can be hugely impactful. Um, you know, one of the things, uh, that, that we are wanting to make, especially clear, um, in the context of first responders already carrying Naloxone and administering Naloxone when they come upon overdose, uh, situations is that with fentanyl in the community, death happens quickly. It can happen virtually immediately. It can happen well before a first responder would or would arrive at a scene even if nine 11 were called relatively quickly. So it's critical, especially in the context of fentanyl for community members to have Naloxone on hand. And that's what this standing order does. It will accelerate the distribution of Naloxone through county clinics, and then also through community-based organizations throughout the county. So we can be sure that everybody who thinks they may be interacting with somebody who uses drugs, has Naloxone with them. And it's, it's a, it's a very, um, it's very small comes in, uh, in, uh, uh, in a very small package. Speaker 2: 04:06 Um, it's extremely easy to use it. It just, uh, involves, uh, pumping medication into a person's, uh, nasal passage. And so if someone is carrying it and they come upon someone who is in the midst of an overdose, they can save their life. Um, if, uh, if, if somebody knows that they have a family member who is using drugs, even if somebody suspects that they have a family member who is using recreational drugs, it would be important for that person to have Naloxone with them. Because again, we're finding fentanyl all over the place in every illicit, uh, uh, category of drug that we have. Um, and so our hope is to really normalize it, and you've Speaker 1: 04:49 Touched on this, but under this new health order, how could someone get access to Naloxone and where can, Speaker 2: 04:56 So initially it will be made available through, uh, county clinics, uh, county public health clinics, county run, behavioral health clinics. Um, that's our immediate next step as we put in place, um, distribution through community-based organizations, which we are expediting. So, so that it happens as soon as possible. Um, again, this is medication that will be free. Uh, we, we are being supplied Naloxone through the department of healthcare services at the state as part of their harm reduction program. Speaker 1: 05:29 And so can anyone walk in and get it? Absolutely, absolutely. You know, in a story published yesterday by voice of San Diego, they report on the impact of fentanyl overdoses and the homeless population in San Diego county, 82, homeless San Diego ones have died in the last year of fentanyl overdoses. Uh, what are the challenges of getting Naloxone to this population and it being used to save lives? Speaker 2: 05:54 So it's of course, an especially vulnerable population, the homeless population is on virtually all fronts, uh, people who are chronically homeless, uh, have higher rates of chronic physical illness, higher rates of mental illness. And it's challenging, I think for the chronically homeless population, um, uh, you know, just in, in that it, you know, it it's all logistical aspects of life or are challenging for the chronically homeless population. We want to make sure that people are keeping this medication with them at all times. And, and just keeping one's belongings together for somebody who is chronically homeless is challenging. So that's a challenge, certainly. Um, on the other hand, uh, you know, as we engage in additional, uh, outreach efforts and engagement efforts, um, in, in our overarching work, um, to address homelessness, Naloxone can be a key ingredient. Um, it's, uh, it can be a really effective tool actually for engaging with people, um, who are using drugs, potentially harmfully, who are homeless, who may be reluctant to engage with homeless outreach workers who may be suspicious of their motivations. Using Naloxone as a means for engagement can actually be a really powerful tool in addressing homelessness. Speaker 1: 07:12 I've been speaking with Luke Bergman, director of behavioral health services for the county of San Diego, Luke, thank you very much for joining us. Thank you. I appreciate it.