Effort under way to make naloxone opioid antidote more accessible in state

Bay Area public health officials have begun receiving shipments of naloxone — the drug that reverses the effects of an opioid overdose — in the first state-funded effort to get the emergency antidote to local health departments across California.

The distribution of the drug, funded by a one-time $3 million grant approved by state legislators in 2016, marks a ramp-up in the state’s response to deadly overdoses of prescription painkillers, heroin and the synthetic opioid fentanyl.

While the number of people dying from opioid overdoses in California has held relatively steady over the past several years — between 1,900 and 2,000 people each year — the number of deaths related to fentanyl is rising quickly. The number of Californians who died from fentanyl overdoses nearly tripled between 2013 and 2016, from 81 to 234, according to data from state health officials. Heroin-related deaths also rose during the same period, from 483 to 565, about 17 percent.

“The overdose epidemic is really staggering, and California has not escaped it,” said Katie Burk of the San Francisco Department of Public Health, who manages the city’s contract for the DOPE Project, an overdose prevention program funded by the city and run by the Harm Reduction Coalition. The coalition provides training and assistance to drug users and service providers such as homeless shelters and methadone counselors.

Naloxone, which is sold under the brand name Narcan, can be administered as a nasal spray or an auto-injector. The drug works by knocking opioids off receptors in the brain that suppress breathing during an overdose, thus “reversing” the effects of the overdose immediately. The state grant is funding the distribution of Narcan spray to 56 of the state’s 61 local health departments, according to the California Department of Public Health.

All nine Bay Area counties, as well as the city of Berkeley, are slated to receive thousands of doses of Narcan, collectively, by the end of the year. Many local health departments already help coordinate naloxone distribution in their communities, often by making auto-injector naloxone kits available at needle exchange programs, but this marks the first state-financed effort to expand the availability of naloxone to health departments across the state.

How municipalities distribute the drug is up to them. In Marin County, police officers have undergone training on how to administer Narcan and recently saved three lives in Novato, Fairfax and Mill Valley by reversing overdoses, said Matt Willis, the county’s public health officer.

In Alameda County, police officers in several law enforcement agencies — the county sheriff’s department and the police departments for Fremont, Newark and Pleasanton — will begin carrying Narcan once they have completed training, said Karl Sporer, medical director of Alamada County emergency medical services.

Doses of Narcan have been allocated to local organizations that already distribute the drug, including HIV Education and Prevention Project of Alameda County (HEPPAC), a nonprofit that operates syringe-exchange programs; Health Care for the Homeless; and detention health services providers that work with people leaving jails and treatment centers who are at risk of overdosing or relapsing.

San Francisco will use the grant to expand overdose prevention efforts to try to reach more people who seek treatment through methadone programs.

San Francisco has long been a pioneer in making naloxone accessible to drug users and family and friends who are most likely to witness an overdose and take action outside of a medical setting. In 2002, the city and the Harm Reduction Coalition began one of the nation’s earliest pilot programs to get naloxone to those most at risk of overdosing — at supportive housing units, addiction recovery centers, jails and through syringe access programs. In San Francisco, the number of naloxone overdose reversals administered by members of the community has risen steadily each year, from about 62 in 2005 to 883 in 2016.

The California Department of Public Health and the Harm Reduction Coalition plan to train local law enforcement agencies and treatment centers over the next six months on how to recognize overdoses and administer naloxone, said a spokeswoman for the state public health agency.

Naloxone is not a cure-all for opioid abuse, experts said, and drug users also benefit from long-term therapies such as methadone, a pain relief drug taken under the supervision of a physician that eases the symptoms of withdrawal and blocks the feeling of euphoria triggered by addictive opioids.

“It’s just one more tool in our public health tool belt,” said Jessica Osorio, interim director of Contra Costa County Health Department’s HIV/AIDS and STD program. “It fits in with treatment, syringe exchange and empowering family members and friends — they’re the easiest people to be helping with harm reduction.”