Marin gets $800K annually to target overdose prevention

Marin County is set to receive $800,000 annually for nine years from a settlement with pharmaceutical companies, officials said this week.

The county, which has an average of one resident dying from an accidental drug overdose almost every week, will use the money to expand Marin’s overdose prevention staffing network; beef up supplies of the overdose-reversal nasal spray Narcan; and engage additional substance use treatment providers, Marin County Public Health Officer Dr. Matt Willis said.

“About every five days, on average, we lose someone to a drug overdose,” Willis told the Marin Board of Supervisors on Tuesday. “Accidental drug overdose is the third most common cause of death in Marin for those under 75, after cancer and heart disease.”

Marin had between 60 and 70 overdose deaths in 2022 — the final number is still under investigation by the Marin County Sheriff’s Coroner’s Division — and 65 in 2021. That is double the 30 deaths in 2018, and triple the 17 overdose deaths in 2015, Willis said.

The huge increase is attributable to the rising proliferation of the synthetic opioid fentanyl. Fentanyl, which is 100 times more potent than morphine, is added by illicit manufacturers to other opioid pain relievers, and to fake pills that look like “safe” prescription drugs such as Percocet or Xanax. Even a small dose of fentanyl can kill within a few minutes.

OD Free Marin, a broad coalition dedicated to reducing the risk of drug overdoses, is working to turn that trend around, Willis told the county board. The coalition coordinates countywide strategies and includes Marin County Behavioral Health and Recovery Services, Public Health, health care providers, schools, and community members.

“We’re coordinating a new infrastructure aimed at reversing this crisis,” Willis said. “Our goal is to flatten the curve — just like we did with the COVID-19 pandemic.”

Supervisor Katie Rice, who has been working on the issue for several years, said the rate of overdose deaths in Marin is alarming.

“I think one death every five days constitutes a public health crisis and a real emergency,” she said.

She said the county needs to ramp up access to Narcan, the nasal spray that can immediately reverse an overdose, and to increase public education and awareness.

“We need to have the pedal to the metal on both fronts,” Rice said.

On Wednesday, the U.S. Food and Drug Administration announced approval of an over-the-counter version of Narcan, called naloxone. Willis said the announcement was good news — even though pharmacies in Marin likely won’t be able to stock the over-the-counter version until this summer.

For now, Narcan is available without a prescription at many pharmacies if someone has health insurance. Health leaders suggest calling the pharmacy in advance to confirm availability.

People without health insurance have several options, which are listed at odfreemarin.org/narcan. Narcan kits are available for free at vending machines at the county jail in San Rafael and at the Marin Health and Human Service department’s courtyard in San Rafael. The Spahr Center in Corte Madera also has kits available.

In addition, all Marin public K-12 schools and most county private, independent and parochial schools have received Narcan supplies and staff trainings, said John Carroll, Marin superintendent of schools.

“This has been a collaborative effort in partnership between Marin County Office of Education, school districts and the team at Marin County HHS and OD Free Marin and the Spahr Center,” Carroll said. “It has been made possible through Narcan Distribution Program grants from the California Department of Health Care Services.”

Narcan is easy to administer, Willis said Tuesday while providing a live demonstration to supervisors at the meeting. Those administering the nasal spray should also call 911, even if the overdose is reversed.

Willis said the annual $800,000 in settlement funds will help to bridge the current gaps in the county’s overdose prevention system. That includes adding more of what are called substance use navigators to identify people at risk and connect them with a plan for services and support.

The county currently has several substance-use navigators who stay at Marin hospital emergency rooms to meet with nonfatal overdose patients before they are released. Marin has an average of two nonfatal overdose incidents daily, Willis said.

“We don’t just want to stabilize people and release them,” Willis said. “We want to engage them in a plan and extend a hand.”

More navigators are needed at other settings, such as community clinics, schools and the county jail, he added.

The settlement funds come from a nationwide lawsuit against opioid manufacturer Johnson and Johnson and the largest pharmaceutical opioid distributors: McKesson, AmerisourceBergen and Cardinal Health. Marin joined the lawsuit in 2021.

The lawsuit alleged that the manufacturers downplayed the addictive and potentially lethal impacts of prescription opioids.  Additional settlements with three pharmacy chains — CVS, Walgreens and Walmart — and two additional manufacturers, Allergan and Teva, are still pending.

“It’s good that the industry that helped create this crisis is funding some of the solutions,” Willis said. “This money will help us save lives. The crisis is getting worse nationally and in our own backyard.”