Marin fentanyl overdoses trigger use of new alert system

Marin County officials have issued their first public health alert about rising fentanyl overdoses.

The new alert system was prompted by not only spikes in 911 calls for fatal and non-fatal overdoses but also an increase in wastewater that tests positive for “substances of concern,” said Dr. Matt Willis, the county’s public health officer.

When those conditions are met, Willis said, his staff will send messages to clinicians, mental health service providers, schools and the community about the situation.

“The ultimate goal of the overdose spike alert is to prevent more deaths,” Willis said. “It’s hard to measure exactly what impact our alert had, but the drop in fentanyl deaths is a sign that people may have gotten the message and took steps to protect themselves.”

The first alert followed five suspected fentanyl-related cases within two weeks in late February. In response, the county issued a public health warning about the overdose spike for March 1-14.

Fentanyl is a synthetic opioid that is 100 times stronger than morphine and 50 times stronger than heroin, according to the Centers for Disease Control and Prevention. The drug has been mixed with narcotics such as cocaine, heroin and MDMA.

Criminal proceedings began in Marin this month for a suspect accused of manslaughter for allegedly supplying fentanyl that triggered a fatal overdose in a passenger during a car ride through Marin in August. The victim was among Marin County’s 17 confirmed fentanyl-related deaths last year.

No fentanyl-related deaths have been reported in the county so far this month, said Haylea Hannah, an analyst at the Marin County Department of Health and Human Services.

On Wednesday, she said the data are based on the coroner’s preliminary tests and that deaths in March might be determined to be overdoses as investigations continue.

The public health staff recently conducted a survey of 132 people for their responses to this month’s fentanyl alert. The survey found that 47% said they carry Narcan with them and that 43 respondents said they discussed the alert with friends or relatives. County staff also reported that nearly 88% of respondents were women and 73% were between ages 50 to 79.

Hannah said that her staff hopes the public health advisory and work among groups such as the county-led coalition OD Free Marin to distribute Narcan might have curbed the sudden increase in overdoses.

She also said that the February cases could have been affected by differences in street dealing, such as methamphetamine being mixed with fentanyl.

“The uptick in February may have also been caused by acute changes in the illegal drug supply that would be short in duration or fluctuate over time,” Hannah said.

OD Free Marin, the overdose prevention program, is distributing free fentanyl test strips along with Narcan in a vending machine at Ritter Center, a community support center in San Rafael.

The clinic manager, Rachelle Valenzuela, said this week that the machine is regularly restocked.

“Use of the vending machine allows our staff to address the lack of awareness of our clients about the risk of fentanyl in many drugs and the need for using fentanyl testing strips,” she said.

Ritter Center also has an emergency Narcan box. Visitors need to interact with staff in order to access the medication, Valenzuela said.

Narcan vending machines are also available in the lobby at the Marin County Jail, the Marin Health and Wellness Campus in San Rafael and the West Marin Health and Human Services Multi-Service Center in Point Reyes Station.

Narcan was also allocated to all public middle and high schools across the county, according to OD Free Marin.

Anita Renzetti, OD Free Marin’s program coordinator, said there are plans to install fentanyl test strip vending machines in Novato, southern Marin and Kaiser Permanente’s San Rafael Park office on Los Gamos Drive.

Willis said that OD Free Marin also distributed hundreds of fentanyl test strips to other partners such as Dominican University of California in San Rafael and the Multicultural Center of Marin.

“They are not foolproof, but for people who use drugs and want to avoid fentanyl, they can be lifesaving,” he said.

OD Free Marin 2024 is planning an online forum from 6:30 to 8 p.m. April 10. Registration and additional details are available at shorturl.at/tOQ08.