A recent surge in fentanyl overdoses in Marin County and beyond has prompted an urgent local initiative to make the antidote drug naloxone more available to the public through pharmacies.

Dr. Jeff DeVido of Marin County Health and Human Services holds up an intranasal naloxone device.
Marin County Public Health Officer Dr. Matt Willis said he’s pleased that 20 out of 36 pharmacies in Marin County furnish naloxone, a medication available in injectable and nasal spray forms that reverses the potentially fatal effects of opioid overdose. The widespread availability of naloxone, often marketed under the brand Narcan, can help reverse the trend of opioid overdose deaths.

“We’ve been fighting the opioid crisis for several years now, but the trend of fentanyl use among younger people is particularly alarming,” Willis said.

Fentanyl is a synthetic opioid that is 80-100 times stronger than morphine, and since 2017 is responsible for the majority of opioid overdose deaths nationally. Willis said a recent mass overdose in Chico, and an increase in the number of fentanyl-related overdoses in Marin prompted outreach to pharmacies that were not yet furnishing naloxone in Marin.

California law allows pharmacists to furnish naloxone without a doctor’s prescription directly to customers who request it. Most insurance plans cover the cost of the medication, and one need not use opioids themselves to obtain this medication.

“If 100 percent of our pharmacies offered naloxone, it would be a big step,” said Dr. Jeff DeVido, Chief of Addiction Services for the Marin County Department of Health and Human Services (Marin HHS). “We’re working hard to increase the availability of naloxone, and pharmacies have a vital role to play in getting this life-saving medication into the hands of anyone who might be near someone who is at risk for overdose.”

In Marin, opioid overdose remains the leading cause of accidental death. In response to the crisis, the RxSafe Marin coalition was founded in 2014 with support from Marin HHS. Since its inception, the coalition has worked with healthcare providers, mental health specialists, pharmacists, law enforcement, schools and families of people at risk to reduce overdose risk with a wide range of strategies, including promoting wider availability of naloxone.

“Our ambulances respond to three to five opioid overdoses per week in Marin,” Willis said. “The hope always is that the ambulance will arrive in time to revive the person with naloxone. But we can do better. Getting it into the hands of friends and family who may be close by can save lives.”

For Marin County resident Susan Kim, January 23 marks the sixth anniversary of her son’s death from an opioid overdose. Trey Lagomarsino, 23, died after ingesting too much codeine cough syrup. As an RxSafe Marin volunteer, Kim helped develop a list of Marin County pharmacies that furnish naloxone.

“Anyone who’s concerned that a loved one could be at risk should visit one of these pharmacies and request Narcan — you don’t need a prescription,” Kim said. “It can give young people struggling with opioids another chance, another opportunity to stay in the fight to recovery.”

This is not the first RxSafe Marin initiative to increase access to the overdose antidote. In 2017, DeVido trained police officers in the use of naloxone. Today, law enforcement officers throughout Marin, including those with the Marin County Sheriff’s Office, carry the life-saving medication. Since 2017, officers in Marin have rescued at least nine people from opioid overdose by using naloxone in the field. Some Marin schools and libraries are also carrying naloxone. Additional addiction treatment facilities and community service organizations such as San Rafael’s Marin Treatment Center and Corte Madera’s Spahr Center, have been helping the effort by furnishing naloxone directly to interested individuals.

“Our ultimate goal is to prevent overdose in the first place by treating addiction,” DeVido said. “Naloxone can help make sure a temporary problem of drug use doesn’t have fatal consequences. We applaud those pharmacies that have stepped up and are offering to provide naloxone to users of opioids and their families or friends. We welcome the opportunity to work with the rest of our pharmacies to bring us to 100 percent participation.”

To follow the trend and educate its residents, the California Department of Public Health maintains an online opioid surveillance dashboard. More resources can be found on the RxSafe Marin website, including “Know the Risks” posters in English and Spanish.