San Rafael, CA – To Marin County health officials, the White House’s October 26 declaration that the opioid epidemic is a public health emergency was a first step toward a late-coming national response.
Dr. Matt Willis speaks at the first RxSafe Marin conference in 2014.“While this news from Washington helps draw attention to the crisis, Marin County hasn’t waited for federal systems to respond,” said Dr. Matt Willis, Marin County Public Health Officer. “Framing this as a local public health emergency several years earlier has allowed us to address the many dimensions of this issue in a more coordinated way. This is a complex epidemic, and we need all hands on deck.”
Drug overdose is the leading cause of accidental death in Marin, and the majority are due to prescription drugs. In Marin, 2012-2016 there were 61 deaths from motor vehicle accidents and 100 drug overdose deaths. The epidemic peaked locally in 2012 and 2013 when a Marin resident died from an accidental overdose every two weeks. Most of the drug overdoses are linked to opioids, a class of drugs that includes prescription pain medications such as vicodin, codeine, and fentanyl, as well as street drugs such as heroin.
Marin was among the first California counties to approach opioid abuse as a public health crisis. In 2014 the Marin County Department of Health and Human Services (HHS) issued a public health advisory regarding opioid overdoses, coinciding with the launch of countywide opioid prescribing standards for local doctors. Since then the county has seen a significant decline in opioid prescriptions, with a 30 percent reduction from 2014-2016. Overdose death rates also declined 27 percent during the interval.
RxSafe Marin is a community-based initiative dedicated to saving lives and reducing harm from prescription drug abuse, and Marin HHS has been a founding partner since the initiative was founded in 2014. One of the first groups of its kind in California, RxSafe Marin built on the advocacy work of experts and community activists including Marin HHS, the Marin County District Attorney’s Office, the Marin County Public Defender’s Office, Marin County Office of Education and many other stakeholders. This initiative created a structure for cross-sector problem-solving and offers a model to other communities formulating a response.
In April 2017, Marin HHS and RxSafe Marin had a hand in making naloxone, a medication that reverses an opioid overdose, more available countywide. Naloxone blocks the effects of opioids during an overdose, and restores breathing. Friends and family members of those at risk for overdose, along with first responders and police officers, are being encouraged to carry naloxone. Police officers in San Rafael, Fairfax and Central Marin began carrying naloxone this spring, and Marin HHS plans to increase its availability in other settings, including schools.
“We see every overdose as preventable,” Willis said. “Our goal is zero overdoses, and this life-saving antidote is an important step in reaching that goal.”
RxSafe Marin will be recognized for modeling local solutions to addressing the opioid epidemic by the California State Association of Counties will recognize on October 31 at the Marin Board of Supervisors meeting in San Rafael.
“Marin County has been a leader on combating the opioid epidemic,” said Marin County Board of Supervisors President Judy Arnold. “We have worked with partner agencies to educate youth and adults alike about the dangers of drug use, increased our efforts for safe medication drop-off and worked with the local medical industry. I am pleased the White House has stepped up. This is a critical issue here at home and across the country.”
Susan Kim of Novato lost her son Trey to a prescription opioid overdose in 2013. "The way a person dies in no way affects their life or the love and sadness their family feels,” she said in an RxSafe Marin video. “There's no shame in that game to be struggling, and it's important for families to know that they are supported and they won't be judged. Everybody needs to talk about it so we can get treatment programs in place."
On November 15, RxSafe Marin will host a community forum to address opioid addiction, treatment, and life-saving medications such as naloxone. The free event is from noon to 2 p.m. at the Marin County Office of Education, 1111 Las Gallinas Avenue, San Rafael. Dr. Jeff Devido, Marin HHS Chief of Addiction Services, and panel will address new opportunities for treating addiction in Marin and how to reverse an overdose. Online registration for the event is open.
Community feedback on the issue is welcomed. Email RxSafeMarin@gmail.com.