Civil grand jury urges more action on opioids
Report says deadly overdoses still ‘trending upward’
With an estimated 4,400 Marin residents suffering from opioid misuse, county officials need to do more to prevent and treat the disease, according to the Marin County Civil Grand Jury.
In its new report, “Opioid Misuse: Strengthening Marin County’s Response,” the grand jury is recommending that the Marin County Department of Health and Human Services make the drug naloxone, the opioid overdose antidote, more widely available throughout the county.
The grand jury is also calling for a cost-benefit analysis to determine whether more should be invested in adding recovery coaches to staff and whether the Marin Healthcare District, which manages MarinHealth Medical Center
in Greenbrae, could add more substance use professionals in the emergency department, among other recommendations.
“The county has taken important steps to prevent opioid misuse, including participating in a statewide system for monitoring the opioid prescribing patterns of healthcare providers,” said the grand jury, a government watchdog committee empowered by the local judiciary.
The report also acknowledged county health officials for leading the formation of RxSafe Marin, an organization dedicated to reducing opioid use and preventing addiction, and for adopting the Drug Medi- Cal Organized Delivery System, which operates as a care plan for patients who need comprehensive treatment for substance
“Opioid addiction, overdose and death will only be successfully addressed through a multi-prong, multi-player approach.”
— Supervisor Katie Rice
addictions.
“Despite these laudable programs, the misuse of opioids in Marin County continues,” the report says. “Emergency department visits from opioid overdoses are trending upward. In 2019, the number of opioid-related overdose deaths in Marin was higher than it was in any of the preceding eight years. More needs to be done.”
The grand jury reported that opioids, such as hydrocodone and oxycodone, became widely used prescription pain relievers in the late 1990s, contributing to one of the more lethal drug-related crises in the nation. Drug overdose remains the leading cause of accidental death in Marin County, with 451 fatalities between 2006 and 2019. Opioids contributed to nearly half of those deaths, the grand jury reported.
In 2019 alone, there were 43 drug overdose deaths. Prescription opioids contributed to four of those, eight were from heroin and fentanyl was responsible for 11. Non-opioids, such as cocaine and methamphetamines, contributed to 24, the grand jury reported.
Dr. Jeff Davido, the chief of addiction services at the health department, said the county is grateful for the report.
“Marin County HHS and the grassroots coalition called RxSafe Marin have made great strides in creating awareness in the community about opioid addiction and ways to prevent overdoses, though we still have much work to do,” Davido said in an email.
The Spahr Center, a Marin nonprofit serving the lesbian, gay, bisexual and transgender community and those affected by HIV, is a partner organization in RxSafe Marin.
Andy Fyne, the center’s “harm reduction” coordinator, said providing naloxone to the community has proved to save lives.
The center distributes naloxone kits that contain a testing substance so opioid users can see if their drugs contain any fentanyl, a potentially deadly synthetic opioid.
Through November, the agency distributed more than 380 kits that reversed 85 overdoses, Fyne said. In 2019, 473 kits were distributed and 30 reversals were reported.
Marin Medical Pharmacy in San Rafael has offered naloxone for several years, said Benson Toy, lead pharmacist. He said he recommends that anyone who takes a prescription opioid for a chronic condition also have a prescription for Narcan, the brand-name naloxone nasal spray.
“Sometimes people take the opioids accidentally, and having Narcan could be an emergency aid to help revive them,” Benson said. “They should still seen by a paramedic because depending on the dose, they could have a relapse.”
He praised the grand jury for exploring the issue, saying, “It’s great when you bring in politics. You get more muscle to take it on.”
Katie Rice, president of the Board of Supervisors, said “opioid addiction, overdose and death will only be successfully addressed through a multi- prong, multi-player approach.”
Rice said that prevention of addiction and addressing the legal and illegal presence of drugs in Marin is “equally as important as providing adequate treatment, recovery and coaching support.”
Rice agreed that increasing the number of substance use navigators and recovery coaches, and making naloxone more widely available, would help to prevent accidental deaths.
What’s also needed, she said, are “resources to support expanded education focused on prevention; destigmatization; resources to expand access to mental health counseling; and other resources to support folks — especially our youth — from turning to drugs, prescription or other, when struggling with the stresses/challenges that life is throwing at them.”
The county, along with the Marin Healthcare District, has until March 14 to respond to the report.