Santa Clara County Preventing Opioid Overdose Deaths

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Santa Clara County, CA – Due to their effect on the part of the brain which regulates breathing, opioids in high doses can cause respiratory depression and death. The distribution and use of naloxone (narcan) is one strategy being use to prevent additional opioid overdose deaths. As part of this effort, on Wednesday, August 29, 2019, SCCOPP handed out narcan kits at the SCVMC Farmer’s Market.

From January 1, 2018 to August 13, 2018, there have been 27 confirmed opioid deaths in Santa Clara County. Of these, 15 were related to illicit drugs: 4 related to fentanyl and 11 from heroin. The Coroner’s Office currently has outstanding cases of drug deaths which have not been finalized as they are awaiting toxicology results. The fentanyl deaths were males with an average age of 26.5 years. 

“No part of our community is exempt from this epidemic—we all know a friend, family member, or loved one devastated by opioids,” said Bruce Copley, Deputy Director of the Behavioral Health Services Department. “Our health system is working together prevent deaths from overdoses, treat people with substance-use disorders, and prevent people from starting using drugs in the first place.”  

The Santa Clara County Opioid Overdose Prevention Project (SCCOOPP) is a multidisciplinary, multiagency group led by the Behavioral Health Services Department (BHSD) to combat opioid use and overdose in our community. Their strategies are focused on prevention and treatment:

  • Fifteen law enforcement agencies throughout the county have been provided with overdose prevention education and narcan kits from BHSD, saving two lives.
  • Santa Clara Valley Medical Center (SCVMC) pharmacies developed and implemented protocols to automatically dispense Narcan kits and education for anyone prescribed opioids above 50 mg.
  • The Public Health Department’s Syringe Access Program, began distributing narcan kits along with information on how to prevent, recognize and respond to an opioid overdose in August 2016. In response to the growing threat of fentanyl-contaminated street drugs, the program began distributing fentanyl test strips in August 2018. These strips allow people who use drugs to test drug supplies for the presence of fentanyl.
  • Medication Assisted Treatment (MAT) clinic capacity for treatment was expanded by hiring a full-time physician with 200 patient slots a month, specifically for opioid treatments.
  • Medication assisted treatment was launched for the inpatient units at SCVMC and at the hospital’s Emergency Department in July 2018.
  • Safe opioid prescribing guidelines on how to prescribe opioids, alternative medications and education were provided by BHSD to primary care clinicians and specialists throughout the county.
  • Narcan community education is available every Friday from 1-2 pm at each medication assistance treatment clinic site, and every participant is provided a narcan kit.
  • Educational information has been provided to schools (high-schools, colleges and universities) on how to prevent drug overdose and treatment options. Prevention information was also offered to high-school PTAs.
  • The campus police department at SJSU has been trained and narcan kits were provided. At Stanford University, opioid education seminars have been provided to medical students.
  • The Behavioral Health Services Department provided opioid education and medication safety guidelines to senior centers.
  • Suboxone certification courses have been made available to all physicians in Santa Clara County to expand capacity for treatment in outpatient clinics.
  • Primary care physicians can make direct referrals to MAT clinics for evaluation, treatment, and stabilization.
  • Medication assisted treatment is provided at Behavioral Health Services Department substance use treatment residential sites by a mobile team from the MAT clinic.
  • The Valley Homeless Healthcare Program clinic provides medication assisted treatment and distributes narcan kits.

 

Additional efforts are underway, such as SCCOOPP working to create opioid education programs at universities and protocols to place narcan kits on campuses for student access to life-saving opioid overdose medication. 

About Fentanyl Laced Pills

  • Pills or other drugs purchased off the street may be laced with fentanyl and can be deadly. Fentanyl laced pills can look similar to other pharmaceutical drugs but are usually off color with the borders of the pills irregular.
  • Fentanyl can be found in opioid street drugs such as heroin and oxycodone but also in non-opioid street drugs such as methamphetamine, cocaine, and benzodiazepines (like Xanax). This means that people may be exposed to fentanyl without any knowledge that they might be taking an opioid. 
  • Fentanyl is 80-100X more potent than morphine and 50X more potent than pure heroin. 

Information about Opioids

  • Opioids are psychoactive substances derived from the opium poppy, or their synthetic equivalents. Examples are morphine and heroin.
  • Worldwide, an estimated 69 000 people die from opioid overdose each year.
  • There are an estimated 15 million people who suffer from opioid dependence (i.e. an addiction to opioids). The majority of people dependent on opioids use illicitly cultivated and manufactured heroin, but an increasing proportion use prescription opioids.
  • There are effective treatments for opioid dependence yet only a fraction of people who need such treatment are receiving it.
  • The inexpensive medication naloxone can completely reverse the effects of opioid overdose and prevent deaths due to opioid overdose.
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