October 24, 2022 — Drug overdose deaths increased dramatically last year, with the availability of ever more powerful synthetic and addictive drugs. Dr. Jeanine Miller, the director of the county’s Behavioral Health Department, told the Board of Supervisors last week that opioids and synthetic drugs are taking a heavy toll.*
“We went from 43 (overdose deaths) in 2020 to 72 in 2021,” she said. Three additional people who died from overdose were determined to have intentionally committed suicide. “When we look at opioids as a whole, we’re looking at natural, semi-synthetic, and synthetic. That’s our number one. If we separate that out, and just look at the synthetic, which is fentanyl, our number one overdose is actually methamphetamine, followed very close to fentanyl. We believe fentanyl would be actually the number one if it wasn’t for Narcan and Naloxone, and we continue to work on getting that in our community.”
The opioid blocker Naloxone was first approved as a fast-acting medication for opioid overdose in 1971. But Narcan, the nasal spray that can reverse overdose within minutes, only received tentative FDA approval in 2018, with final approval granted in April of the following year. Since then, it’s become a mainstay for first responders. A smattering of communities across the country have installed vending machines, where people can help themselves to a free box of Narcan. Some local organizations offer it for free to people suffering from drug addiction, and to their friends and family members.
On Saturday during Farmers Market, county, tribal, and non-profit workers set up tables in Alex Thomas Plaza in Ukiah to share information about drug overdose and treatment, and to spread the word about the rising death rate.
Lindsey Daugherty, the Executive Director of NAMI Mendocino, the local branch of the National Alliance on Mental Illness, spoke about what’s still being learned about Narcan. Some reports indicate that people who have overdosed multiple times require more than one dose of Narcan to be revived.
“There is some research out there to suggest that we are developing some kind of an immunity to the Narcan,” she said. “Or that the opiates are becoming stronger and stronger, or being taken in higher doses. So that is one theory. Another theory is that it can take a couple of doses of Narcan to bring someone back to consciousness. Typically, you would give a dose and wait two minutes to see how that goes, and give another as needed.” She added that “Narcan itself is not psychoactive. It’s an opiate blocker, so it blocks the opiate receptors in the brain, stops that person from being high immediately, and throws them into acute withdrawal, so really intense withdrawal symptoms.” She pointed out that Narcan is still relatively new, but that “There is no known side effects currently to giving people multiple doses of opiate blocker.”
Gabriel Ray, who works for the Pinoleville Nation’s Native American Youth and Family Empowerment Program, is working on an approach he hopes will prevent kids from needing emergency treatment. He said he is “teaching kids about their culture. I think it’s important to know your history, where you came from…we don’t know our culture. We’re picking up other types of culture, and sometimes that may be gang culture. So getting to our kids younger is good, and then working with the families. Having as much support as we can provide to our tribal families.” Ray has offered talking circles in schools, and has a whole program called Boys with Braids, to teach kids about the cultural significance of long hair, and to discourage bullying.
The Pinoleville Pomo Nation is the owner of New Life Clinic, an outpatient medication assisted treatment program that’s been in Ukiah for about a year. Physician Assistant Noah Schutz gave an overview of the program, which includes three medications: Suboxone, which is widely available as an outpatient treatment; the traditional Methadone; and Naltrexone, what Schutz calls “a full antagonist.” He said many of the clinic’s approximately 155 patients have found out about the clinic’s services by word of mouth, but also through referrals from the hospital, probation, parole, and jail. “Basically, it’s giving our facility a call, and just saying, we’re interested in treatment, and we set up a time, ideally that day, if not the day after, to get people some care,” he concluded.
Jill Ells is the manager of the county’s Substance Use Disorder Treatment program. She has been in the field for 23 years, and said, “I’ve never seen the likes of what is happening with our county right now. With the nation.” She explained that residential treatment is available, but some patients, especially kids, have to travel a long way to get it. The Ukiah Recovery Center offers residential treatment locally, and people with insurance through Partnership Health Plan can take advantage of services in seven counties, including Mendocino, that are part of a regional model. “So if we can’t get you in a program here in Mendocino County, we absolutely can get you in a program in one of the other six counties that’s a part of this regional model,” she declared. But Els has sent young patients for treatment as far away as Los Angeles. “Our adolescents are the concern,” she acknowledged. “Sending them clear to LA to me is not the solution. It is one of our county problems, yes.”