The Pima County Board of Supervisors plans to spend $180,000 from a multi-million dollar settlement with a drug maker to buy and distribute Narcan, in an otherwise fatal opioid overdose. It “masks” the area with a drug that can be reversed.

The move, which was approved earlier this month, said Pima officials were working to reduce overdose deaths as the synthetic opioid fentanyl became “everywhere” here.

Over the next 18 years, Pima County will receive $48.5 million. It is the result of a settlement that ended a series of lawsuits by all 50 state attorneys general against leading opioid makers Johnson & Johnson and his three drug distributors (Amerisource Bergen, Cardinal Health). and Mackeson.

The three distributors will pay a total of approximately $21 billion over the next 18 years, Johnson & Johnson will pay up to $5 billion over nine years, and $3.7 billion over the next three years.

Last September, Pima County received $1.5 million. This was the first payment from the settlement as part of the One Arizona Plan. It is a statewide agreement created under former Arizona Attorney General Mark Brnovich to guide the distribution of funds.

In a unanimous vote on April 4, the Board approved the spending plan. This will provide the county with approximately 6,000 units of Narcan, the brand name for the overdose drug naloxone.

In a pre-voting presentation, the county’s chief medical officer, Dr. Francisco Garcia, said 50 to 60 percent of overdoses in recent years have been linked to fentanyl. “What’s particularly troubling about fentanyl is the fact that it’s ubiquitous, affordable, and readily available,” he said. ”

There were 286 overdose deaths in Pima County in 2017, and overdose numbers peaked at 497 deaths in the five years to 2021, according to data from the Pima County Coroner’s Office. In 2022, the number of deaths dropped slightly to 495 for him, and in 2023 there were 103 deaths, 66 of which were fentanyl-related.

In 2019, fentanyl was associated with 29% of fatal overdoses, while by 2022 synthetic opioids were associated with 61% of overdoses in Pima County.

Fentanyl “Priority Public Health Issue”

In a Board of Supervisors memo, Pima County Administrator Jean Lescher said he identified substance abuse as a “public health priority” in 2015 as part of a health needs assessment for the Pima County community.

“The document and the process that produced it spurred a series of community conversations and data analysis to explore how this crisis is progressing in Pima County, community treatment resource limitations, and intervention and investment priorities. I tried to explain the field,” she wrote, adding: The county has made some progress, especially in treating and supporting pregnant and postpartum women with opioid dependence.

“The ubiquitous availability of fentanyl and common opioids, in particular, has caused very high levels of human suffering and death,” Lesher wrote. “It is our duty to take a Pima County-wide approach that engages key partners and stakeholders in developing innovative creative solutions to reduce the human cost of this disease.”

In 2017, the county began tracking overdoses, but public health strategies were primarily aimed at reducing the harm associated with pharmaceutical opioids such as oxycodone, tramadol and hydrocodone, she wrote. But fentanyl has taken hold, helping propel what she calls a “continuous upward trend of fatal overdoses” that plateaued in 2022 after “three years of straight increases.”

“However, this year’s overall total remained unacceptably high at 458, an average of 38.2 deaths per month,” Lesher wrote.

Teresa Cullen, Pima County Health Director, said the county is now distributing 1,200 to 1,500 doses of Narcan throughout the community, along with fentanyl test strips that can be used to test other drugs for the presence of fentanyl. I said yes.

Last year, DEA officials launched a “one pill kills” program. caveat Regarding counterfeit tablets containing fentanyl. Nearly one-sixth of counterfeit tablets contain lethal doses of fentanyl, according to the DEA’s analysis. This includes counterfeit versions of Oxycodone, Percocet, Xanax, and Adderall.

“Every time we administer Narcan, it saves lives, and while it matters, we create a need and hopefully we have the opportunity to come up with some interventions that can be used at that time.” said Karen.

“This is a big problem,” says Cullen. “The Department of Health believes we are an important part of the solution, but we cannot deal with this alone.” correspondence.

“We don’t all know what to do. We’re working with national experts who live in the Tucson area to provide information,” she said. She added that the county has received about $450,000 from the state to establish best practices.

“We are using all the resources available,” said Cullen, adding that Department of Health officials are on about 20 county and city committees that address these issues. . “But the numbers themselves speak to the onslaught and devastation that is occurring because of this substance abuse problem.”

In March, the CDC announced that overdoses have increased fivefold over the past 20 years and will kill 107,622 people in 2021. This includes his 71,238 due to illegal fentanyl.

Fentanyl is routinely used in clinical settings as a potent pain reliever, but illicit forms of the drug have killed thousands, making the drug at the center of state and legislative efforts to reduce drug production. contain bills designed to crack down on and put sellers to death. to illicit heroin.

During his presentation, Garcia noted that overdoses increased from 2019 to 2021. Since 2019, the county has spent her $4.2 million to begin a series of new measures to mitigate overdoses, including Narcan distribution, opioid monitoring, and additional public health administrators.

The county has received just over $1.3 million in federal and state grants to combat opioid addiction and overdoses. This includes nearly $375,000 from the CDC for the Overdose Data 2 Action Program. During the meeting, Cullen told the board that the county is also applying for additional grants under his OD2A program.

Noting that the county has made some progress on overdose, Lesher writes that by 2022, teenage overdose deaths will have fallen by more than two-thirds, or a 66.67% drop. Additionally, heroin-related deaths will drop to a record low of 18 in 2022, a 42% drop from the previous year.

Garcia links overdose deaths to fewer overdose deaths due to increased Narcan distribution and the county’s efforts to “cover communities with this life-saving intervention.”

“The Narcan nasal spray and fentanyl test are important tools for preventing and reversing opioid overdose,” Garcia wrote in a note. Making it accessible and affordable is a key strategy for addressing the ongoing drug overdose crisis in Pima County.”

Spending money on Narkan is ‘easy’

Mark Parson, program manager for the county’s Community Mental Health and Addiction Division, said the county has been a central distribution point for Narcan since 2019. He said the program has changed significantly since that time as the county has “strategically pivoted resources.” To accommodate changes in addiction patterns. In 2019, fentanyl didn’t stand out as much, with officials relying on face-to-face encounters with people who might need Narcan. We distribute at least 1,200 kits (each containing 2 servings) each month.

This program does not apply to law enforcement officers, medical personnel, and hospitals who have received their own Narcan kits through state programs. Instead, the county has moved to community-wide distribution, providing kits to community groups and businesses such as convenience stores. He said there are currently 164 partner organizations working with the county.

“We try to partner with as many companies as possible,” Person said. Although the majority of overdoses occur in private homes, places with public restrooms and high foot traffic are good candidates for distributing Narkan, he said.

“Unfortunately, the reality is that some of these businesses have experienced overdoses.

In the program’s first year, the county has distributed 2,460 doses of Narkan, Persson said. In his fourth year of the 2022 program, the county has distributed his 12,593 doses. Each kit costs about $29 and each kit contains two doses of him.

At the end of March, the FDA approved Narcan for over-the-counter sales at over 60,000 pharmacies, expanding access to the drug to combat overdose.

The county will also look for trends to understand how to channel more resources into communities with more deadly overdoses.

“We use that data to repurpose those resources,” he said.

“This is a valid reason to use these settlement funds. Demand often exceeds our capacity,” he said, adding that the new allocation will be used to bundle the county’s supply. “Considering Narkan is the only life-saving tool, this is a no-brainer,” he said.

“We are a resource without barriers, we want to distribute to everyone, we are not picking and choosing,” he said. “But we are prioritizing individuals who are suffering from opiates (prescription or illicit) or those working with families.”

“We want to put the kit into everyone’s hands so they can fight this epidemic,” Parson said.