Department of Behavioral Health Confirms Increase in Fentanyl in Local Opioid Overdose Deaths

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Author: Behavioral Health

Date: 06/01/2021 11:26:53 AM

The Behavioral Health Department has confirmed that opioid overdose deaths have increased 62% since 2016 in San Luis Obispo County, with an alarming increase in the presence of fentanyl in those deaths as well.


The Behavioral Health Department has confirmed that opioid overdose deaths have increased 62% since 2016 in San Luis Obispo County, with an alarming increase in the presence of fentanyl in those deaths as well. In 2020, 34 of 55 opioid overdose deaths included fentanyl, compared to 6 of 34 opioid overdose deaths in 2016, including fentanyl (SLO County Coroner’s Office, 2020). This is the first year that fentanyl was present in more than half of opioid-related overdose deaths.

Fentanyl is a synthetic opioid which is 100 times more potent than morphine and 30 to 50 times more potent than heroin. It is used in healthcare to relieve pain in critically ill or injured patients, such as those with cancer or recovering from surgery. Fentanyl is also manufactured and sold illegally outside of healthcare settings. This illegal fentanyl comes in powder or other forms, including pills that look like prescription drugs. It is sometimes mixed with other drugs, including heroin, cocaine and methamphetamine, with or without the user’s knowledge. Because fentanyl is so strong, a tiny amount can prevent a person from breathing. Please click HERE for more information on fentanyl.

83%fentanyl_chart.PNG of opioid overdose deaths in 2020 were categorized as “multiple drug intoxication”, meaning that several drugs have been identified by toxicology reports. These recent reports show that fentanyl has been mixed with other opioids, stimulants such as methamphetamine and cocaine, and prescription drugs such as Xanax. In 32% of fentanyl-related opioid overdose deaths, fentanyl was the only opioid identified among other non-opioid substances. People who use counterfeit prescription stimulants or pills may be less aware of the risks and signs of an opioid overdose, and less likely to have medication available to reverse the overdose.

“Our hearts are with those who have lost loved ones to an overdose,” said Dr. Penny Borenstein, San Luis Obispo County Medical Officer of Health. “We want everyone to know: The illicit fentanyl is here in San Luis Obispo County and carries a high risk of overdose. Any drug you buy on the street can be contaminated with lethal levels of fentanyl.

The safest course of action is not to use illicit drugs. Although it is impossible to eliminate the risk of overdose if you use street drugs, there are steps you can take to reduce the risk:

Get naloxone. If you or a loved one uses street drugs – opioids, stimulants, counterfeit pills – take naloxone and learn how to use it. Naloxone (also known by its brand name Narcan) is a drug that can reverse an opioid overdose. It is not addictive, has virtually no side effects, and has no potential for abuse as it produces no high effects. It is not a controlled substance. It comes as a nasal spray or injection and can be safely given to anyone who is suspected of having overdosed. Naloxone only works on opioids in the brain and will not affect a person without opioids in their system. See the attached list for where to get low cost or free naloxone in SLO County.

Consider testing for fentanyl. Fentanyl test strips are used to test for the presence or absence of fentanyl and many fentanyl analogues (very closely related drugs) in the illicit drug supply. These test strips are not entirely accurate (in part because illegally manufactured fentanyl varies in its chemical makeup), but offer some information. In general, a negative result cannot rule out the possibility that fentanyl is present, but a positive result means that fentanyl is present. It is safer to assume that any illicit drug may contain traces of fentanyl. Test strips are available for purchase commercially or supplied through the Bangers SLO Syringe exchange and overdose prevention program.

Know the signs of overdose and be ready to call 911. Signs of overdose include small constricted “point” pupils; falling asleep or losing consciousness; slow, shallow breathing; choking or gurgling sounds; soft body; and pale, blue, or cold skin. If you are not sure, it is safer to treat the situation as a potential overdose. Call 911, administer naloxone (if you have it), and don’t leave the person alone. The California Good Samaritan Law 9-1-1, AB 472, implemented on January 1, 2013, protects the alleged overdose victim from arrest or summons for possession or use of a controlled substance. The law states that it should not be a crime for a person to be under the influence of, or to possess for personal use, a controlled substance or drug paraphernalia, drug-related overdose if that person seeks medical assistance for the drug-related overdose. Law enforcement cannot make an arrest unless: the drug sale has taken place the drug was administered against the will of the person or the person being driven under the influence.

Connect with treatment. The County Drug & Alcohol Services team offers services to support recovery and can also help connect residents to other treatment programs. To learn more, visit Drug & Alcohol Services or call 800-838-1381.

If you would like to get involved in the fight against opioid overdose and abuse in SLO County, you are welcome to join the SLO Opioid Safety Coalition. Since January 2016, this group has worked together on practical measures to tackle the opioid epidemic on the central coast. This group is led by a diverse coalition of community members, including county behavioral and public health departments, law enforcement, physicians, pharmacists, treatment professionals, educators, community members, recoverers and others.

Where can you get naloxone in SLO County?

In case of emergency suspected of overdose, CALL 911 and GIVE NALOXONE ASAP, this is the best chance to save lives! Naloxone is available free or at low cost nationwide, including in confidential or anonymous settings. It is fully covered (free) by Medi-Cal and is fully or partially covered by most insurances. It is available for people who use opioids for any reason and for those who know someone who uses them.

FREE & CONFIDENTIAL access to naloxone is available to all community members Monday through Friday, 8:00 a.m. to 5:00 p.m. at one of the four County Drug & Alcohol Services centers in Paso Robles, Atascadero, San Luis Obispo and Grover Beach. Click HERE for clinic locations. The SLO Bangers Syringe Exchange and Overdose Prevention Program also offers FREE and CONFIDENTIAL distribution of naloxone to all community members on Wednesday evenings from 5:30 p.m. to 8:15 p.m. in San Luis Obispo. Call 805-458-0123 for more information or come see us Wednesdays 5:30 to 8:30 p.m. at 2191 Johnson Ave, parking lot near Bishop Street.

In California, pharmacists are allowed to dispense naloxone without a prescription if they have completed the required training. Most large retail pharmacies can dispense naloxone without a prescription, although it is advisable to call ahead to make sure the licensed pharmacist is there and the naloxone is in stock. Ask your healthcare professional for a prescription or see a list of local pharmacies that offer naloxone without a prescription below. Individual co-payments for naloxone vary depending on the insurance. It’s free with Medi-Cal.

  • CVS Pharmacy – all CA locations (including those located at Target)
  • Rite Aid Pharmacy – All CA Locations
  • Wal-Mart Pharmacy – All CA Locations
  • Walgreens Pharmacy – All CA Locations
  • Vons Pharmacy – All CA Locations
  • Costco Pharmacy – must be a Costco member
  • Cayucos pharmacy
  • Cal Poly Health Services – must be a student at Cal Poly
  • Nipomo Rexall Pharmacy



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