Sacramento County Fentanyl Awareness Summit brings community groups together.
In 2022, over 110,000 people across the U.S. lost their lives to drug overdose, mostly due to fentanyl; over 220 of those deaths occurred in Sacramento County. Of note, 73% were male and 85% were housed. These numbers are disturbing and continuing to rise.
On August 17, 2023, the Sacramento County Opioid Coalition, led by the Sierra Sacramento Valley Medical Society, helped to sponsor the Sacramento County Fentanyl Awareness Summit at Sacramento State University. The full-day program had more than 360 people from multiple organizations who shared their specialized approaches to the opioid and fentanyl crisis.
The day started with Dr. Aimee Moulin, who briefly reviewed the physiology of fentanyl. It is rapidly absorbed when smoked but poorly absorbed by the skin; it is stored in body fat and allows early tolerance and an increased risk for addiction. This was an important point for many in the room as there has been widespread misinformation about how touching fentanyl can cause an overdose, misinformation that could lead people to be hesitant to help someone experiencing an overdose.
A subject who has overdosed on a narcotic, including fentanyl. will have pinpoint pupils, hypoventilation and a rapidly increasing lack of response to stimuli. Inhaled Narcan (or intranasal Naloxone) will reverse the overdose. Narcan was provided to everyone who attended, and a special session was devoted to how to recognize and respond to an opioid overdose.
The One Pill Can Kill campaign sponsored a panel with District Attorney Thein Ho who shared that 98% of pills bought on the street are fake and there are currently more fentanyl deaths than gun deaths. He said that anyone who supplies fentanyl to consumers would be indicted for murder.
Pike Long, a harm reduction specialist with the California Department of Public Health, warned about the dangers of Xylazine, a sedative for large animals, which is a product seen being used with increasing frequency. There was also a specific program discussing “Tranq,” which is the mixing of Xylazine and fentanyl to produce stronger, lasting effects. Long noted that fentanyl responds to Narcan but Xylazine does not, and CPR and rescue breathing are important life-saving options in these instances.
Angela Webb of Arrive Alive California says their The Gone Too Soon Memorial Project has reached over 47,000 middle and high school students. The message, especially to young people, is “If you didn’t get it directly from a pharmacy, don’t take any pills.”
The Reaching Diverse Communities Panel was extraordinary, with three key takeaways. The first was that you need to be a parent rather than your child’s friend; as a parent, it’s important to talk to your kids about sex, drugs, and all relevant dangers in your community. They also need to know that fentanyl is not just a “white” drug and greatly affects our Black, Indigenous and Hispanic communities.
The Lived Experience panel featured those who have lost family to opioid overdose and those in recovery from substance-use disorder. Some of the family members on the panel had photos of their loved ones on stage as they spoke about their loss. It was outstanding but terribly emotional for the panel as well as the audience. All the presentations were excellent, but what was most touching was hearing firsthand about these experiences and how putting a face to the overdose data is important if we are going to make a dent in this crisis.
The Substance Use Disorder, Prevention and Treatment panel highlighted several statistics mentioning the height of this issue. To put the cause of addiction into perspective, research has shown that 20% of the population who are exposed to narcotics get such a reaction that they immediately crave a repeat dose. This panel represented C.O.R.E. Recovery Programs, MAT (Medication Assisted Treatment), Sacramento County Coalition for Youth, and Omni Youth Programs. The group stressed that their message is not only to talk to your kids, but how, when, and what to say to them so the conversation is effective.
The Harm Reduction Panel was interesting and stressed their ability to dispense harm reduction supplies free of cost to our community, including access to clean syringes, needle exchange, PPE, condoms and more.
The Law Enforcement Panel included representatives from the U.S. Attorney’s office for the Eastern District of California. They emphasized treatment and enforcement but dodged a question about support for supervised injection facilities. These facilities have been shown to decrease overdose deaths and also decrease infections from HIV, hepatitis B and hepatitis C. Both the Trump and the Biden Departments of Justice have vowed to not allow supervised injection facilities in the U.S., and legislation to implement them in California was vetoed by Gov. Newsom. Federal law makes aiding people taking narcotics illegal; the Trump Administration fought the city of Philadelphia about its plans and now the Biden Administration is fighting the City of New York. Rhode Island, however is planning to open supervised injection facilities in 2024.
An important message from Mia Vivone, a professional consultant and coach specializing in trauma, encouraged our community to avoid causing shame to the person afflicted with substance use disorder as it does not lead to physical or mental recovery or improvement. She stressed that we must avoid shame-based language and suggested the term substance use disorder or substance dependency. More than 75% of those with this disorder have had at least one childhood trauma. She closed by stressing that this is a treatable condition.
At the closing of the summit program, two presentations informed what is being done to reach the homeless population here in Sacramento County. The Metro Fire Department has developed a Medical Integrated Healthcare program that has saved the County over $1 million per year by providing services. Sacramento Street Medicine is another group that is actively providing support to our unhoused neighbors; their program performs constant medical outreach to try to improve the health and wellbeing of all they encounter.
An important takeaway is that resources are available for opioid use disorder, but almost 90% of potential users do not have access to treatment. Health care professionals of all medical degrees should pay attention and support the wide range of efforts to reach out to those who are struggling. If we, as SSVMS and CMA, can take a stand to improve care for those with substance abuse disorder, we will all benefit. This meeting was a good beginning!
