City, first responders considering sites for Naloxone distribution boxes | Sequim Gazette

Oct 16, 2024

Effort could provide medicine to help reverse an opioid overdose

Community leaders are considering placing Naloxone — commonly known by one brand name Narcan — in distribution boxes around the City of Sequim to help any residents reverse effects from opioid overdoses.

City councilor Dan Butler proposed at the Sept. 9 city council meeting that Sequim enter into a Memorandum of Understanding (MOU) with Clallam County Health and Human Services Department’s Harm Reduction Program to make Narcan available at sites to be determined on city property recommended by first responders.

Councilors voted 6-0, with mayor Brandon Janisse excused, for staff to draft an MOU with the county at the next council meeting. The item was not on the Sept. 23 agenda as of press deadline.

Butler told councilors the MOU is about addressing a gap where vulnerable people may not call emergency services for an overdose. He compared distributing Naloxone to defibrillators found in the community.

“You don’t know when the next person is going to drop from a heart attack, but we’re glad it’s there,” he said.

According to the Drug Enforcement Agency, “Naloxone is a medicine that rapidly reverses an opioid overdose” and “an antagonist … that it attaches to opioid receptors and reverses and blocks the effects of other opioids.”

It’s given through a nasal spray or injected into a muscle, under the skin or in the veins.

“Naloxone can quickly restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose,” according to the DEA.

Councilors agreed providing Naloxone is important but they asked for first responders to recommend the best locations, and for more details on who will pay for the supplies, oversee restocking boxes and maintain distribution boxes.

In an interview, Butler said the effort will likely start small with a few sites in Sequim and grow as needed, with efforts to educate residents on Naloxone — misnomers, what it does, how to use it, etc.

Photo by Emergent BioSolutions With distribution sites in Port Angeles and the West End, City of Sequim leaders seek distribution box sites to be determined by first responders that would be best for providing free Naloxone, or commonly known by one brand name Narcan, to provide the medicine to reverse effects of an opioid overdose.

Staff with Trinity United Methodist Church said they plan to offer Naloxone out of its free food pantry at a later date, while Butler said St. Luke’s Episcopal Church is considering making it available in its pantry, too.

Butler said entities receiving Naloxone through the county would enter into an MOU as it’d be distributed on private property.

Councilor Kathy Downer, a city liaison to the Clallam Transit board of directors, has also asked its board to discuss offering Naloxone in a distribution box at the Sequim Transit Center. They’ve approved one at the Gateway Transit Center in Port Angeles, she said.

Overdoses

With Clallam County among the highest counties of opioid overdoses per 10,000 residents, Butler said he learned of county staff’s efforts distributing Naloxone, and that he wanted to see if the city could expand on what the county is trying to do.

“We’re addressing (the gap of people who overdose without Naloxone available) and if you look at (the Clallam County Coroner’s) data, the demographic is sobering as 50-plus is the majority,” he said.

Siri Forsman-Sims, Harm Reduction program coordinator, said the Sequim area with the 98382 zip code accounts for about 30 percent of all opioid overdoses in Clallam County in recent years, ranging from teenagers to an 82-year-old.

She said it can take up to eight months to confirm an overdose death in the county’s system, and where people are logged as overdosing is where they live — not where they overdose.

According to the Clallam County Coroner’s data, about 10% of overdoses (20) occurred in Sequim from 2015-2023.

Of the county’s totals, a majority of overdoses (59) from 2015-June 2024 occurred in the 50- to 59-year-old range, while the next highest total (46) was the 40-49 age range, 41 overdoses for 30-39, and 31 overdoses for 60-69.

“It’s people of all ages,” Butler said. “This isn’t just a youth issue.”

Forsman-Sims said the overdoses could be someone using illicit drugs or being confused by the amount of opiate prescription drugs they’re taking.

“We’re trying to get it into the hands of the people who might overdose,” she said.

Fentanyl is cheap, Forsman-Sims said, and it’s being cut in with methamphetamine and other drugs, and “it’s reeking havoc on our folks.”

Butler said opiates are “meant to help you forget about pain” and “Narcan can go into the brain, boot out the opioid and last for up to 90 minutes.”

He and Forsman-Sims said that because of the potency of certain opioids, it may require two-three doses of Narcan to revive people.

People can be combative, too, when they come out of an overdose, Sequim deputy police chief John Southard confirmed.

Placement

Forsman-Sims said her program is responsible for seven distribution boxes in Port Angeles and the West End that offer Naloxone with about 300 boxes distributed monthly, or 600 doses.

Some locations were by request, such as at the Clallam Bay Fire Department, Peninsula College, and Clallam County Health and Human Service buildings. Other locations include the Mariposa House in Forks, Serenity House Shelter in Port Angeles, and at Safeway across from the Clallam County Courthouse in Port Angeles.

She said the most active distribution box is the Health and Human Services building on East Third Street in Port Angeles.

Another distribution box is set for the Maloney Heights apartments and the Gateway Transit Center.

Some boxes carry other supplies, such as Covid-19 tests and fentanyl test strips along with Naloxone.

The county has switched from offering Narcan to RiVive, as it’s made by Harm Reduction Therapeutics, a nonprofit pharmaceutical company.

“The whole purpose is to put it in the hands of someone who might overdose; grandma and grandpa in Sunland, or someone living on the street,” Forsman-Sims said.

“The approach from the state is to get into the hands least likely to have access to it, the most needy folks out there.”

She added that data from first responders should drive placement, and they want distribution boxes in well lit places so they won’t be damaged.

Fire Chief Justin Grider with Clallam County Fire District 3 said in an interview that offering Naloxone will definitely help as it’s “value-added.”

As they do with other medication, staffers record when Naloxone is used, Grider said, and firefighters/medics are working with Sequim Police to gather data and recommend locations.

He said overdoses are not a frequent call for the fire district, and that Sequim likely sees more accidental overdoses from certain medications rather than illicit drugs due to the age of Sequim’s population.

Southard said Sequim officers do not carry Naloxone as the fire district does a great job of responding to those calls but they assist when needed.

For more about the Harm Reduction Center, 325 1/2 W. Second St., Port Angeles, call 360-565-2671, or visit clallamcountywa.gov/660/Harm-Reduction-Health-Center.