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"content": "\u003cp>As the nation continues to struggle with an opioid crisis now supercharged by fentanyl, overdoses have become one of the leading causes of workplace deaths.\u003c/p>\n\u003cp>California is no different: Workplace overdose deaths have risen so dramatically that in 2021 and 2022, they caused more fatalities than falls at construction sites or being hit by machinery, and in 2022, were second only to car crashes and other transportation incidents.\u003c/p>\n\u003cp>That year, the toll surpassed 110 workers, accounting for 18% of the state’s workplace deaths, compared to 11% nationwide.\u003c/p>\n\u003cp>Federal and state government experts have \u003ca href=\"https://www.bls.gov/opub/ted/2024/unintentional-overdoses-rose-for-the-tenth-straight-year-in-2022.htm\">raised the alarm\u003c/a> over this trend, which has puzzled some policymakers because drug use is not a hazard created directly by the job. After all, those who die of an overdose at work represent a small share of thousands of Californians who overdose each year.\u003c/p>\n\u003cp>Still, business owners and union officials alike are increasingly having to grapple with one of the nation’s most prominent public health challenges.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“When fentanyl came around, we started having a huge uptick in overdoses and deaths — even suicides,” said Paul Moreno, president of Ironworkers Local 433 in Southern California.\u003c/p>\n\u003cp>In 2022, his local began holding recovery meetings for members that now draw as many as a dozen attendees a month. Moreno, who said he’s been sober 19 years, visits worksites and the union hall, passing around the 988 \u003ca href=\"https://calmatters.org/health/2021/09/988-911-funding-crisis-hotline-suicide-california/\">mental health crisis hotline number\u003c/a>, giving out his own personal phone number and distributing doses of the overdose reversal drug naloxone (commonly sold as Narcan).\u003c/p>\n\u003cp>“I took Narcan classes. I passed out Narcan on the job sites. I never thought I’d be doing that,” he said. “The phone calls from the members, sometimes I don’t know what to say besides listen. We still need more training.”\u003c/p>\n\u003cp>A new California law directs the state’s workplace safety agencies to require worksites to stock Narcan in their first aid kits, but the regulations haven’t been issued yet. A spokesperson said Cal/OSHA is “in the early stages of rulemaking,” a process that \u003ca href=\"https://calmatters.org/politics/capitol/2024/02/workplace-safety-california-indoor-heat/\">could take years\u003c/a>.\u003c/p>\n\u003cp>Not much is publicly known about overdose deaths at California worksites. A small office in Cal/OSHA that compiles workplace fatality data has, for at least the past two years, noted the rise in overdoses in its \u003ca href=\"https://www.dir.ca.gov/dosh/CFOI/California-Occupational-Fatalities.pdf\">annual reports\u003c/a>. However, the office said it cannot release details due to privacy restrictions.\u003c/p>\n\u003cp>The agency has not responded to a public records request CalMatters filed in September for all overdose incidents, fatal or nonfatal, that have been reported at worksites.\u003c/p>\n\u003ch2>State won’t release details on deaths\u003c/h2>\n\u003cp>County coroners’ offices, which investigate some deaths, vary widely in whether they can identify incidents based on whether a person died at their job. Death records from the past three years obtained from Alameda, San Bernardino and Riverside counties provide glimpses into the grim trend.\u003c/p>\n\u003cp>In 2021, a flooring installer stepped out for a smoke break at a construction site in Temecula and was found by coworkers on the side of the house, dead from a fentanyl overdose. A packing plant worker in Corona went to the bathroom and did not return; coworkers found him bent over with a straw, lighter and piece of foil nearby, having overdosed on methamphetamine, fentanyl and heroin. In Fremont, a manager found a night-shift janitor in the bathroom with a white powdery substance, overdosed on fentanyl. In Livermore this year, a driver was found in his parked semi-truck as he waited to make a scheduled delivery, also dead from fentanyl.\u003c/p>\n\u003cfigure id=\"attachment_12017660\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12017660\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27.jpg\" alt=\"\" width=\"1200\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27-160x107.jpg 160w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Narcan nasal spray containers available at a rally at the First Street U.S. Courthouse in Los Angeles on April 22, 2024. \u003ccite>(Ted Soqui for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California officials have little to say about the rising death toll. Cal/OSHA refused to make an official available for an interview and would not explain why overdoses account for a much higher share of the state’s workplace deaths compared to the rest of the nation.\u003c/p>\n\u003cp>Instead, the agency cited the \u003ca href=\"https://calmatters.org/explainers/california-opioid-crisis/\">broader national opioid crisis\u003c/a>. “California had more than 7,000 people die from opioid-related overdose deaths in 2022,” spokesperson Erika Monterroza wrote in an email. “Unfortunately, these deaths happen all over our state, including in our workplaces.”\u003c/p>\n\u003cp>The state Department of Public Health said it is considering conducting a study. That agency’s occupational health branch is “aware of this issue and is considering a project to examine all opioid overdoses by industry and occupation,” a spokesperson said. In October, the department said staff are in the “initial stages of preparing for an analysis” but did not provide a completion date.\u003c/p>\n\u003cp>Studies in other states indicate the problem is worse in certain industries. In Massachusetts, where overdoses are the top cause of workplace deaths, researchers with the state public health agency examined all overdose deaths — whether at work or not — and found deaths occurred disproportionately among those working in manual-labor, high-injury industries.\u003c/p>\n\u003cp>Those jobs, said Emily Sparer-Fine, director of the Massachusetts public health agency’s \u003ca href=\"https://www.mass.gov/orgs/occupational-health-surveillance-program\">Occupational Health Surveillance Program\u003c/a>, are often seasonal or unstable, and workers may be financially strained and pressured to work through pain.\u003c/p>\n\u003cp>“Certain industries and occupations, (such as) construction, fishing had a much higher rate of overdose,” Sparer-Fine said in an interview. “But it was also jobs that had lower access to paid sick leave, higher rates of job insecurity, higher rates of overall workplace injury.”\u003c/p>\n\u003cp>In a new study this year, Sparer-Fine’s team also dug into \u003ca href=\"https://www.mass.gov/doc/opioid-related-overdose-deaths-among-injured-workers-in-massachusetts-findings-from-the-public-health-data-warehouse/download\">workers’ compensation data\u003c/a> and found that working-age Massachusetts residents were 35% more likely to have died of an overdose if they were previously injured on the job.\u003c/p>\n\u003cp>Workers in similar industries are overrepresented in the California workplace overdose deaths, including in trucking and warehousing, according to federal data.\u003c/p>\n\u003cp>So are workers in construction, where unions and employers are confronting a mental health and addiction crisis. Nationwide, construction workers are \u003ca href=\"https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-07.pdf\">more likely than workers in any other profession\u003c/a> to overdose and also have one of the \u003ca href=\"https://www.cdc.gov/mmwr/volumes/72/wr/mm7250a2.htm?s_cid=mm7250a2_w\">highest rates of suicide\u003c/a>.\u003c/p>\n\u003cp>Chris Trahan Cain, executive director of the National Center for Construction Research and Training, has since 2018 led the response to the industry’s opioid crisis. She has focused on a longtime reliance on painkillers to deal with injuries involving the muscles and bones, which \u003ca href=\"https://www.cpwr.com/wp-content/uploads/KF2020-MSDs-Opioids-US-workers.pdf\">nearly a third of construction workers\u003c/a> report experiencing. Studies like the ones in Massachusetts were among the first to reveal the toll.\u003c/p>\n\u003cp>The center, formed by the nation’s construction unions, has recommended stocking naloxone in union halls, requiring apprentices be taught about opioid abuse and ensuring members have coverage of drug treatment programs. They’re also providing tips on talking to doctors about how to treat injuries without long-term opioids prescriptions. The goal, Cain said, is to avoid blaming individual workers.\u003c/p>\n\u003cp>“When this information first came to light, what I heard was, ‘Oh, it’s just the macho culture, it’s the type of people who go into construction,’” she said. “We can’t tell you how many of these deaths are because somebody started on a prescription, but we know that some of them are. We know a lot of these deaths are also from illicit drug use that have nothing to do with workplaces, but where we can (make) changes as an industry to impact these numbers is what we’re trying to do.”\u003c/p>\n\u003ch2>Businesses respond to crisis\u003c/h2>\n\u003cp>Employers, too, are trying to break the stigma of seeking help. Since 2021, the Associated General Contractors of California has provided materials to hold jobsite meetings about mental health.\u003c/p>\n\u003cp>Not all employers know how to raise the issue and some fear reprisal for appearing to pry into employees’ personal lives, said Frank Nunes, CEO of the Wall and Ceiling Alliance, a Pleasanton-based specialty contractors’ group. Some, Nunes said, are advised by attorneys to avoid talking about it.\u003c/p>\n\u003cp>“It’s still very sensitive,” he said. “You’ve got to be very careful how you ask somebody how (they’re) doing and not offend them.”\u003c/p>\n\u003cp>Still, Nunes joined officials of District Council 16 of the International Union of Painters and Allied Trades at a recovery event in San Leandro in October, promoting treatment programs covered by their contracts and encouraging workers to use them.\u003c/p>\n\u003cp>“We have to address these things in the field,” he told about 100 union members. “There’s a cultural change we all need to work on.”\u003c/p>\n\u003cp>In a cavernous training hall where apprentices learn how to install drywall, union members told their peers how they had recovered from addiction. The union invited former Raiders tight end Darren Waller to talk about his own experiences with addiction and depression.\u003c/p>\n\u003cp>Reflecting on union officials’ numbers on construction worker deaths by overdose or suicide, Waller told the crowd: “Those are lives that still deserve to be among us.”\u003c/p>\n\u003cp>Robert Williams, the local’s business manager and secretary-treasurer, described what he called a familiar scenario: A worker experiences a job site injury or persistent soreness, feels pressure to work through it, then escalates from an over-the-counter pill to a prescription painkiller to an illicit opioid addiction.\u003c/p>\n\u003cp>“We’re only with our families a small portion of the day,” he said. “The people we work with, we’re with 80% of the time. We’ve got to be open on those job sites.”\u003c/p>\n\u003cfigure id=\"attachment_12017662\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12017662\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06.jpg\" alt=\"\" width=\"1200\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06-160x107.jpg 160w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Robert Williams, left, business manager and secretary-treasurer, and James Boster, right, director of mental health and addiction, with District Council 16 of the International Union of Painters and Allied Trades, at their union office in Livermore on Nov. 6, 2024. \u003ccite>(Laure Andrillon for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The union and local employers realized they had a problem on their hands last summer. After sifting through their health plan records, they found 91 members had died of overdose or suicide (not necessarily at work) in 18 months.\u003c/p>\n\u003cp>The revelation forced union officials to rethink their roles in workers’ lives, Williams said in an interview.\u003c/p>\n\u003cp>“We look out for safety on the jobs, so if there’s a death on a job site because of a safety hazard, it’s front-page news,” he said. “But if there’s death by an overdose or death by suicide of a construction worker when they go home, nobody talks about that. So instead of thinking about just the safety side, it’s that holistic side of, how do we make somebody better for themselves and their families?”\u003c/p>\n\u003cp>Williams quickly appointed a director of addiction and mental health. James Boster, himself in recovery from a painkiller addiction he said he developed after a non-work injury, speaks at apprenticeship programs and worksites, helps workers get into recovery programs and acts as a crisis counselor.\u003c/p>\n\u003cp>In the past year, Boster said he’s helped place 51 union members into residential or outpatient treatment programs. During a recent interview at the union’s headquarters in Livermore, he said he was anxious: He had secured a “scholarship” for one member who hadn’t logged enough hours in recent months to have full health coverage, but the worker had chosen to postpone treatment.\u003c/p>\n\u003cp>“I can never walk away from a member, and something happens, and not hold that personally,” Boster said.\u003c/p>\n\u003cp>Boster and Williams are eager to expand their program. Ideas include installing someone with Boster’s role across the district’s 20 local unions and establishing a fund to help members who haven’t worked enough hours to afford treatment.\u003c/p>\n\u003cp>Other advocates, meanwhile, have pushed the state to require naloxone at worksites as part of an overall strategy to reduce overdoses.\u003c/p>\n\u003cp>Earlier this year, the National Safety Council, an advocacy group, petitioned California labor agencies to do just that. Proponents said the medication, which can temporarily reverse an overdose by blocking the brain’s opioid receptors, is easy to administer and not harmful.\u003c/p>\n\u003cp>[aside tag='fentanyl' label='More on Fentanyl']\u003c/p>\n\u003cp>Citing its workplace death data, Cal/OSHA supported the proposal before the independent Occupational Safety & Health Standards Board, which decides whether to approve such regulations.\u003c/p>\n\u003cp>“It’s in the top two or three killers of workers now, and just a few years ago, it was a very small number,” Eric Berg, Cal/OSHA deputy chief of health and research and standards, said at a June 20 board meeting. “So it’s just become a really serious problem for workers, and it’s killing workers. I think we have an obligation to act.”\u003c/p>\n\u003cp>But board members hesitated. Chairperson David Alioto called the proposal an “odd request.” While addiction is a legitimate public health concern, it’s not a workplace hazard like wildfire smoke for employees who must work outside, he said.\u003c/p>\n\u003cp>“I have not seen a regulation where an employer is providing a remedy for a risk that the employer did not create,” Alioto said.\u003c/p>\n\u003cp>Board members also said they worried about whether all businesses would be able to store the medication at the right temperature and whether employers would bear liability over the medication’s use.\u003c/p>\n\u003cp>The standards board ultimately voted for the agency to discuss the matter before an advisory committee. In September, Gov. Gavin Newsom signed a law directing Cal/OSHA to draft a workplace naloxone rule by December 2027 and giving the board until December 2028 to consider it.\u003c/p>\n\u003cp>So far, no advisory committee has met.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Share your story\u003c/strong>: We want to hear from workers, family members and employers. If you have experience with addiction, mental health or overdose on a job site, and you’re willing to share your story with a CalMatters reporter, please reach out to jeanne@calmatters.org.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the nation continues to struggle with an opioid crisis now supercharged by fentanyl, overdoses have become one of the leading causes of workplace deaths.\u003c/p>\n\u003cp>California is no different: Workplace overdose deaths have risen so dramatically that in 2021 and 2022, they caused more fatalities than falls at construction sites or being hit by machinery, and in 2022, were second only to car crashes and other transportation incidents.\u003c/p>\n\u003cp>That year, the toll surpassed 110 workers, accounting for 18% of the state’s workplace deaths, compared to 11% nationwide.\u003c/p>\n\u003cp>Federal and state government experts have \u003ca href=\"https://www.bls.gov/opub/ted/2024/unintentional-overdoses-rose-for-the-tenth-straight-year-in-2022.htm\">raised the alarm\u003c/a> over this trend, which has puzzled some policymakers because drug use is not a hazard created directly by the job. After all, those who die of an overdose at work represent a small share of thousands of Californians who overdose each year.\u003c/p>\n\u003cp>Still, business owners and union officials alike are increasingly having to grapple with one of the nation’s most prominent public health challenges.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When fentanyl came around, we started having a huge uptick in overdoses and deaths — even suicides,” said Paul Moreno, president of Ironworkers Local 433 in Southern California.\u003c/p>\n\u003cp>In 2022, his local began holding recovery meetings for members that now draw as many as a dozen attendees a month. Moreno, who said he’s been sober 19 years, visits worksites and the union hall, passing around the 988 \u003ca href=\"https://calmatters.org/health/2021/09/988-911-funding-crisis-hotline-suicide-california/\">mental health crisis hotline number\u003c/a>, giving out his own personal phone number and distributing doses of the overdose reversal drug naloxone (commonly sold as Narcan).\u003c/p>\n\u003cp>“I took Narcan classes. I passed out Narcan on the job sites. I never thought I’d be doing that,” he said. “The phone calls from the members, sometimes I don’t know what to say besides listen. We still need more training.”\u003c/p>\n\u003cp>A new California law directs the state’s workplace safety agencies to require worksites to stock Narcan in their first aid kits, but the regulations haven’t been issued yet. A spokesperson said Cal/OSHA is “in the early stages of rulemaking,” a process that \u003ca href=\"https://calmatters.org/politics/capitol/2024/02/workplace-safety-california-indoor-heat/\">could take years\u003c/a>.\u003c/p>\n\u003cp>Not much is publicly known about overdose deaths at California worksites. A small office in Cal/OSHA that compiles workplace fatality data has, for at least the past two years, noted the rise in overdoses in its \u003ca href=\"https://www.dir.ca.gov/dosh/CFOI/California-Occupational-Fatalities.pdf\">annual reports\u003c/a>. However, the office said it cannot release details due to privacy restrictions.\u003c/p>\n\u003cp>The agency has not responded to a public records request CalMatters filed in September for all overdose incidents, fatal or nonfatal, that have been reported at worksites.\u003c/p>\n\u003ch2>State won’t release details on deaths\u003c/h2>\n\u003cp>County coroners’ offices, which investigate some deaths, vary widely in whether they can identify incidents based on whether a person died at their job. Death records from the past three years obtained from Alameda, San Bernardino and Riverside counties provide glimpses into the grim trend.\u003c/p>\n\u003cp>In 2021, a flooring installer stepped out for a smoke break at a construction site in Temecula and was found by coworkers on the side of the house, dead from a fentanyl overdose. A packing plant worker in Corona went to the bathroom and did not return; coworkers found him bent over with a straw, lighter and piece of foil nearby, having overdosed on methamphetamine, fentanyl and heroin. In Fremont, a manager found a night-shift janitor in the bathroom with a white powdery substance, overdosed on fentanyl. In Livermore this year, a driver was found in his parked semi-truck as he waited to make a scheduled delivery, also dead from fentanyl.\u003c/p>\n\u003cfigure id=\"attachment_12017660\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12017660\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27.jpg\" alt=\"\" width=\"1200\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/04222LA-Homeless-Court_TS_CM_27-160x107.jpg 160w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Narcan nasal spray containers available at a rally at the First Street U.S. Courthouse in Los Angeles on April 22, 2024. \u003ccite>(Ted Soqui for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California officials have little to say about the rising death toll. Cal/OSHA refused to make an official available for an interview and would not explain why overdoses account for a much higher share of the state’s workplace deaths compared to the rest of the nation.\u003c/p>\n\u003cp>Instead, the agency cited the \u003ca href=\"https://calmatters.org/explainers/california-opioid-crisis/\">broader national opioid crisis\u003c/a>. “California had more than 7,000 people die from opioid-related overdose deaths in 2022,” spokesperson Erika Monterroza wrote in an email. “Unfortunately, these deaths happen all over our state, including in our workplaces.”\u003c/p>\n\u003cp>The state Department of Public Health said it is considering conducting a study. That agency’s occupational health branch is “aware of this issue and is considering a project to examine all opioid overdoses by industry and occupation,” a spokesperson said. In October, the department said staff are in the “initial stages of preparing for an analysis” but did not provide a completion date.\u003c/p>\n\u003cp>Studies in other states indicate the problem is worse in certain industries. In Massachusetts, where overdoses are the top cause of workplace deaths, researchers with the state public health agency examined all overdose deaths — whether at work or not — and found deaths occurred disproportionately among those working in manual-labor, high-injury industries.\u003c/p>\n\u003cp>Those jobs, said Emily Sparer-Fine, director of the Massachusetts public health agency’s \u003ca href=\"https://www.mass.gov/orgs/occupational-health-surveillance-program\">Occupational Health Surveillance Program\u003c/a>, are often seasonal or unstable, and workers may be financially strained and pressured to work through pain.\u003c/p>\n\u003cp>“Certain industries and occupations, (such as) construction, fishing had a much higher rate of overdose,” Sparer-Fine said in an interview. “But it was also jobs that had lower access to paid sick leave, higher rates of job insecurity, higher rates of overall workplace injury.”\u003c/p>\n\u003cp>In a new study this year, Sparer-Fine’s team also dug into \u003ca href=\"https://www.mass.gov/doc/opioid-related-overdose-deaths-among-injured-workers-in-massachusetts-findings-from-the-public-health-data-warehouse/download\">workers’ compensation data\u003c/a> and found that working-age Massachusetts residents were 35% more likely to have died of an overdose if they were previously injured on the job.\u003c/p>\n\u003cp>Workers in similar industries are overrepresented in the California workplace overdose deaths, including in trucking and warehousing, according to federal data.\u003c/p>\n\u003cp>So are workers in construction, where unions and employers are confronting a mental health and addiction crisis. Nationwide, construction workers are \u003ca href=\"https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-07.pdf\">more likely than workers in any other profession\u003c/a> to overdose and also have one of the \u003ca href=\"https://www.cdc.gov/mmwr/volumes/72/wr/mm7250a2.htm?s_cid=mm7250a2_w\">highest rates of suicide\u003c/a>.\u003c/p>\n\u003cp>Chris Trahan Cain, executive director of the National Center for Construction Research and Training, has since 2018 led the response to the industry’s opioid crisis. She has focused on a longtime reliance on painkillers to deal with injuries involving the muscles and bones, which \u003ca href=\"https://www.cpwr.com/wp-content/uploads/KF2020-MSDs-Opioids-US-workers.pdf\">nearly a third of construction workers\u003c/a> report experiencing. Studies like the ones in Massachusetts were among the first to reveal the toll.\u003c/p>\n\u003cp>The center, formed by the nation’s construction unions, has recommended stocking naloxone in union halls, requiring apprentices be taught about opioid abuse and ensuring members have coverage of drug treatment programs. They’re also providing tips on talking to doctors about how to treat injuries without long-term opioids prescriptions. The goal, Cain said, is to avoid blaming individual workers.\u003c/p>\n\u003cp>“When this information first came to light, what I heard was, ‘Oh, it’s just the macho culture, it’s the type of people who go into construction,’” she said. “We can’t tell you how many of these deaths are because somebody started on a prescription, but we know that some of them are. We know a lot of these deaths are also from illicit drug use that have nothing to do with workplaces, but where we can (make) changes as an industry to impact these numbers is what we’re trying to do.”\u003c/p>\n\u003ch2>Businesses respond to crisis\u003c/h2>\n\u003cp>Employers, too, are trying to break the stigma of seeking help. Since 2021, the Associated General Contractors of California has provided materials to hold jobsite meetings about mental health.\u003c/p>\n\u003cp>Not all employers know how to raise the issue and some fear reprisal for appearing to pry into employees’ personal lives, said Frank Nunes, CEO of the Wall and Ceiling Alliance, a Pleasanton-based specialty contractors’ group. Some, Nunes said, are advised by attorneys to avoid talking about it.\u003c/p>\n\u003cp>“It’s still very sensitive,” he said. “You’ve got to be very careful how you ask somebody how (they’re) doing and not offend them.”\u003c/p>\n\u003cp>Still, Nunes joined officials of District Council 16 of the International Union of Painters and Allied Trades at a recovery event in San Leandro in October, promoting treatment programs covered by their contracts and encouraging workers to use them.\u003c/p>\n\u003cp>“We have to address these things in the field,” he told about 100 union members. “There’s a cultural change we all need to work on.”\u003c/p>\n\u003cp>In a cavernous training hall where apprentices learn how to install drywall, union members told their peers how they had recovered from addiction. The union invited former Raiders tight end Darren Waller to talk about his own experiences with addiction and depression.\u003c/p>\n\u003cp>Reflecting on union officials’ numbers on construction worker deaths by overdose or suicide, Waller told the crowd: “Those are lives that still deserve to be among us.”\u003c/p>\n\u003cp>Robert Williams, the local’s business manager and secretary-treasurer, described what he called a familiar scenario: A worker experiences a job site injury or persistent soreness, feels pressure to work through it, then escalates from an over-the-counter pill to a prescription painkiller to an illicit opioid addiction.\u003c/p>\n\u003cp>“We’re only with our families a small portion of the day,” he said. “The people we work with, we’re with 80% of the time. We’ve got to be open on those job sites.”\u003c/p>\n\u003cfigure id=\"attachment_12017662\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12017662\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06.jpg\" alt=\"\" width=\"1200\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/110624_Construction-Unions_LA_CM_06-160x107.jpg 160w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\">\u003cfigcaption class=\"wp-caption-text\">Robert Williams, left, business manager and secretary-treasurer, and James Boster, right, director of mental health and addiction, with District Council 16 of the International Union of Painters and Allied Trades, at their union office in Livermore on Nov. 6, 2024. \u003ccite>(Laure Andrillon for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The union and local employers realized they had a problem on their hands last summer. After sifting through their health plan records, they found 91 members had died of overdose or suicide (not necessarily at work) in 18 months.\u003c/p>\n\u003cp>The revelation forced union officials to rethink their roles in workers’ lives, Williams said in an interview.\u003c/p>\n\u003cp>“We look out for safety on the jobs, so if there’s a death on a job site because of a safety hazard, it’s front-page news,” he said. “But if there’s death by an overdose or death by suicide of a construction worker when they go home, nobody talks about that. So instead of thinking about just the safety side, it’s that holistic side of, how do we make somebody better for themselves and their families?”\u003c/p>\n\u003cp>Williams quickly appointed a director of addiction and mental health. James Boster, himself in recovery from a painkiller addiction he said he developed after a non-work injury, speaks at apprenticeship programs and worksites, helps workers get into recovery programs and acts as a crisis counselor.\u003c/p>\n\u003cp>In the past year, Boster said he’s helped place 51 union members into residential or outpatient treatment programs. During a recent interview at the union’s headquarters in Livermore, he said he was anxious: He had secured a “scholarship” for one member who hadn’t logged enough hours in recent months to have full health coverage, but the worker had chosen to postpone treatment.\u003c/p>\n\u003cp>“I can never walk away from a member, and something happens, and not hold that personally,” Boster said.\u003c/p>\n\u003cp>Boster and Williams are eager to expand their program. Ideas include installing someone with Boster’s role across the district’s 20 local unions and establishing a fund to help members who haven’t worked enough hours to afford treatment.\u003c/p>\n\u003cp>Other advocates, meanwhile, have pushed the state to require naloxone at worksites as part of an overall strategy to reduce overdoses.\u003c/p>\n\u003cp>Earlier this year, the National Safety Council, an advocacy group, petitioned California labor agencies to do just that. Proponents said the medication, which can temporarily reverse an overdose by blocking the brain’s opioid receptors, is easy to administer and not harmful.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Citing its workplace death data, Cal/OSHA supported the proposal before the independent Occupational Safety & Health Standards Board, which decides whether to approve such regulations.\u003c/p>\n\u003cp>“It’s in the top two or three killers of workers now, and just a few years ago, it was a very small number,” Eric Berg, Cal/OSHA deputy chief of health and research and standards, said at a June 20 board meeting. “So it’s just become a really serious problem for workers, and it’s killing workers. I think we have an obligation to act.”\u003c/p>\n\u003cp>But board members hesitated. Chairperson David Alioto called the proposal an “odd request.” While addiction is a legitimate public health concern, it’s not a workplace hazard like wildfire smoke for employees who must work outside, he said.\u003c/p>\n\u003cp>“I have not seen a regulation where an employer is providing a remedy for a risk that the employer did not create,” Alioto said.\u003c/p>\n\u003cp>Board members also said they worried about whether all businesses would be able to store the medication at the right temperature and whether employers would bear liability over the medication’s use.\u003c/p>\n\u003cp>The standards board ultimately voted for the agency to discuss the matter before an advisory committee. In September, Gov. Gavin Newsom signed a law directing Cal/OSHA to draft a workplace naloxone rule by December 2027 and giving the board until December 2028 to consider it.\u003c/p>\n\u003cp>So far, no advisory committee has met.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>Share your story\u003c/strong>: We want to hear from workers, family members and employers. If you have experience with addiction, mental health or overdose on a job site, and you’re willing to share your story with a CalMatters reporter, please reach out to jeanne@calmatters.org.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "More California Colleges Provide Narcan Amid Ongoing Opioid Crisis",
"headTitle": "More California Colleges Provide Narcan Amid Ongoing Opioid Crisis | KQED",
"content": "\u003cp>When Mel McKernan moved in with her new roommate, Braedon Ellis, they bonded quickly. Every night, she would stay up until 1 a.m. just waiting for Ellis to get back from her job so they could watch TV together. McKernan, 19, was a second-year student at Seattle University. Ellis was 20 and working as a Domino’s delivery driver.\u003c/p>\n\u003cp>“She genuinely was the light of my life,” recalled McKernan, who has since transferred to UC Berkeley. “She had this beautiful purple hair. I felt like that was just an aura that she carried around with her.”\u003c/p>\n\u003cp>McKernan thought she had made a friend for life. The two young women lived with two other roommates in a beautiful waterfront house in Kenmore, Washington. But behind the walls, a darkness lurked. Their other roommates were addicted to fentanyl, an extremely potent synthetic opioid.\u003c/p>\n\u003cp>McKernan had braced herself for the possibility of losing a roommate. But she never expected it to be Ellis. Their magnetic connection severed when Ellis overdosed from a combination of drugs that included fentanyl.\u003c/p>\n\u003cp>“It completely changed my view on opioids,” McKernan said. “Because I was like, this could hit anyone. It can hit literally anyone.”\u003c/p>\n\u003cfigure id=\"attachment_11976746\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976746\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy.jpg\" alt=\"A young person with a red shirt eye makeup, shoulder-length hair and necklaces and a nose piercing, smiles at the camera.\" width=\"1568\" height=\"1174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-1536x1150.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Braedon Ellis. \u003ccite>(Courtesy of Dionne Waltz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Fentanyl is now the leading cause of drug-related deaths nationwide. After a new wave of deadly overdoses among Californians 15 to 24 started to rise in 2019, lawmakers turned to California’s public colleges and universities to offer life-saving resources to its students.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Campus-Opioid-Safety-Act.aspx\">The Campus Opioid Safety Act\u003c/a>, which took effect Jan. 1, 2023, required campus health centers at most public colleges and universities to offer students free Narcan, a nasal spray that can reverse an opioid overdose. Some colleges and universities have since armed students with Narcan, but not all have followed suit.\u003c/p>\n\u003ch2>The rise of fentanyl deaths\u003c/h2>\n\u003cp>Today, when someone in the United States dies of a drug-related overdose, it’s \u003ca href=\"https://nida.nih.gov/publications/drugfacts/fentanyl#:~:text=Synthetic%20opioids%2C%20including%20fentanyl%2C%20are%20now%20the%20most%20common%20drugs%20involved%20in%C2%A0drug%20overdose%20deaths%C2%A0in%20the%20United%20States.\">usually linked to fentanyl\u003c/a>. That’s a change from \u003ca href=\"https://www.fda.gov/media/126835/download#page=2\">20 years ago\u003c/a>, when prescription opioids like OxyContin were the leading killer, according to Theo Krzywicki, founder and CEO of End Overdose, a national nonprofit based in Los Angeles aimed at eliminating drug-related overdose deaths, especially among teens and young adults.\u003c/p>\n\u003cp>“Fentanyl is a very different drug than OxyContin,” Krzywicki said. “The way people use it has changed.” Because fentanyl delivers a stronger and shorter-lived high than other opioids, people often use more of it, he said, and build up a tolerance to it quickly.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For years, the opioid epidemic hit middle-aged Californians harder, but the new wave brought on a rise in death rates for teens and young adults. By 2021, teens 15 to 19 were five times as likely to die from an opioid overdose compared to 2019. For 20- to 24-year-olds, they were over three times as likely. Meanwhile, rates for adults between 25 and 75 years old roughly doubled in the same time frame.\u003c/p>\n\u003cp>Recently, opioid-related fatalities among the state’s young people have started to reverse. While death rates for adults 25 and over continue to rise, rates have declined for people under 25. Since 2021, per-capita rates for opioid-related overdose deaths dropped by over a third for Californians 15 to 19 and 20 to 24.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/lF7mD/12/\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Rising awareness could be what’s driving the recent decline, according to a statement from the Los Angeles County Department of Public Health. College-aged students increasingly use social media to spread information about the risks of fentanyl and where to find life-saving resources such as Narcan. Young people also tend to have stronger support systems and are less likely to use drugs alone, according to the statement.\u003c/p>\n\u003ch2>Lawmakers require colleges to combat the crisis\u003c/h2>\n\u003cp>Melissa Hurtado, a Democratic Central Valley state senator, introduced the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB367#:~:text=67384.%C2%A0(a,terms%20and%20conditions.\">Campus Opioid Safety Act\u003c/a>, or SB 367, in February 2021. She said she chose to target college campuses after hearing story after story of young people overdosing in her district.\u003c/p>\n\u003cp>“It was just such a serious threat,” Hurtado said. “And it still is.”\u003c/p>\n\u003cfigure id=\"attachment_11976753\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976753\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy.jpg\" alt=\"A Latina woman under a tent speaking.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">State Sen. Melissa Hurtado speaks at a press conference on Oct. 14, 2022. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This January, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB461\">another law\u003c/a>, AB 461, went into effect that added fentanyl test strips to the requirements. Drug users can use the small paper strips to check if their supply contains fentanyl. Counterfeit prescription pills, made to look like OxyContin or Adderall, \u003ca href=\"https://www.dea.gov/alert/sharp-increase-fake-prescription-pills-containing-fentanyl-and-meth#:~:text=Some%20of%20the%20most%20common%20counterfeit%20pills%20are%20made%20to%20look%20like%20prescription%20opioids%20such%20as%20oxycodone%20(Oxycontin%C2%AE%2C%20Percocet%C2%AE)%2C%20hydrocodone%20(Vicodin%C2%AE)%2C%20and%20alprazolam%20(Xanax%C2%AE)%3B%20or%20stimulants%20like%20amphetamines%20(Adderall%C2%AE).\">often contain fentanyl\u003c/a>, according to the U.S. Drug Enforcement Administration.\u003c/p>\n\u003cp>The act requires campus health centers at California State University campuses and community colleges to order free Narcan through a state program called the \u003ca href=\"https://www.dhcs.ca.gov/individuals/Pages/Naloxone_Distribution_Project.aspx\">Naloxone Distribution Project\u003c/a>. Schools also must educate their students about preventing overdoses and let them know where they can find opioid overdose reversal medication. The law “requests” the University of California system to do the same, stopping short of a requirement because of the system’s \u003ca href=\"https://policy.ucop.edu/delegations-of-authority/california-constitution-article-9-education.html#:~:text=The%20university%20shall%20be%20entirely,%2C%20ethnic%20heritage%2C%20or%20sex.\">constitutional autonomy\u003c/a>.\u003c/p>\n\u003cp>At least 100 public colleges in California have Narcan somewhere on campus, according to data from the state distribution project that included a list of all applications from colleges and universities. Although not required by law, some private universities like Stanford also offer Narcan to students.\u003c/p>\n\u003cp>Every UC and Cal State has ordered Narcan from the state distribution project in the last two years, with the exception of CSU Maritime Academy. However, CSU Maritime said in an email statement that Narcan is available through their student health center.\u003c/p>\n\u003cp>Fourteen of California’s 72 physical community college districts were not represented in the data, but Narcan could still be on those campuses. Victor Valley College in San Bernardino County ordered Narcan through its police department, so the request was categorized as law enforcement. DeAnza College in Santa Clara County received its supply of Narcan from the county health department, according to college spokesperson Marisa Spatafore.\u003c/p>\n\u003ch2>Cal State Bakersfield gets the word out\u003c/h2>\n\u003cp>Hurtado represents much of Kern County, one of the deadliest counties for opioid-related overdoses among young people. In 2022, 15- to 19-year-olds in Kern County fatally overdosed on opioids at a rate three times higher than the statewide rate for the same age group, according to the California Department of Public Health. For 20- to 24-year-olds, the rate was twice as high.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/avb2V/7/\" width=\"800\" height=\"450\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>The county is home to Cal State Bakersfield, whose health education department has given its students about 60 boxes of Narcan since January 2023. After completing a short online training, students can drop by the campus health clinic to pick up the opioid reversal drug.\u003c/p>\n\u003cp>Lauren Hedlund, a health educator at Cal State Bakersfield, said her team gets the word out to students through tabling, activities, and flyers. They also bring Narcan directly to classrooms if an instructor requests it. The instructor showed the training video beforehand, and the health education team then visited the class to answer questions and hand out Narcan.\u003c/p>\n\u003cp>“It’s just making sure that I can reach as many students as possible so that they’re aware,” Hedlund said. She added that even if a student never needs the resources, they could know someone who does.\u003c/p>\n\u003ch2 id=\"h-some-colleges-lag-behind\" class=\"wp-block-heading\">Some colleges lag behind\u003c/h2>\n\u003cp>More than a year after the law went into effect, some colleges have yet to put Narcan in the hands of students. Elsewhere in Kern County, community colleges in Taft, Ridgecrest, and Bakersfield do not have a program for distributing Narcan to students. Bakersfield College is currently working on setting up a vending machine that would stock Narcan, menstrual products, and other health items, according to Marissa Perez, a medical assistant at the college.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" postID=\"mindshift_62742,news_11975973,mindshift_62310,news_11969903\"]In the East Bay Area, Peralta Community College District received Narcan from the state early last year, but until recently, no efforts were made to make it available through the student health center. The district initially distributed Narcan to its security staff. No Narcan trainings have been held for students, although the safety department \u003ca href=\"https://peralta-edu.zoom.us/rec/play/pRx2NQk9vgqrJniy2Gu6qChwfHr9yyYN4FlNKHMq6D3CoXJobYui2rf8uJjOFrftvUL_OnbiXq4rqtD1.pwr82YrScr4Tq3dh?canPlayFromShare=true&from=share_recording_detail&startTime=1705616150000&componentName=rec-play&originRequestUrl=https%3A%2F%2Fperalta-edu.zoom.us%2Frec%2Fshare%2FopA52LARpVZiiOOvTconQzxZogVH5aFfHRUu17oxAAFUAZF87XhWEHLihfoKA4M6.NHj_aQT-bkukD_Ll%3FstartTime%3D1705616150000\">held a training this year\u003c/a> at an event for college employees.\u003c/p>\n\u003cp>Students can request a single packaged dose of Narcan through the district’s public safety office, according to a Feb. 14 announcement sent by Amy Marshall, the associate director of public safety. The email was sent to employees but not to students. Marshall informed CalMatters via email that the health center received Narcan on Feb. 20. However, the district’s associate vice chancellor of educational services, Tina Vasconcellos, clarified in an email to CalMatters that the Narcan would be for health center staff to use within the clinic and that they would not distribute Narcan to students.\u003c/p>\n\u003cp>A spokesperson from Hurtado’s office confirmed that even if a college has Narcan somewhere on campus, the school needs to offer it to students to comply with the law.\u003c/p>\n\u003ch2 id=\"h-uc-berkeley-students-steer-efforts\" class=\"wp-block-heading\">UC Berkeley students steer efforts\u003c/h2>\n\u003cp>Crushed after losing her close friend, McKernan dropped out of Seattle University and took a year off college to stay home in Sacramento. Now 21, she’s finding her footing as a transfer student at UC Berkeley, majoring in social welfare. She’s fervent about spreading harm reduction resources like Narcan, destigmatizing addiction, and addressing the deeper systemic issues that lead to addiction.\u003c/p>\n\u003cfigure id=\"attachment_11976749\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976749\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy.jpg\" alt='Students in a plaza with a tent and a banner outside that reads \"End Overdose.\"' width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">UC Berkeley End Overdose Co-Presidents Shannon McCabe (left) and Tyler Mahomes (right) pass out free fentanyl test strips at Sproul Plaza on campus in Berkeley on Jan. 23, 2024. \u003ccite>(Juliana Yamada for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At her former university, McKernan had tried to organize her fellow students around overdose prevention but struggled to find enough volunteers. So when she saw students from End Overdose’s UC Berkeley chapter handing out fentanyl test strips in Sproul Plaza on a recent afternoon, she asked immediately if she could join, offering to share infographics she’d made for social media.\u003c/p>\n\u003cp>Before her roommate’s death, she knew her household would benefit from Narcan, but she didn’t find out where to access it in time. “A lot of people, including myself, just learn about it too late,” McKernan said.\u003c/p>\n\u003cp>Tyler Mahomes, a legal studies major at UC Berkeley, founded the chapter of End Overdose last year. It’s one of the organization’s many college chapters across the United States, where students spread overdose prevention awareness and resources to fellow students. Mahomes’ team brings Narcan directly to fraternities and other student groups and works with his university to patch holes in their harm reduction efforts. For example, he notified the university when his dorm hadn’t been restocked with overdose safety kits containing Narcan.\u003c/p>\n\u003cfigure id=\"attachment_11976751\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976751\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy.jpg\" alt='A box of medicine and a pamphlet next to it that reads \"Free Fentanyl Testing Strips.\"' width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">A box of Narcan nasal spray at UC Berkeley student organization End Overdose’s table at Sproul Plaza on Jan. 23, 2024. The organization passes out free fentanyl test strips to students and gives other organizations training on Narcan usage. \u003ccite>(Juliana Yamada for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The students can even go where the university cannot. Last fall, the chapter volunteered at the Portola Music Festival in San Francisco to hand out Narcan to festivalgoers.\u003c/p>\n\u003cp>Students are receptive to End Overdose’s peer-to-peer, non-judgmental approach. “They don’t see us as this administrative force,” Mahomes said. “We’re students like them […] so they feel very comfortable.”\u003c/p>\n\u003cp>The approach has already seen some results. According to Mahomes, one student at a frat party recovered from an overdose after someone used Narcan provided by End Overdose.\u003c/p>\n\u003ch2 id=\"h-the-spark-that-went-out\" class=\"wp-block-heading\">The spark that went out\u003c/h2>\n\u003cp>Ellis, the purple-haired light of McKernan’s life, left behind her mother and an 8-year-old brother when fentanyl took her life. Her mother, Dionne Waltz, would find out two days later while driving to pick her son up from school.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Mel McKernan\"]‘[I]f you’re educated and you’re prepared, it’s so much less likely that you’re going to lose a life to overdose.’[/pullquote]Ellis was a “fireball,” Waltz recalled. She still misses her daughter’s kind and generous spirit. When they went out for coffee, Ellis would insist on covering the tab, even paying for the car behind them. Even though she didn’t make a lot of money, she’d always save up to buy her little brother something nice for Christmas.\u003c/p>\n\u003cp>Two years later, the initial shock has faded. Waltz still grieves her only daughter. But she sees flickers of her spark everywhere: in the sunsets, in the birds, and in anything bright pink, one of Ellis’ favorite colors.\u003c/p>\n\u003cp>“On the inside, there’s that hollow echo all the time,” Waltz said. “I think about her every single day.”\u003c/p>\n\u003cfigure id=\"attachment_11976756\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976756\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy.jpg\" alt=\"A mother and an 8-year-old daughter.\" width=\"1568\" height=\"1119\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-800x571.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-1020x728.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-1536x1096.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Dionne Waltz and Braedon Ellis. \u003ccite>(Courtesy of Dionne Waltz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When Ellis’ spark went out, another was lit. McKernan vowed not to lose another friend to an overdose. She believes that just starting a conversation about Narcan could save others.\u003c/p>\n\u003cp>“Because if you’re educated and you’re prepared, it’s so much less likely that you’re going to lose a life to overdose,” McKernan said.\u003c/p>\n\u003cp>\u003cem>Khan is a fellow with the \u003c/em>\u003ca href=\"http://www.calmatters.org/projects/college-journalism-network\">\u003cem>CalMatters College Journalism Network\u003c/em>\u003c/a>\u003cem>, a collaboration between CalMatters and student journalists from across California. This story and other higher education coverage are supported by the College Futures Foundation.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "The Campus Opioid Safety Act required colleges and universities to put the power of reversing fentanyl overdoses directly into the hands of students. Some campuses give out the life-saving nasal spray Narcan, while others do not.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Mel McKernan moved in with her new roommate, Braedon Ellis, they bonded quickly. Every night, she would stay up until 1 a.m. just waiting for Ellis to get back from her job so they could watch TV together. McKernan, 19, was a second-year student at Seattle University. Ellis was 20 and working as a Domino’s delivery driver.\u003c/p>\n\u003cp>“She genuinely was the light of my life,” recalled McKernan, who has since transferred to UC Berkeley. “She had this beautiful purple hair. I felt like that was just an aura that she carried around with her.”\u003c/p>\n\u003cp>McKernan thought she had made a friend for life. The two young women lived with two other roommates in a beautiful waterfront house in Kenmore, Washington. But behind the walls, a darkness lurked. Their other roommates were addicted to fentanyl, an extremely potent synthetic opioid.\u003c/p>\n\u003cp>McKernan had braced herself for the possibility of losing a roommate. But she never expected it to be Ellis. Their magnetic connection severed when Ellis overdosed from a combination of drugs that included fentanyl.\u003c/p>\n\u003cp>“It completely changed my view on opioids,” McKernan said. “Because I was like, this could hit anyone. It can hit literally anyone.”\u003c/p>\n\u003cfigure id=\"attachment_11976746\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976746\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy.jpg\" alt=\"A young person with a red shirt eye makeup, shoulder-length hair and necklaces and a nose piercing, smiles at the camera.\" width=\"1568\" height=\"1174\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-800x599.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-1020x764.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-copy-1536x1150.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Braedon Ellis. \u003ccite>(Courtesy of Dionne Waltz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Fentanyl is now the leading cause of drug-related deaths nationwide. After a new wave of deadly overdoses among Californians 15 to 24 started to rise in 2019, lawmakers turned to California’s public colleges and universities to offer life-saving resources to its students.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Campus-Opioid-Safety-Act.aspx\">The Campus Opioid Safety Act\u003c/a>, which took effect Jan. 1, 2023, required campus health centers at most public colleges and universities to offer students free Narcan, a nasal spray that can reverse an opioid overdose. Some colleges and universities have since armed students with Narcan, but not all have followed suit.\u003c/p>\n\u003ch2>The rise of fentanyl deaths\u003c/h2>\n\u003cp>Today, when someone in the United States dies of a drug-related overdose, it’s \u003ca href=\"https://nida.nih.gov/publications/drugfacts/fentanyl#:~:text=Synthetic%20opioids%2C%20including%20fentanyl%2C%20are%20now%20the%20most%20common%20drugs%20involved%20in%C2%A0drug%20overdose%20deaths%C2%A0in%20the%20United%20States.\">usually linked to fentanyl\u003c/a>. That’s a change from \u003ca href=\"https://www.fda.gov/media/126835/download#page=2\">20 years ago\u003c/a>, when prescription opioids like OxyContin were the leading killer, according to Theo Krzywicki, founder and CEO of End Overdose, a national nonprofit based in Los Angeles aimed at eliminating drug-related overdose deaths, especially among teens and young adults.\u003c/p>\n\u003cp>“Fentanyl is a very different drug than OxyContin,” Krzywicki said. “The way people use it has changed.” Because fentanyl delivers a stronger and shorter-lived high than other opioids, people often use more of it, he said, and build up a tolerance to it quickly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For years, the opioid epidemic hit middle-aged Californians harder, but the new wave brought on a rise in death rates for teens and young adults. By 2021, teens 15 to 19 were five times as likely to die from an opioid overdose compared to 2019. For 20- to 24-year-olds, they were over three times as likely. Meanwhile, rates for adults between 25 and 75 years old roughly doubled in the same time frame.\u003c/p>\n\u003cp>Recently, opioid-related fatalities among the state’s young people have started to reverse. While death rates for adults 25 and over continue to rise, rates have declined for people under 25. Since 2021, per-capita rates for opioid-related overdose deaths dropped by over a third for Californians 15 to 19 and 20 to 24.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/lF7mD/12/\" width=\"800\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>Rising awareness could be what’s driving the recent decline, according to a statement from the Los Angeles County Department of Public Health. College-aged students increasingly use social media to spread information about the risks of fentanyl and where to find life-saving resources such as Narcan. Young people also tend to have stronger support systems and are less likely to use drugs alone, according to the statement.\u003c/p>\n\u003ch2>Lawmakers require colleges to combat the crisis\u003c/h2>\n\u003cp>Melissa Hurtado, a Democratic Central Valley state senator, introduced the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB367#:~:text=67384.%C2%A0(a,terms%20and%20conditions.\">Campus Opioid Safety Act\u003c/a>, or SB 367, in February 2021. She said she chose to target college campuses after hearing story after story of young people overdosing in her district.\u003c/p>\n\u003cp>“It was just such a serious threat,” Hurtado said. “And it still is.”\u003c/p>\n\u003cfigure id=\"attachment_11976753\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976753\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy.jpg\" alt=\"A Latina woman under a tent speaking.\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/101922_Bakersfield_Election_LV_CM_03-CM-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">State Sen. Melissa Hurtado speaks at a press conference on Oct. 14, 2022. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This January, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB461\">another law\u003c/a>, AB 461, went into effect that added fentanyl test strips to the requirements. Drug users can use the small paper strips to check if their supply contains fentanyl. Counterfeit prescription pills, made to look like OxyContin or Adderall, \u003ca href=\"https://www.dea.gov/alert/sharp-increase-fake-prescription-pills-containing-fentanyl-and-meth#:~:text=Some%20of%20the%20most%20common%20counterfeit%20pills%20are%20made%20to%20look%20like%20prescription%20opioids%20such%20as%20oxycodone%20(Oxycontin%C2%AE%2C%20Percocet%C2%AE)%2C%20hydrocodone%20(Vicodin%C2%AE)%2C%20and%20alprazolam%20(Xanax%C2%AE)%3B%20or%20stimulants%20like%20amphetamines%20(Adderall%C2%AE).\">often contain fentanyl\u003c/a>, according to the U.S. Drug Enforcement Administration.\u003c/p>\n\u003cp>The act requires campus health centers at California State University campuses and community colleges to order free Narcan through a state program called the \u003ca href=\"https://www.dhcs.ca.gov/individuals/Pages/Naloxone_Distribution_Project.aspx\">Naloxone Distribution Project\u003c/a>. Schools also must educate their students about preventing overdoses and let them know where they can find opioid overdose reversal medication. The law “requests” the University of California system to do the same, stopping short of a requirement because of the system’s \u003ca href=\"https://policy.ucop.edu/delegations-of-authority/california-constitution-article-9-education.html#:~:text=The%20university%20shall%20be%20entirely,%2C%20ethnic%20heritage%2C%20or%20sex.\">constitutional autonomy\u003c/a>.\u003c/p>\n\u003cp>At least 100 public colleges in California have Narcan somewhere on campus, according to data from the state distribution project that included a list of all applications from colleges and universities. Although not required by law, some private universities like Stanford also offer Narcan to students.\u003c/p>\n\u003cp>Every UC and Cal State has ordered Narcan from the state distribution project in the last two years, with the exception of CSU Maritime Academy. However, CSU Maritime said in an email statement that Narcan is available through their student health center.\u003c/p>\n\u003cp>Fourteen of California’s 72 physical community college districts were not represented in the data, but Narcan could still be on those campuses. Victor Valley College in San Bernardino County ordered Narcan through its police department, so the request was categorized as law enforcement. DeAnza College in Santa Clara County received its supply of Narcan from the county health department, according to college spokesperson Marisa Spatafore.\u003c/p>\n\u003ch2>Cal State Bakersfield gets the word out\u003c/h2>\n\u003cp>Hurtado represents much of Kern County, one of the deadliest counties for opioid-related overdoses among young people. In 2022, 15- to 19-year-olds in Kern County fatally overdosed on opioids at a rate three times higher than the statewide rate for the same age group, according to the California Department of Public Health. For 20- to 24-year-olds, the rate was twice as high.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/avb2V/7/\" width=\"800\" height=\"450\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>The county is home to Cal State Bakersfield, whose health education department has given its students about 60 boxes of Narcan since January 2023. After completing a short online training, students can drop by the campus health clinic to pick up the opioid reversal drug.\u003c/p>\n\u003cp>Lauren Hedlund, a health educator at Cal State Bakersfield, said her team gets the word out to students through tabling, activities, and flyers. They also bring Narcan directly to classrooms if an instructor requests it. The instructor showed the training video beforehand, and the health education team then visited the class to answer questions and hand out Narcan.\u003c/p>\n\u003cp>“It’s just making sure that I can reach as many students as possible so that they’re aware,” Hedlund said. She added that even if a student never needs the resources, they could know someone who does.\u003c/p>\n\u003ch2 id=\"h-some-colleges-lag-behind\" class=\"wp-block-heading\">Some colleges lag behind\u003c/h2>\n\u003cp>More than a year after the law went into effect, some colleges have yet to put Narcan in the hands of students. Elsewhere in Kern County, community colleges in Taft, Ridgecrest, and Bakersfield do not have a program for distributing Narcan to students. Bakersfield College is currently working on setting up a vending machine that would stock Narcan, menstrual products, and other health items, according to Marissa Perez, a medical assistant at the college.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In the East Bay Area, Peralta Community College District received Narcan from the state early last year, but until recently, no efforts were made to make it available through the student health center. The district initially distributed Narcan to its security staff. No Narcan trainings have been held for students, although the safety department \u003ca href=\"https://peralta-edu.zoom.us/rec/play/pRx2NQk9vgqrJniy2Gu6qChwfHr9yyYN4FlNKHMq6D3CoXJobYui2rf8uJjOFrftvUL_OnbiXq4rqtD1.pwr82YrScr4Tq3dh?canPlayFromShare=true&from=share_recording_detail&startTime=1705616150000&componentName=rec-play&originRequestUrl=https%3A%2F%2Fperalta-edu.zoom.us%2Frec%2Fshare%2FopA52LARpVZiiOOvTconQzxZogVH5aFfHRUu17oxAAFUAZF87XhWEHLihfoKA4M6.NHj_aQT-bkukD_Ll%3FstartTime%3D1705616150000\">held a training this year\u003c/a> at an event for college employees.\u003c/p>\n\u003cp>Students can request a single packaged dose of Narcan through the district’s public safety office, according to a Feb. 14 announcement sent by Amy Marshall, the associate director of public safety. The email was sent to employees but not to students. Marshall informed CalMatters via email that the health center received Narcan on Feb. 20. However, the district’s associate vice chancellor of educational services, Tina Vasconcellos, clarified in an email to CalMatters that the Narcan would be for health center staff to use within the clinic and that they would not distribute Narcan to students.\u003c/p>\n\u003cp>A spokesperson from Hurtado’s office confirmed that even if a college has Narcan somewhere on campus, the school needs to offer it to students to comply with the law.\u003c/p>\n\u003ch2 id=\"h-uc-berkeley-students-steer-efforts\" class=\"wp-block-heading\">UC Berkeley students steer efforts\u003c/h2>\n\u003cp>Crushed after losing her close friend, McKernan dropped out of Seattle University and took a year off college to stay home in Sacramento. Now 21, she’s finding her footing as a transfer student at UC Berkeley, majoring in social welfare. She’s fervent about spreading harm reduction resources like Narcan, destigmatizing addiction, and addressing the deeper systemic issues that lead to addiction.\u003c/p>\n\u003cfigure id=\"attachment_11976749\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976749\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy.jpg\" alt='Students in a plaza with a tent and a banner outside that reads \"End Overdose.\"' width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_15-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">UC Berkeley End Overdose Co-Presidents Shannon McCabe (left) and Tyler Mahomes (right) pass out free fentanyl test strips at Sproul Plaza on campus in Berkeley on Jan. 23, 2024. \u003ccite>(Juliana Yamada for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At her former university, McKernan had tried to organize her fellow students around overdose prevention but struggled to find enough volunteers. So when she saw students from End Overdose’s UC Berkeley chapter handing out fentanyl test strips in Sproul Plaza on a recent afternoon, she asked immediately if she could join, offering to share infographics she’d made for social media.\u003c/p>\n\u003cp>Before her roommate’s death, she knew her household would benefit from Narcan, but she didn’t find out where to access it in time. “A lot of people, including myself, just learn about it too late,” McKernan said.\u003c/p>\n\u003cp>Tyler Mahomes, a legal studies major at UC Berkeley, founded the chapter of End Overdose last year. It’s one of the organization’s many college chapters across the United States, where students spread overdose prevention awareness and resources to fellow students. Mahomes’ team brings Narcan directly to fraternities and other student groups and works with his university to patch holes in their harm reduction efforts. For example, he notified the university when his dorm hadn’t been restocked with overdose safety kits containing Narcan.\u003c/p>\n\u003cfigure id=\"attachment_11976751\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976751\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy.jpg\" alt='A box of medicine and a pamphlet next to it that reads \"Free Fentanyl Testing Strips.\"' width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/012324_Opioid-Safety_JY_CM_08-copy-1536x1024.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">A box of Narcan nasal spray at UC Berkeley student organization End Overdose’s table at Sproul Plaza on Jan. 23, 2024. The organization passes out free fentanyl test strips to students and gives other organizations training on Narcan usage. \u003ccite>(Juliana Yamada for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The students can even go where the university cannot. Last fall, the chapter volunteered at the Portola Music Festival in San Francisco to hand out Narcan to festivalgoers.\u003c/p>\n\u003cp>Students are receptive to End Overdose’s peer-to-peer, non-judgmental approach. “They don’t see us as this administrative force,” Mahomes said. “We’re students like them […] so they feel very comfortable.”\u003c/p>\n\u003cp>The approach has already seen some results. According to Mahomes, one student at a frat party recovered from an overdose after someone used Narcan provided by End Overdose.\u003c/p>\n\u003ch2 id=\"h-the-spark-that-went-out\" class=\"wp-block-heading\">The spark that went out\u003c/h2>\n\u003cp>Ellis, the purple-haired light of McKernan’s life, left behind her mother and an 8-year-old brother when fentanyl took her life. Her mother, Dionne Waltz, would find out two days later while driving to pick her son up from school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Ellis was a “fireball,” Waltz recalled. She still misses her daughter’s kind and generous spirit. When they went out for coffee, Ellis would insist on covering the tab, even paying for the car behind them. Even though she didn’t make a lot of money, she’d always save up to buy her little brother something nice for Christmas.\u003c/p>\n\u003cp>Two years later, the initial shock has faded. Waltz still grieves her only daughter. But she sees flickers of her spark everywhere: in the sunsets, in the birds, and in anything bright pink, one of Ellis’ favorite colors.\u003c/p>\n\u003cp>“On the inside, there’s that hollow echo all the time,” Waltz said. “I think about her every single day.”\u003c/p>\n\u003cfigure id=\"attachment_11976756\" class=\"wp-caption alignnone\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11976756\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy.jpg\" alt=\"A mother and an 8-year-old daughter.\" width=\"1568\" height=\"1119\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-800x571.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-1020x728.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-160x114.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/02/021624-Braedon-Ellis-CM-03-scaled-copy-1536x1096.jpg 1536w\" sizes=\"(max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Dionne Waltz and Braedon Ellis. \u003ccite>(Courtesy of Dionne Waltz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When Ellis’ spark went out, another was lit. McKernan vowed not to lose another friend to an overdose. She believes that just starting a conversation about Narcan could save others.\u003c/p>\n\u003cp>“Because if you’re educated and you’re prepared, it’s so much less likely that you’re going to lose a life to overdose,” McKernan said.\u003c/p>\n\u003cp>\u003cem>Khan is a fellow with the \u003c/em>\u003ca href=\"http://www.calmatters.org/projects/college-journalism-network\">\u003cem>CalMatters College Journalism Network\u003c/em>\u003c/a>\u003cem>, a collaboration between CalMatters and student journalists from across California. This story and other higher education coverage are supported by the College Futures Foundation.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'There to Save a Life': San Francisco Bars Fight Fentanyl Overdoses With Narcan",
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"headTitle": "‘There to Save a Life’: San Francisco Bars Fight Fentanyl Overdoses With Narcan | KQED",
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"content": "\u003cp>Tika Hall was at a music show in San Francisco’s Mission District in February when around 10 p.m. someone yelled out, “Does anyone have Narcan?”\u003c/p>\n\u003cp>Hall, who is an artist, a musician and a longtime San Francisco resident, understood this meant someone had overdosed, and that their survival could depend on finding Narcan, a naloxone nasal spray that reverses opioid overdoses.\u003c/p>\n\u003cp>Hall and a friend ran to the nearest bar, one of the few places still open that might carry it.\u003c/p>\n\u003cp>“When I go into crisis mode, I get a lizard brain, and I was like, ‘What we have to do is go get this thing,’” Hall said.\u003c/p>\n\u003cp>When the first bar did not have Narcan, they tried the next one, The Eagle, which did. The bartender gave them the medicine, no questions asked, and the Narcan was used to revive the person who had overdosed.\u003c/p>\n\u003cfigure id=\"attachment_11947461\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947461\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut.jpg\" alt=\"A closed white box with a pink asterisk logo hangs on a wall in a dimly lit bar with a bar counter further back and a bartender and two patrons.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A harm-reduction box created by Josh Yule hangs on the wall at Mothership bar in San Francisco on April 11, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If this had happened somewhere there wasn’t a bar that had Narcan nearby, or if this had happened during the day when a bar wasn’t open, I don’t know what would have happened,” Hall said.\u003c/p>\n\u003cp>Now Hall carries Narcan with her everywhere, and the incident underscores the importance of making the antidote available for the public in places like bars. \u003ca href=\"https://sf.gov/sites/default/files/2023-04/2023%2004_OCME%20Overdose%20Report_0.pdf\">Two hundred people have fatally overdosed in San Francisco in the first three months of this year (PDF)\u003c/a>, and nationwide there has been a steep \u003ca href=\"https://apnews.com/article/health-opioids-synthetic-government-and-politics-8f64b776b82d6e8bc2e324b732e4b6e2\">rise in accidental overdoses\u003c/a>, as other illicit drugs — like cocaine and methamphetamines — have been increasingly \u003ca href=\"https://www.npr.org/2021/07/05/1013203805/party-drugs-are-being-increasingly-laced-with-fentanyl\">laced with fentanyl\u003c/a>.\u003c/p>\n\u003cp>Bay Area bar owners, staff and advocates are taking the initiative to keep patrons and the community safe. The nonprofit \u003ca href=\"https://fentcheck.org/\">FentCheck\u003c/a> brings Narcan and fentanyl test strips to bars and other community spaces, and bars are stocking the life-saving medication, as well as hosting trainings on how to administer it. Those promoting harm reduction in the nightlife community say the effort has also opened up a necessary conversation about the risks and realities of drug use.\u003c/p>\n\u003ch2>Harm-reduction boxes offer ‘a beacon for conversation’\u003c/h2>\n\u003cp>That push to reduce stigma and save lives is why Josh Yule has been building harm-reduction boxes and delivering them to bars since December. The bright, medical-white boxes contain Narcan; a neon pink, three-step guide to administering it; and fentanyl test strips.\u003c/p>\n\u003cp>Yule, a former bartender at The Knockout who still books shows there, makes the boxes at a friend’s woodshop in San Leandro. Nine San Francisco establishments house the boxes so far, including The Knockout, The Phone Booth, The Make Out Room and Mothership.\u003c/p>\n\u003cfigure id=\"attachment_11947458\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947458\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut.jpg\" alt=\"A white man with glasses looks at the camera as he gestures toward three white boxes with asterisk logos on them lined up next to each other in a bar.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule shows a group of bar employees gathered for a Narcan training session the harm-reduction boxes he hopes to distribute to other Bay Area bars, at The Knockout in San Francisco on Dec. 15, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Each box is dedicated to Yule’s mother, Roberta Damron, who fatally overdosed on fentanyl in 2021. He signs the inside doors of the boxes “For Mom.”\u003c/p>\n\u003cp>“It is there to save a life. First and foremost, that’s what it does,” Yule said. “But it’s also there so people can talk to one another. People can feel safe that they know it’s there.”\u003c/p>\n\u003cp>Yule said his mother’s death, at age 66, was a shock. His mother was religious, straightlaced and hilarious.\u003c/p>\n\u003cp>“She was awesome,” Yule said.\u003c/p>\n\u003cp>He remembered how, when he was in middle school, his mom tore down a poster in his room of Sid Vicious, the bassist for The Sex Pistols who died of a drug overdose.\u003c/p>\n\u003cp>“She would be really embarrassed that this is how she passed away. I just know that. And I think about that often,” Yule said. “I never really understood what was going on. Maybe I didn’t really want to understand. I’m still figuring that one out.”\u003c/p>\n\u003cp>Yule had been studying graphic design at California College of the Arts, when he decided to pour his energy into work focused on destigmatizing opioid use disorders.\u003c/p>\n\u003cfigure id=\"attachment_11947463\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947463\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut.jpg\" alt=\"Two hands holding a few photos, with a mother and child in the topmost photo.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule looks through the few photos he has of his mother, at his home in San Francisco on April 21, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He designed posters and stickers, but also wanted to create something physical that could become a “beacon for conversation.” The harm-reduction boxes became his thesis project.\u003c/p>\n\u003cp>Before his mother’s death, Yule had also lost two friends to fatal overdoses.\u003c/p>\n\u003cp>“We should be destigmatizing this disorder. It’s the only way to get anywhere. We’re just taking baby steps,” Yule said. “I wish that there was something that beckoned me to talk to my friend, or something I had seen. Maybe he would still be around. Maybe I would have put two and two together about my mom.”\u003c/p>\n\u003ch2>Bar staff train and prepare for emergencies\u003c/h2>\n\u003cp>Then, last winter, bar staff and community members were pushed to action after a string of near fatal overdoses in Mission District bars. Anita Ellis, a bartender at The Phone Booth and Pop’s Bar, organized a training for any interested bartenders in learning about Narcan as well as fentanyl test strips.\u003c/p>\n\u003cfigure id=\"attachment_11947611\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut.jpg\" alt=\"A white woman stands behind a dimly lit bar as an older white man with a white beard speaks smilingly to her\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11947611\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A harm reduction box made by Josh Yule and painted by artist Chelsea Wong hangs at the end of the bar at the Phone Booth while Anita Ellis bartends. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At least 50 people showed up at The Knockout for the December training, many more than a similar training Ellis had organized years before.\u003c/p>\n\u003cp>“I felt a lot of community spirit, this feeling of, ‘Let’s take care of one another.’” Ellis said. “The idea of somebody losing their life because they want to do a little blow in the bathroom because it’s their birthday or whatever occasion, or no occasion at all, I find that to be ludicrous. That shouldn’t be happening.”\u003c/p>\n\u003cp>Yule talked about the harm-reduction boxes during the event, and about 20 people signed up for them. He’s still working through that list, and more people have signed up since then. He’s also looking to expand to restaurants, and hopes to gain enough traction that the city or state takes over to continue the effort.\u003c/p>\n\u003cfigure id=\"attachment_11947609\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut.jpg\" alt=\"People stand and listen at a bar\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11947609\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A group of bar employees gathered for a Narcan training session listen to Josh Yule discuss harm reduction boxes he created to help prevent fentanyl overdoses in bars at The Knockout in San Francisco on Dec. 15, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Joanna Lioce, staff manager at Vesuvio Cafe in North Beach, picked up one of the harm-reduction boxes during that training. Years before, in response to overdoses in the alley outside the bar, Vesuvio staff were trained in administering Narcan. Lioce was able to reverse an overdose in the alleyway with Narcan.\u003c/p>\n\u003cp>“It’s like anything — if you see someone fall in a pool and you can get out and save them, you’re going to do it,” Lioce said.\u003c/p>\n\u003cp>She says Narcan is essential for bars in the age of fentanyl, like carrying a fire extinguisher.\u003c/p>\n\u003cp>Yule’s boxes alert patrons that Narcan is available in emergencies.\u003c/p>\n\u003cp>“We all kind of sound like grandmas now. Like, at least me and my friends are like, ‘Back in my day, you could buy cocaine in the Tenderloin and didn’t even have to worry about it.’ Now it’s like, ‘No, you can’t do anything like that,’” Lioce said.\u003c/p>\n\u003cfigure id=\"attachment_11947459\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947459\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut.jpg\" alt=\"A white man with glasses and a sweater opens a white wooden box with "How to Administer Naloxone" written in red on the inside of the box lid, as two women look on from the man's left.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule shows local bar employee Joanna Lioce a harm-reduction box he created to help prevent fentanyl overdoses, after a Narcan training session at The Knockout in San Francisco on Dec. 15, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But there are still barriers to accessing Narcan for free, and Yule said one of the biggest challenges in completing his project was figuring out where to get Narcan. Now he goes to the city’s Community Behavioral Health Services pharmacy, where the public can get Narcan for free.\u003c/p>\n\u003ch2>A potential policy solution, and barriers in supply\u003c/h2>\n\u003cp>A bill from Assemblymember Matt Haney, \u003ca href=\"https://legiscan.com/CA/text/AB24/2023#:~:text=California%20Assembly%20Bill%2024&text=Bill%20Title%3A%20Emergency%20response%3A%20opioid%20antagonist%20kits.&text=An%20act%20to%20add%20Chapter,Code%2C%20relating%20to%20emergency%20response\">Assembly Bill 24\u003c/a>, could require libraries, gas stations, residential hotels and bars in areas hardest hit by drug overdoses to carry Narcan, or face $100 fines.\u003c/p>\n\u003cp>“There is enough Narcan to put in all of these establishments and also get into the hands of organizations who work directly with people who are using drugs. They really need to be in both places,” Haney said in an interview. “And we have to stop nickel-and-diming this if we are going to save lives.”[aside label=\"Related Stories\" postID=\"news_11944267,science_1982214,news_11945418\"]In a statement, San Francisco Entertainment Commission Senior Analyst Dylan Rice said the commission is identifying policy, supply chain and consumer price considerations that would make it possible to achieve a vision for Narcan to be available behind every bar in San Francisco.\u003c/p>\n\u003cp>Some harm reduction advocates remain worried about resources. Laura Guzman, acting executive director of the National Harm Reduction Coalition, said their organization primarily distributes overdose reversal medication to syringe exchange programs that serve residents most vulnerable to overdoses.\u003c/p>\n\u003cp>“In San Francisco, we are still waiting to see if there will be additional allocation of naloxone that we could be distributing throughout all of the supportive housing, shelters, etcetera,” Guzman said. “There hasn’t been in San Francisco or in the state yet an amplification of naloxone access.”\u003c/p>\n\u003cp>Gov. Gavin Newsom has pledged \u003ca href=\"https://www.kqed.org/news/11944267/newsom-doubles-down-on-naloxone-distribution-in-new-master-plan-to-curb-overdose-deaths\">$79 million to go toward distributing Narcan\u003c/a>.\u003c/p>\n\u003cp>The medication could also become available over the counter later this year, though the manufacturer has said it could cost as much as $50 per kit, \u003ca href=\"https://www.washingtonpost.com/health/2023/04/20/narcan-price-over-the-counter/\">a price tag advocates say puts it out of reach for people who need it most\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Laura Thomas, director of HIV and harm reduction policy at the San Francisco AIDS Foundation who also sits on the San Francisco Entertainment Commission, said she wants to see a day where all venues have Narcan, but is also concerned about diverting scarce resources. She said the AIDS Foundation uses its own organizational funds to buy Narcan because it does not get enough supplies from the state.\u003c/p>\n\u003cp>“And that is a huge problem because we are distributing Narcan to people who are the most likely to be at the scene of an overdose and the most likely to reverse an overdose,” Thomas said.\u003c/p>\n\u003ch2>The community continues to educate each other\u003c/h2>\n\u003cp>If you’re looking to access Narcan or learn how to use it, you could also try \u003ca href=\"https://www.sfoasis.com/princess\">Princess\u003c/a>, the weekly Saturday night dance party and drag spectacular at Oasis.[pullquote align=\"right\" size=\"medium\" citation=\"Anita Ellis, bartender\"]‘The idea of somebody losing their life because they want to do a little blow in the bathroom … That shouldn’t be happening.’[/pullquote]Virtually every weekend for about 18 months, Cary Escovedo has offered overdose prevention education during the show, usually for about five minutes after intermission. Escovedo, whose drag name is Kochina Rude and who co-hosts the event with Lisa Frankenstein, has partnered with the \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">Drug Overdose Prevention and Education\u003c/a> Project on the effort, and distributes about 24 doses of Narcan per show.\u003c/p>\n\u003cp>She starts off by asking the audience if they know what Narcan is, and then outlines a scenario that could happen in any club where a hypothetical person is found unresponsive.\u003c/p>\n\u003cp>In the scenario, friends call 911, administer Narcan and provide rescue breathing.\u003c/p>\n\u003cp>When the overdose is reversed, the audience cheers. Kochina Rude ends on a high note, focusing on how queer people are in a unique position to take care of each other.\u003c/p>\n\u003cp>“Because historically we have had to do so out of necessity,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11947483\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947483\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut.jpg\" alt=\"Two white men with glasses talk over a white box in process of completion in a furniture store with carpentry equipment around them.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule (left) and Jeremiah Nielsen work to make harm-reduction boxes at the Oakland handmade furniture manufacturing shop Jeremiah Collection, on Dec. 7, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even if some bar owners may want to pretend drug use does not happen, bartenders can still come to Kochina Rude and access Narcan on their own, she said. During the weekly shows, she reminds the audience that they should not be scared to act.\u003c/p>\n\u003cp>“By taking this Narcan today, you now are serving as a community first responder in the event of an overdose, wherever you are,” she tells the audience. “And it can happen anytime and anywhere.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "With the fentanyl epidemic showing no signs of abating, bar staff and nonprofits are pushing for Narcan to be widely available in bars as they train and prepare for a spike in fatal opioid overdoses on the San Francisco nightlife scene.",
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"title": "'There to Save a Life': San Francisco Bars Fight Fentanyl Overdoses With Narcan | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tika Hall was at a music show in San Francisco’s Mission District in February when around 10 p.m. someone yelled out, “Does anyone have Narcan?”\u003c/p>\n\u003cp>Hall, who is an artist, a musician and a longtime San Francisco resident, understood this meant someone had overdosed, and that their survival could depend on finding Narcan, a naloxone nasal spray that reverses opioid overdoses.\u003c/p>\n\u003cp>Hall and a friend ran to the nearest bar, one of the few places still open that might carry it.\u003c/p>\n\u003cp>“When I go into crisis mode, I get a lizard brain, and I was like, ‘What we have to do is go get this thing,’” Hall said.\u003c/p>\n\u003cp>When the first bar did not have Narcan, they tried the next one, The Eagle, which did. The bartender gave them the medicine, no questions asked, and the Narcan was used to revive the person who had overdosed.\u003c/p>\n\u003cfigure id=\"attachment_11947461\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947461\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut.jpg\" alt=\"A closed white box with a pink asterisk logo hangs on a wall in a dimly lit bar with a bar counter further back and a bartender and two patrons.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64549_006_KQED_MothershipHarmReduction_04112023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A harm-reduction box created by Josh Yule hangs on the wall at Mothership bar in San Francisco on April 11, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“If this had happened somewhere there wasn’t a bar that had Narcan nearby, or if this had happened during the day when a bar wasn’t open, I don’t know what would have happened,” Hall said.\u003c/p>\n\u003cp>Now Hall carries Narcan with her everywhere, and the incident underscores the importance of making the antidote available for the public in places like bars. \u003ca href=\"https://sf.gov/sites/default/files/2023-04/2023%2004_OCME%20Overdose%20Report_0.pdf\">Two hundred people have fatally overdosed in San Francisco in the first three months of this year (PDF)\u003c/a>, and nationwide there has been a steep \u003ca href=\"https://apnews.com/article/health-opioids-synthetic-government-and-politics-8f64b776b82d6e8bc2e324b732e4b6e2\">rise in accidental overdoses\u003c/a>, as other illicit drugs — like cocaine and methamphetamines — have been increasingly \u003ca href=\"https://www.npr.org/2021/07/05/1013203805/party-drugs-are-being-increasingly-laced-with-fentanyl\">laced with fentanyl\u003c/a>.\u003c/p>\n\u003cp>Bay Area bar owners, staff and advocates are taking the initiative to keep patrons and the community safe. The nonprofit \u003ca href=\"https://fentcheck.org/\">FentCheck\u003c/a> brings Narcan and fentanyl test strips to bars and other community spaces, and bars are stocking the life-saving medication, as well as hosting trainings on how to administer it. Those promoting harm reduction in the nightlife community say the effort has also opened up a necessary conversation about the risks and realities of drug use.\u003c/p>\n\u003ch2>Harm-reduction boxes offer ‘a beacon for conversation’\u003c/h2>\n\u003cp>That push to reduce stigma and save lives is why Josh Yule has been building harm-reduction boxes and delivering them to bars since December. The bright, medical-white boxes contain Narcan; a neon pink, three-step guide to administering it; and fentanyl test strips.\u003c/p>\n\u003cp>Yule, a former bartender at The Knockout who still books shows there, makes the boxes at a friend’s woodshop in San Leandro. Nine San Francisco establishments house the boxes so far, including The Knockout, The Phone Booth, The Make Out Room and Mothership.\u003c/p>\n\u003cfigure id=\"attachment_11947458\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947458\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut.jpg\" alt=\"A white man with glasses looks at the camera as he gestures toward three white boxes with asterisk logos on them lined up next to each other in a bar.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62179_002_KQED_KnockoutNarcanTraining_12152022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule shows a group of bar employees gathered for a Narcan training session the harm-reduction boxes he hopes to distribute to other Bay Area bars, at The Knockout in San Francisco on Dec. 15, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Each box is dedicated to Yule’s mother, Roberta Damron, who fatally overdosed on fentanyl in 2021. He signs the inside doors of the boxes “For Mom.”\u003c/p>\n\u003cp>“It is there to save a life. First and foremost, that’s what it does,” Yule said. “But it’s also there so people can talk to one another. People can feel safe that they know it’s there.”\u003c/p>\n\u003cp>Yule said his mother’s death, at age 66, was a shock. His mother was religious, straightlaced and hilarious.\u003c/p>\n\u003cp>“She was awesome,” Yule said.\u003c/p>\n\u003cp>He remembered how, when he was in middle school, his mom tore down a poster in his room of Sid Vicious, the bassist for The Sex Pistols who died of a drug overdose.\u003c/p>\n\u003cp>“She would be really embarrassed that this is how she passed away. I just know that. And I think about that often,” Yule said. “I never really understood what was going on. Maybe I didn’t really want to understand. I’m still figuring that one out.”\u003c/p>\n\u003cp>Yule had been studying graphic design at California College of the Arts, when he decided to pour his energy into work focused on destigmatizing opioid use disorders.\u003c/p>\n\u003cfigure id=\"attachment_11947463\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947463\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut.jpg\" alt=\"Two hands holding a few photos, with a mother and child in the topmost photo.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64677_004_KQED_JoshYuleMomPhotos_04212023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule looks through the few photos he has of his mother, at his home in San Francisco on April 21, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He designed posters and stickers, but also wanted to create something physical that could become a “beacon for conversation.” The harm-reduction boxes became his thesis project.\u003c/p>\n\u003cp>Before his mother’s death, Yule had also lost two friends to fatal overdoses.\u003c/p>\n\u003cp>“We should be destigmatizing this disorder. It’s the only way to get anywhere. We’re just taking baby steps,” Yule said. “I wish that there was something that beckoned me to talk to my friend, or something I had seen. Maybe he would still be around. Maybe I would have put two and two together about my mom.”\u003c/p>\n\u003ch2>Bar staff train and prepare for emergencies\u003c/h2>\n\u003cp>Then, last winter, bar staff and community members were pushed to action after a string of near fatal overdoses in Mission District bars. Anita Ellis, a bartender at The Phone Booth and Pop’s Bar, organized a training for any interested bartenders in learning about Narcan as well as fentanyl test strips.\u003c/p>\n\u003cfigure id=\"attachment_11947611\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut.jpg\" alt=\"A white woman stands behind a dimly lit bar as an older white man with a white beard speaks smilingly to her\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11947611\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64686_007_KQED_HarmReductionPhoneBooth_04172023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A harm reduction box made by Josh Yule and painted by artist Chelsea Wong hangs at the end of the bar at the Phone Booth while Anita Ellis bartends. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At least 50 people showed up at The Knockout for the December training, many more than a similar training Ellis had organized years before.\u003c/p>\n\u003cp>“I felt a lot of community spirit, this feeling of, ‘Let’s take care of one another.’” Ellis said. “The idea of somebody losing their life because they want to do a little blow in the bathroom because it’s their birthday or whatever occasion, or no occasion at all, I find that to be ludicrous. That shouldn’t be happening.”\u003c/p>\n\u003cp>Yule talked about the harm-reduction boxes during the event, and about 20 people signed up for them. He’s still working through that list, and more people have signed up since then. He’s also looking to expand to restaurants, and hopes to gain enough traction that the city or state takes over to continue the effort.\u003c/p>\n\u003cfigure id=\"attachment_11947609\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut.jpg\" alt=\"People stand and listen at a bar\" width=\"1920\" height=\"1280\" class=\"size-full wp-image-11947609\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS64693_018_KQED_KnockoutNarcanTraining_12152022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A group of bar employees gathered for a Narcan training session listen to Josh Yule discuss harm reduction boxes he created to help prevent fentanyl overdoses in bars at The Knockout in San Francisco on Dec. 15, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Joanna Lioce, staff manager at Vesuvio Cafe in North Beach, picked up one of the harm-reduction boxes during that training. Years before, in response to overdoses in the alley outside the bar, Vesuvio staff were trained in administering Narcan. Lioce was able to reverse an overdose in the alleyway with Narcan.\u003c/p>\n\u003cp>“It’s like anything — if you see someone fall in a pool and you can get out and save them, you’re going to do it,” Lioce said.\u003c/p>\n\u003cp>She says Narcan is essential for bars in the age of fentanyl, like carrying a fire extinguisher.\u003c/p>\n\u003cp>Yule’s boxes alert patrons that Narcan is available in emergencies.\u003c/p>\n\u003cp>“We all kind of sound like grandmas now. Like, at least me and my friends are like, ‘Back in my day, you could buy cocaine in the Tenderloin and didn’t even have to worry about it.’ Now it’s like, ‘No, you can’t do anything like that,’” Lioce said.\u003c/p>\n\u003cfigure id=\"attachment_11947459\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947459\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut.jpg\" alt=\"A white man with glasses and a sweater opens a white wooden box with "How to Administer Naloxone" written in red on the inside of the box lid, as two women look on from the man's left.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62181_012_KQED_KnockoutNarcanTraining_12152022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule shows local bar employee Joanna Lioce a harm-reduction box he created to help prevent fentanyl overdoses, after a Narcan training session at The Knockout in San Francisco on Dec. 15, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But there are still barriers to accessing Narcan for free, and Yule said one of the biggest challenges in completing his project was figuring out where to get Narcan. Now he goes to the city’s Community Behavioral Health Services pharmacy, where the public can get Narcan for free.\u003c/p>\n\u003ch2>A potential policy solution, and barriers in supply\u003c/h2>\n\u003cp>A bill from Assemblymember Matt Haney, \u003ca href=\"https://legiscan.com/CA/text/AB24/2023#:~:text=California%20Assembly%20Bill%2024&text=Bill%20Title%3A%20Emergency%20response%3A%20opioid%20antagonist%20kits.&text=An%20act%20to%20add%20Chapter,Code%2C%20relating%20to%20emergency%20response\">Assembly Bill 24\u003c/a>, could require libraries, gas stations, residential hotels and bars in areas hardest hit by drug overdoses to carry Narcan, or face $100 fines.\u003c/p>\n\u003cp>“There is enough Narcan to put in all of these establishments and also get into the hands of organizations who work directly with people who are using drugs. They really need to be in both places,” Haney said in an interview. “And we have to stop nickel-and-diming this if we are going to save lives.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In a statement, San Francisco Entertainment Commission Senior Analyst Dylan Rice said the commission is identifying policy, supply chain and consumer price considerations that would make it possible to achieve a vision for Narcan to be available behind every bar in San Francisco.\u003c/p>\n\u003cp>Some harm reduction advocates remain worried about resources. Laura Guzman, acting executive director of the National Harm Reduction Coalition, said their organization primarily distributes overdose reversal medication to syringe exchange programs that serve residents most vulnerable to overdoses.\u003c/p>\n\u003cp>“In San Francisco, we are still waiting to see if there will be additional allocation of naloxone that we could be distributing throughout all of the supportive housing, shelters, etcetera,” Guzman said. “There hasn’t been in San Francisco or in the state yet an amplification of naloxone access.”\u003c/p>\n\u003cp>Gov. Gavin Newsom has pledged \u003ca href=\"https://www.kqed.org/news/11944267/newsom-doubles-down-on-naloxone-distribution-in-new-master-plan-to-curb-overdose-deaths\">$79 million to go toward distributing Narcan\u003c/a>.\u003c/p>\n\u003cp>The medication could also become available over the counter later this year, though the manufacturer has said it could cost as much as $50 per kit, \u003ca href=\"https://www.washingtonpost.com/health/2023/04/20/narcan-price-over-the-counter/\">a price tag advocates say puts it out of reach for people who need it most\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Laura Thomas, director of HIV and harm reduction policy at the San Francisco AIDS Foundation who also sits on the San Francisco Entertainment Commission, said she wants to see a day where all venues have Narcan, but is also concerned about diverting scarce resources. She said the AIDS Foundation uses its own organizational funds to buy Narcan because it does not get enough supplies from the state.\u003c/p>\n\u003cp>“And that is a huge problem because we are distributing Narcan to people who are the most likely to be at the scene of an overdose and the most likely to reverse an overdose,” Thomas said.\u003c/p>\n\u003ch2>The community continues to educate each other\u003c/h2>\n\u003cp>If you’re looking to access Narcan or learn how to use it, you could also try \u003ca href=\"https://www.sfoasis.com/princess\">Princess\u003c/a>, the weekly Saturday night dance party and drag spectacular at Oasis.\u003c/p>\u003c/div>",
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"content": "‘The idea of somebody losing their life because they want to do a little blow in the bathroom … That shouldn’t be happening.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Virtually every weekend for about 18 months, Cary Escovedo has offered overdose prevention education during the show, usually for about five minutes after intermission. Escovedo, whose drag name is Kochina Rude and who co-hosts the event with Lisa Frankenstein, has partnered with the \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">Drug Overdose Prevention and Education\u003c/a> Project on the effort, and distributes about 24 doses of Narcan per show.\u003c/p>\n\u003cp>She starts off by asking the audience if they know what Narcan is, and then outlines a scenario that could happen in any club where a hypothetical person is found unresponsive.\u003c/p>\n\u003cp>In the scenario, friends call 911, administer Narcan and provide rescue breathing.\u003c/p>\n\u003cp>When the overdose is reversed, the audience cheers. Kochina Rude ends on a high note, focusing on how queer people are in a unique position to take care of each other.\u003c/p>\n\u003cp>“Because historically we have had to do so out of necessity,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11947483\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11947483\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut.jpg\" alt=\"Two white men with glasses talk over a white box in process of completion in a furniture store with carpentry equipment around them.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/04/RS62150_020_KQED_HarmReductionBoxes_12072022-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Josh Yule (left) and Jeremiah Nielsen work to make harm-reduction boxes at the Oakland handmade furniture manufacturing shop Jeremiah Collection, on Dec. 7, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even if some bar owners may want to pretend drug use does not happen, bartenders can still come to Kochina Rude and access Narcan on their own, she said. During the weekly shows, she reminds the audience that they should not be scared to act.\u003c/p>\n\u003cp>“By taking this Narcan today, you now are serving as a community first responder in the event of an overdose, wherever you are,” she tells the audience. “And it can happen anytime and anywhere.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Newsom Doubles Down on Naloxone Distribution in New 'Master Plan' to Curb Overdose Deaths",
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"content": "\u003cp>On the heels of his statewide tour introducing proposals aimed at tackling California’s homelessness, mental health and substance use disorder crises, Gov. Gavin Newsom on Monday announced a plan to earmark just shy of $100 million in next year’s state budget for overdose prevention services.\u003c/p>\n\u003cp>Under the governor’s \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2023/03/Fentanyl-Opioids-Glossy-Plan_3.20.23.pdf?emrc=86c07e\">“Master Plan for Tackling the Fentanyl and Opioid Crisis” (PDF)\u003c/a>, the brunt of funding — $79 million — would go toward distributing naloxone, a nasal spray or injectable that can reverse opioid overdoses. An additional $3.5 million would be used to distribute the medicine in middle and high schools, where overdoses have increased in recent years.\u003c/p>\n\u003cp>The proposal also includes about $10 million for drug treatment services and $4 million to distribute fentanyl test strips, which allow users to detect the presence of fentanyl in other illicit substances. The synthetic opioid, which is often mixed with other drugs, is up to 50 times stronger than heroin, and accounts for the vast majority of opioid-related overdose deaths.\u003c/p>\n\u003cp>In 2021, \u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/Communications-Toolkits/Fentanyl-Overdose-Prevention.aspx#:~:text=Fentanyl%20is%20a%20synthetic%20opioid,deaths%20were%20related%20to%20fentanyl.\">5,722 of the 6,843 opioid-related overdose deaths in California were linked to fentanyl\u003c/a>, according to preliminary data from the state Department of Public Health.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"fentanyl\"]Newsom’s new funding proposal builds on the nearly $1 billion the state has already allocated since 2018 to address the opioid crisis, some of which has gone toward beefing up efforts to reduce trafficking. In 2022, local and state law enforcement seized 28,765 pounds of fentanyl, a nearly 600% increase over seizures in 2021, according to the governor’s office.\u003c/p>\n\u003cp>“Our comprehensive approach will expand enforcement efforts to crack down on transnational criminal organizations trafficking this poison into our communities — while prioritizing harm-reduction strategies to reduce overdoses and compassionately help those struggling with substance use and addiction,” Newsom said Monday in a press release.\u003c/p>\n\u003cp>The governor also said he wants California to begin manufacturing its own supply of naloxone, which is in increasingly high demand as cities and states across the country grapple with similar upticks in overdose rates. It’s still not clear, though, how the state would produce its own drug, and how it would get around the existing patent on the popular nasal spray form of the medicine.\u003c/p>\n\u003cp>San Francisco public health officials were quick to applaud the governor’s proposal, saying it would “measurably increase” the city’s ability to save lives and “reduce the negative harms associated with opioid and fentanyl use.”\u003c/p>\n\u003cp>In the first two months of 2023, \u003ca href=\"https://sf.gov/sites/default/files/2023-03/2023%2003_OCME%20Overdose%20Report.pdf\">131 people in San Francisco already have died from drug overdoses\u003c/a>, largely driven by fentanyl, according to data from the city’s Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>“The current rate of overdoses is unacceptable,” San Francisco’s Department of Public Health said in a press release Monday, following Newsom’s announcement.\u003c/p>\n\u003cp>The plan, the department said, could be particularly beneficial if it yielded an increased supply of naloxone. In 2022, San Francisco distributed nearly 72,000 naloxone kits through community nonprofits, officials said.\u003c/p>\n\u003cp>But Laura Thomas, director of harm reduction policy for the San Francisco AIDS Foundation, criticized the governor’s new plan as “essentially a glossy repackaging of existing initiatives,” and noted there was no mention of safe-consumption sites.\u003c/p>\n\u003cp>“What Newsom could have done if he really cared about reducing overdoses was sign SB 57 last year,” she said, referring to legislation he vetoed that would have allowed safe-consumption sites in San Francisco, Oakland and Los Angeles. At the time, Newsom argued there wasn’t enough evidence or planning to support launching the controversial sites, where people are able to smoke or inject drugs in a clean, safe environment under medical supervision.\u003c/p>\n\u003cp>Thomas’ nonprofit is among a handful of organizations in San Francisco now exploring ways to privately fund and operate safe-consumption services, which remain illegal at the state and federal levels, but \u003ca href=\"https://www.kqed.org/news/11943309/sf-supervisors-carve-path-for-privately-run-safe-consumption-sites-but-can-nonprofits-fund-them-alone\">recently were sanctioned by the city\u003c/a>.\u003c/p>\n\u003cp>To that end, Thomas also questioned why the governor’s package did not include any details about continuing to fund harm-reduction centers, like the one her organization operates, that distribute naloxone and offer other treatment services.\u003c/p>\n\u003cp>“What’s not in this, unfortunately, is any plan to extend the \u003ca href=\"https://harmreduction.org/our-work/action/california-harm-reduction-initiative-chri/\">California Harm Reduction Initiative\u003c/a>,” a $15.2 million allocation that has helped pay for staffing and other resources at privately run programs around the state, she said.\u003c/p>\n\u003cp>These are “the people who actually do the work of distributing test strips and naloxone to people who use drugs,” Thomas added. “That funding is now slated to end at the end of this year, and that’s where California must be investing more resources to make sure these scrappy orgs on the ground have the money they need.”\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The brunt of funding — $79 million — would go toward distributing naloxone, used to reverse opioid overdoses. But some local harm-reduction advocates said the governor's plan, which has no mention of safe-consumption sites, falls short.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On the heels of his statewide tour introducing proposals aimed at tackling California’s homelessness, mental health and substance use disorder crises, Gov. Gavin Newsom on Monday announced a plan to earmark just shy of $100 million in next year’s state budget for overdose prevention services.\u003c/p>\n\u003cp>Under the governor’s \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2023/03/Fentanyl-Opioids-Glossy-Plan_3.20.23.pdf?emrc=86c07e\">“Master Plan for Tackling the Fentanyl and Opioid Crisis” (PDF)\u003c/a>, the brunt of funding — $79 million — would go toward distributing naloxone, a nasal spray or injectable that can reverse opioid overdoses. An additional $3.5 million would be used to distribute the medicine in middle and high schools, where overdoses have increased in recent years.\u003c/p>\n\u003cp>The proposal also includes about $10 million for drug treatment services and $4 million to distribute fentanyl test strips, which allow users to detect the presence of fentanyl in other illicit substances. The synthetic opioid, which is often mixed with other drugs, is up to 50 times stronger than heroin, and accounts for the vast majority of opioid-related overdose deaths.\u003c/p>\n\u003cp>In 2021, \u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/Communications-Toolkits/Fentanyl-Overdose-Prevention.aspx#:~:text=Fentanyl%20is%20a%20synthetic%20opioid,deaths%20were%20related%20to%20fentanyl.\">5,722 of the 6,843 opioid-related overdose deaths in California were linked to fentanyl\u003c/a>, according to preliminary data from the state Department of Public Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Newsom’s new funding proposal builds on the nearly $1 billion the state has already allocated since 2018 to address the opioid crisis, some of which has gone toward beefing up efforts to reduce trafficking. In 2022, local and state law enforcement seized 28,765 pounds of fentanyl, a nearly 600% increase over seizures in 2021, according to the governor’s office.\u003c/p>\n\u003cp>“Our comprehensive approach will expand enforcement efforts to crack down on transnational criminal organizations trafficking this poison into our communities — while prioritizing harm-reduction strategies to reduce overdoses and compassionately help those struggling with substance use and addiction,” Newsom said Monday in a press release.\u003c/p>\n\u003cp>The governor also said he wants California to begin manufacturing its own supply of naloxone, which is in increasingly high demand as cities and states across the country grapple with similar upticks in overdose rates. It’s still not clear, though, how the state would produce its own drug, and how it would get around the existing patent on the popular nasal spray form of the medicine.\u003c/p>\n\u003cp>San Francisco public health officials were quick to applaud the governor’s proposal, saying it would “measurably increase” the city’s ability to save lives and “reduce the negative harms associated with opioid and fentanyl use.”\u003c/p>\n\u003cp>In the first two months of 2023, \u003ca href=\"https://sf.gov/sites/default/files/2023-03/2023%2003_OCME%20Overdose%20Report.pdf\">131 people in San Francisco already have died from drug overdoses\u003c/a>, largely driven by fentanyl, according to data from the city’s Office of the Chief Medical Examiner.\u003c/p>\n\u003cp>“The current rate of overdoses is unacceptable,” San Francisco’s Department of Public Health said in a press release Monday, following Newsom’s announcement.\u003c/p>\n\u003cp>The plan, the department said, could be particularly beneficial if it yielded an increased supply of naloxone. In 2022, San Francisco distributed nearly 72,000 naloxone kits through community nonprofits, officials said.\u003c/p>\n\u003cp>But Laura Thomas, director of harm reduction policy for the San Francisco AIDS Foundation, criticized the governor’s new plan as “essentially a glossy repackaging of existing initiatives,” and noted there was no mention of safe-consumption sites.\u003c/p>\n\u003cp>“What Newsom could have done if he really cared about reducing overdoses was sign SB 57 last year,” she said, referring to legislation he vetoed that would have allowed safe-consumption sites in San Francisco, Oakland and Los Angeles. At the time, Newsom argued there wasn’t enough evidence or planning to support launching the controversial sites, where people are able to smoke or inject drugs in a clean, safe environment under medical supervision.\u003c/p>\n\u003cp>Thomas’ nonprofit is among a handful of organizations in San Francisco now exploring ways to privately fund and operate safe-consumption services, which remain illegal at the state and federal levels, but \u003ca href=\"https://www.kqed.org/news/11943309/sf-supervisors-carve-path-for-privately-run-safe-consumption-sites-but-can-nonprofits-fund-them-alone\">recently were sanctioned by the city\u003c/a>.\u003c/p>\n\u003cp>To that end, Thomas also questioned why the governor’s package did not include any details about continuing to fund harm-reduction centers, like the one her organization operates, that distribute naloxone and offer other treatment services.\u003c/p>\n\u003cp>“What’s not in this, unfortunately, is any plan to extend the \u003ca href=\"https://harmreduction.org/our-work/action/california-harm-reduction-initiative-chri/\">California Harm Reduction Initiative\u003c/a>,” a $15.2 million allocation that has helped pay for staffing and other resources at privately run programs around the state, she said.\u003c/p>\n\u003cp>These are “the people who actually do the work of distributing test strips and naloxone to people who use drugs,” Thomas added. “That funding is now slated to end at the end of this year, and that’s where California must be investing more resources to make sure these scrappy orgs on the ground have the money they need.”\u003cbr>\n\u003c/p>\u003c/div>",
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"title": "Gov. Newsom Announces Partnership With Drugmaker to Produce Affordable, State-Branded Insulin",
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"content": "\u003cp>\u003cem>Updated Sunday at 2 p.m.\u003c/em>\u003c/p>\n\u003cp>The state of California and a generic drug manufacturer announced a 10-year partnership Saturday to produce affordable, state-branded insulin that they hope will rival longtime producers and push down prices for a medication used by millions of Americans.\u003c/p>\n\u003cp>The product is not expected on store shelves until at least next year, and it was difficult to predict what effect it would have on a market already shaken by change. Earlier this week another major insulin maker promised steep price cuts as pressure builds on drugmakers and insurers to slash the cost of the drug.\u003c/p>\n\u003cp>For those who have been fighting for insulin access, it is a welcome win. “I am elated. I was getting texts all yesterday and the day before,” said Kevin Wren, a patient advocate and volunteer with California \u003ca href=\"https://www.t1international.com/CA/\">#Insulin4All\u003c/a>. “This is huge for everyone with diabetes.”\u003c/p>\n\u003cp>Wren said the price of insulin has risen exponentially since he was diagnosed with diabetes in 2001. “I survived when many have not,” Wren said. He added that something like this on the state level is a win for everyone, especially for those with insulin-dependent diabetes in California.\u003c/p>\n\u003cp>“We’re getting another, other major win in the fight for insulin access,” he said. Back in 2009, he rationed his own insulin because he didn’t have enough money to afford the cost of rent and groceries in addition to insulin — “making one vial last twice as long by having smaller doses or using less and just letting my blood sugar run high, which makes you feel terrible,” Wren said.\u003c/p>\n\u003cp>#Insulin4All is trying to work at the federal level to advocate for a price cap on insulin nationwide.\u003c/p>\n\u003cp>https://twitter.com/KQEDnews/status/1637163217398173696\u003c/p>\n\u003cp>Democratic Gov. Gavin Newsom said he hoped California’s emergence as an insulin-maker would prompt prices to collapse. Research has shown that \u003ca href=\"https://apnews.com/article/health-prices-diabetes-congress-a2f9986b7bf3500b81d1ec80a01e5abb\">prices for the drug have more than tripled\u003c/a> in the past couple of decades.\u003c/p>\n\u003cp>“We are intent to make this about market disruption,” Newsom said at a ceremony announcing the pact at a pharmaceutical warehouse near Los Angeles. He called it “a game changer” for 8 million Americans who use insulin to treat diabetes.[aside label=\"Related Stories\" postID=\"news_11937977,news_11920898\"]Many questions remain. The state and its partner, the nonprofit \u003ca href=\"https://civicarx.org/\">Civica\u003c/a>, have yet to locate a California-based manufacturing facility. Regulatory approvals will be needed. Newsom said a 10-milliliter vial of the state-branded insulin would sell for $30, but it’s possible competitors could slash their prices and undercut the state product.\u003c/p>\n\u003cp>“Is this perfect? We don’t know yet,” Newsom acknowledged at one point.\u003c/p>\n\u003cp>Just days ago, President Joe Biden said his administration is focused “intensely” on lowering health care costs, including pressuring pharmaceutical companies to lower the costs of insulin. Legislation enacted last year capped co-payments for insulin at $35 per month for Medicare beneficiaries. Biden has proposed extending that cap to all Americans.\u003c/p>\n\u003cp>Novo Nordisk said Tuesday that \u003ca href=\"https://apnews.com/article/novo-insulin-price-cuts-8c9eed1f35ad81a29653b6061702ef8d\">it will slash some of its U.S. insulin prices up to 75% starting next year\u003c/a>. The announcement comes less than two weeks after rival Eli Lilly said it will drop some of its prices by 70% or more later this year.\u003c/p>\n\u003cp>Anthony Wright, executive director of Health Access California, a statewide consumer health care advocacy group, welcomed Newsom’s announcement, saying efforts by California and others to develop a competing generic are likely a factor in getting insulin manufacturers to cut their prices.[pullquote align=\"right\" size=\"medium\" citation=\"Gov. Gavin Newsom\"]‘We are intent to make this about market disruption.’[/pullquote]Still, there are obstacles.\u003c/p>\n\u003cp>“The work to develop a generic, get FDA approval and set up manufacturing will take real time,” Wright said in an email. “There may even be more time in the effort to get doctors to prescribe the drug, insurers and [pharmacy benefit managers] to include it on their formularies and patients and the public to accept and ask for it.”\u003c/p>\n\u003cp>There could be other risks. State analysts have warned that \u003ca href=\"https://lao.ca.gov/Publications/Report/4560\">California’s entry into the market could prompt other manufacturers to reduce the availability\u003c/a> of their drugs, a potential unintended consequence.\u003c/p>\n\u003cp>State lawmakers approved \u003ca href=\"https://apnews.com/article/health-california-diabetes-government-and-politics-f846c58d4cb327578d1c7b3a9495d496\">$100 million for the project\u003c/a> last year, with $50 million dedicated to developing three types of insulin and the rest set aside to invest in a manufacturing facility.\u003c/p>\n\u003cfigure id=\"attachment_11944052\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11944052\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2030/03/GettyImages-1248563230-800x536.jpg\" alt=\"A middle aged woman in a white dress with a face mask talks with a white middle aged man as he smiles with onlookers behind them.\" width=\"800\" height=\"536\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230-800x536.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230-1020x683.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Tanya Spirtos, president-elect of the California Medical Association (left), speaks briefly with Gov. Newsom (center) following a press conference. \u003ccite>(Francine Orr/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even with the challenges of entering a competitive, established market, Newsom said taxpayers would have “very ample protections.”\u003c/p>\n\u003cp>If for whatever reason the deal didn’t work out to the state’s benefit, “there’s all kinds of provisions that would allow us to … pull out,” he said.\u003c/p>\n\u003cp>According to state documents, the proposed program could save many patients between $2,000 and $4,000 a year. In addition, lower costs could result in substantial savings because the state buys the product every year for the millions of people on its publicly funded health plans.\u003c/p>\n\u003cp>The state also is exploring the possibility of bringing other drugs to market, including the overdose medication \u003ca href=\"https://apnews.com/article/naloxone-narcan-overdose-availability-ec12f62eef12ebc67de77afdbb6f11b9\">naloxone\u003c/a>. The drug, available as a nasal spray and in an injectable form, is considered a key tool in the battle against a nationwide overdose crisis.\u003c/p>\n\u003cp>“We are not stopping here,” Newsom said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>This post includes additional reporting from \u003ca href=\"https://www.kqed.org/author/lsarah\">KQED’s Lakshmi Sarah\u003c/a>. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Sunday at 2 p.m.\u003c/em>\u003c/p>\n\u003cp>The state of California and a generic drug manufacturer announced a 10-year partnership Saturday to produce affordable, state-branded insulin that they hope will rival longtime producers and push down prices for a medication used by millions of Americans.\u003c/p>\n\u003cp>The product is not expected on store shelves until at least next year, and it was difficult to predict what effect it would have on a market already shaken by change. Earlier this week another major insulin maker promised steep price cuts as pressure builds on drugmakers and insurers to slash the cost of the drug.\u003c/p>\n\u003cp>For those who have been fighting for insulin access, it is a welcome win. “I am elated. I was getting texts all yesterday and the day before,” said Kevin Wren, a patient advocate and volunteer with California \u003ca href=\"https://www.t1international.com/CA/\">#Insulin4All\u003c/a>. “This is huge for everyone with diabetes.”\u003c/p>\n\u003cp>Wren said the price of insulin has risen exponentially since he was diagnosed with diabetes in 2001. “I survived when many have not,” Wren said. He added that something like this on the state level is a win for everyone, especially for those with insulin-dependent diabetes in California.\u003c/p>\n\u003cp>“We’re getting another, other major win in the fight for insulin access,” he said. Back in 2009, he rationed his own insulin because he didn’t have enough money to afford the cost of rent and groceries in addition to insulin — “making one vial last twice as long by having smaller doses or using less and just letting my blood sugar run high, which makes you feel terrible,” Wren said.\u003c/p>\n\u003cp>#Insulin4All is trying to work at the federal level to advocate for a price cap on insulin nationwide.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Democratic Gov. Gavin Newsom said he hoped California’s emergence as an insulin-maker would prompt prices to collapse. Research has shown that \u003ca href=\"https://apnews.com/article/health-prices-diabetes-congress-a2f9986b7bf3500b81d1ec80a01e5abb\">prices for the drug have more than tripled\u003c/a> in the past couple of decades.\u003c/p>\n\u003cp>“We are intent to make this about market disruption,” Newsom said at a ceremony announcing the pact at a pharmaceutical warehouse near Los Angeles. He called it “a game changer” for 8 million Americans who use insulin to treat diabetes.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Many questions remain. The state and its partner, the nonprofit \u003ca href=\"https://civicarx.org/\">Civica\u003c/a>, have yet to locate a California-based manufacturing facility. Regulatory approvals will be needed. Newsom said a 10-milliliter vial of the state-branded insulin would sell for $30, but it’s possible competitors could slash their prices and undercut the state product.\u003c/p>\n\u003cp>“Is this perfect? We don’t know yet,” Newsom acknowledged at one point.\u003c/p>\n\u003cp>Just days ago, President Joe Biden said his administration is focused “intensely” on lowering health care costs, including pressuring pharmaceutical companies to lower the costs of insulin. Legislation enacted last year capped co-payments for insulin at $35 per month for Medicare beneficiaries. Biden has proposed extending that cap to all Americans.\u003c/p>\n\u003cp>Novo Nordisk said Tuesday that \u003ca href=\"https://apnews.com/article/novo-insulin-price-cuts-8c9eed1f35ad81a29653b6061702ef8d\">it will slash some of its U.S. insulin prices up to 75% starting next year\u003c/a>. The announcement comes less than two weeks after rival Eli Lilly said it will drop some of its prices by 70% or more later this year.\u003c/p>\n\u003cp>Anthony Wright, executive director of Health Access California, a statewide consumer health care advocacy group, welcomed Newsom’s announcement, saying efforts by California and others to develop a competing generic are likely a factor in getting insulin manufacturers to cut their prices.\u003c/p>\u003c/div>",
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"content": "‘We are intent to make this about market disruption.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Still, there are obstacles.\u003c/p>\n\u003cp>“The work to develop a generic, get FDA approval and set up manufacturing will take real time,” Wright said in an email. “There may even be more time in the effort to get doctors to prescribe the drug, insurers and [pharmacy benefit managers] to include it on their formularies and patients and the public to accept and ask for it.”\u003c/p>\n\u003cp>There could be other risks. State analysts have warned that \u003ca href=\"https://lao.ca.gov/Publications/Report/4560\">California’s entry into the market could prompt other manufacturers to reduce the availability\u003c/a> of their drugs, a potential unintended consequence.\u003c/p>\n\u003cp>State lawmakers approved \u003ca href=\"https://apnews.com/article/health-california-diabetes-government-and-politics-f846c58d4cb327578d1c7b3a9495d496\">$100 million for the project\u003c/a> last year, with $50 million dedicated to developing three types of insulin and the rest set aside to invest in a manufacturing facility.\u003c/p>\n\u003cfigure id=\"attachment_11944052\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11944052\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2030/03/GettyImages-1248563230-800x536.jpg\" alt=\"A middle aged woman in a white dress with a face mask talks with a white middle aged man as he smiles with onlookers behind them.\" width=\"800\" height=\"536\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230-800x536.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230-1020x683.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2030/03/GettyImages-1248563230.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Tanya Spirtos, president-elect of the California Medical Association (left), speaks briefly with Gov. Newsom (center) following a press conference. \u003ccite>(Francine Orr/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even with the challenges of entering a competitive, established market, Newsom said taxpayers would have “very ample protections.”\u003c/p>\n\u003cp>If for whatever reason the deal didn’t work out to the state’s benefit, “there’s all kinds of provisions that would allow us to … pull out,” he said.\u003c/p>\n\u003cp>According to state documents, the proposed program could save many patients between $2,000 and $4,000 a year. In addition, lower costs could result in substantial savings because the state buys the product every year for the millions of people on its publicly funded health plans.\u003c/p>\n\u003cp>The state also is exploring the possibility of bringing other drugs to market, including the overdose medication \u003ca href=\"https://apnews.com/article/naloxone-narcan-overdose-availability-ec12f62eef12ebc67de77afdbb6f11b9\">naloxone\u003c/a>. The drug, available as a nasal spray and in an injectable form, is considered a key tool in the battle against a nationwide overdose crisis.\u003c/p>\n\u003cp>“We are not stopping here,” Newsom said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This post includes additional reporting from \u003ca href=\"https://www.kqed.org/author/lsarah\">KQED’s Lakshmi Sarah\u003c/a>. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "from-the-underground-to-public-health-policy-a-history-of-harm-reduction-in-san-francisco",
"title": "From the Underground to Public Health Policy: A History of Harm Reduction in San Francisco",
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"content": "\u003cp>It was 1998, and San Francisco was in the midst of a heroin overdose crisis. Rachel McLean was an outreach worker in the Haight, and she says it felt like a war zone.\u003c/p>\n\u003cp>When youth in the neighborhood fatally overdosed, outreach workers would host memorials by a bench in Golden Gate Park’s Panhandle.\u003c/p>\n\u003cp>They’d order pizza, tell stories, make zines and write poetry. But then came one three-week stretch with a new overdose death each week.\u003c/p>\n\u003cp>“And by the time we got to the third memorial, no one could even talk about what they loved and remembered about that person because it was just too much,” McLean said. “And I remember a bunch of kids were like, ‘You know, ‘eff this, I’m just going to go and get high.'”\u003c/p>\n\u003cp>Heroin prices had dropped and the purity had doubled. From 1997 to 2000, 384 people died from heroin-related causes in San Francisco, making it the city’s single-largest cause of accidental death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2000, the San Francisco Health Commission made harm reduction — a philosophy that advocates for making it safer to use drugs rather than criminalizing those who do — an official public health policy. It’s an approach with roots spanning from the Summer of Love in 1967, to the beginning of the AIDS pandemic in the 1980s, to the present-day fight to open sites in San Francisco for people to use drugs safely.\u003c/p>\n\u003cfigure id=\"attachment_11911094\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911094\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Vitka Eisen, president and CEO of HealthRIGHT 360, poses for a portrait at the medical clinic in San Francisco on March 9, 2022. HealthRIGHT 360 is a health care provider for lower-income and otherwise marginalized Californians. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Inside a ‘hippie’ clinic, health care was a right\u003c/h2>\n\u003cp>The Haight Ashbury Free Medical Clinic opened its doors in 1967, committed to an ethos where health care was a right, not a privilege. Tens of thousands of flower children and teenage runaways were flocking to San Francisco to “drop out” of everyday society and experiment with drugs, sex and rock ‘n’ roll.\u003c/p>\n\u003cp>The clinic offered people who used drugs health care at a time when the city’s health department worried compassion would encourage the hippies to stay. It provided a safe space for people dealing with bad trips and heroin withdrawal and, later, for veterans returning from Vietnam with post-traumatic stress disorder.\u003c/p>\n\u003cp>Founder Dr. David Smith said it was illegal for physicians to treat people with substance use disorder with prescription drugs in the 1960s. Clinic volunteers were so worried police would shut the clinic down if people used drugs inside that the door was painted to read: “No dealing!/No holding drugs/No using drugs/No alcohol/No pets/Any of these can close the clinic/We Love You.”\u003c/p>\n\u003cp>When the Summer of Love ended, many people went home, but generations of people searching for meaning stayed behind in San Francisco, where the hard drugs moved in and people’s health care needs overwhelmed the clinic.\u003c/p>\n\u003cfigure id=\"attachment_11611310\" class=\"wp-caption alignright\" style=\"max-width: 355px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11611310\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg\" alt=\"\" width=\"355\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg 355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-160x361.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-240x541.jpg 240w\" sizes=\"(max-width: 355px) 100vw, 355px\">\u003cfigcaption class=\"wp-caption-text\">This painted door marked the entrance to the Haight Ashbury Free Medical Clinic. \u003ccite>(Courtesy of David Smith archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“More than three years of life in the Haight, once the flower pot of America, now shattered into fragments of terror and despair, a ‘behavioral sink’ of pathologies feeding off the pill and the needle,” read a 1971 New York Times piece.\u003c/p>\n\u003cp>Still, the philosophy of the clinic — not only that health care is a right but also that addiction can be treated with medicine — persisted.\u003c/p>\n\u003cp>“It was harm reduction before there was such a term. It was never like, ‘When are you going to get your shit together?’ It was always, ‘Hey, can I see what’s going on?'” said Vitka Eisen, who was a patient at the Haight Ashbury Free Medical Clinic, as it was called in the 1980s.\u003c/p>\n\u003cp>The clinic smelled of patchouli, and a counselor walked around in a leather fringe jacket, Eisen recalled. She would go to the clinic before visiting her family in New York because she didn’t want to be strung out on heroin when she went to see them. She’d pick up a “kick pack” of medicine to fight stomach cramping and nausea, and to help her sleep during withdrawal.\u003c/p>\n\u003cp>“After the seventh or eighth time, I was like, ‘I can’t do this anymore,’” she said.\u003c/p>\n\u003cp>She got treatment at Walden House, an addiction and mental health treatment program in San Francisco, and said she never used drugs again. Now she runs the treatment provider HealthRIGHT 360, the umbrella organization that includes what is known today as the Haight Ashbury Free Clinics.\u003c/p>\n\u003ch2>‘Carrying bleach was like having aspirin’\u003c/h2>\n\u003cp>The philosophy of harm reduction spread internationally when activists and caregivers sought ways to reduce suffering and health risks during the AIDS crisis in the ’80s. Volunteers handed out clean needles and encouraged cleaning needles with bleach.\u003c/p>\n\u003cp>Maia Szalavitz, the author of “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,” says she was addicted to cocaine and heroin at the time. She was unaware that sharing needles put her at risk of contracting HIV until 1986, when she met Maureen Gammon with the San Francisco-based group Mid-City Consortium to Combat AIDS.\u003c/p>\n\u003cfigure id=\"attachment_11911096\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911096\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg\" alt=\"\" width=\"800\" height=\"846\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1020x1079.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-160x169.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1452x1536.jpeg 1452w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1.jpeg 1859w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Maia Szalavitz, author of ‘Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,’ in the 1980s. \u003ccite>(Courtesy of Maia Szalavitz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“She told me I shouldn’t share, but if you have to share, clean the needle with bleach and then with water,” Szalavitz said. “Shooting up is a pretty compulsive thing, so I immediately incorporated this into my compulsive routine and she probably saved my life.”\u003c/p>\n\u003cp>Gammon said carrying bleach was as common as having aspirin.\u003c/p>\n\u003cp>“People just had [bleach], and it was not unusual to go into a corner store or taqueria or bar and ask for a bottle of beach and be able to get it,” Gammon said.\u003c/p>\n\u003ch2>Inside the Ambassador Hotel\u003c/h2>\n\u003cp>The AIDS crisis also forged a new generation of physicians, said Joshua Bamberger, an associate clinical professor of family and community medicine at UCSF.\u003c/p>\n\u003cp>He began his residency at San Francisco General Hospital in 1989, and said all his energy and focus went into caring for men who were dying of AIDS.\u003c/p>\n\u003cp>“Much of my work was really holding men in my arms as they died,” he said. “And as awful as that was, it also created an era of physicians and other healers who bonded over the important things in medicine, which isn’t necessarily slinging medication but providing love and care for people who are really suffering.”\u003c/p>\n\u003cp>Some hospices refused to take in people who had a history of drug use, or had clauses saying they’d only accept people on the condition they’d been sober for six months before being referred. But the people who needed to be referred often had two or three months left to live.\u003c/p>\n\u003cp>So, many people found refuge at the Ambassador Hotel, an SRO in the Tenderloin run by gay rights activist Hank Wilson beginning in 1978. It became one of the few places where AIDS patients who used drugs could live without having to die on the streets. In the 1996 documentary “Life and Death at the Ambassador Hotel,” the site is described as a model in harm-reduction housing.\u003c/p>\n\u003cp>“The Ambassador was sort of a de facto AIDS hospital,” said Bamberger, who did rounds there, providing care alongside community members and friends of those dying. “When treatment options were limited, and [people] didn’t have a home, the Ambassador was a place where they could land.”\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=5XiwqOu_R7I\u003c/p>\n\u003cp>Val Robb, a nurse at the Ambassador Hotel, said she had to learn the culture of the people who stayed there. Many people who used drugs were distrustful of a health care system that considered them not worth treating.\u003c/p>\n\u003cp>“I started speaking the language more, which is, ‘Let me work out a deal. You need me to do this. I want you to do that,'” Robb said. “I need you to go to the doctor. If you go to the doctor, if you let them examine you, then let’s get you some codeine. It wasn’t like, ‘I’m Nurse Nancy doing this thing for you.'”\u003c/p>\n\u003cp>There were times Robb had to go against what she knew about health, such as offering guests cigarettes if they would let her examine them. But she said she still had to draw the line.\u003c/p>\n\u003cp>“Another guy, he says, ‘Val, I’m trying to get high, and my partner couldn’t hit the vein. Can’t you?’ I said, ‘No, I’m a nurse with kids and a license, I can’t do that,'” she recalled.\u003c/p>\n\u003cp>It took years before the city approved or funded some of the harm-reduction practices happening underground. The AIDS crisis hit its peak in San Francisco in 1992, and the following year Mayor Frank Jordan declared a state of emergency and announced that San Francisco would back a program to give clean needles to people who used drugs.\u003c/p>\n\u003ch2>‘Call it Lazarus in a hypodermic’\u003c/h2>\n\u003cp>Meanwhile, naloxone, the medication used to reverse overdoses, was still only widely available in medical settings. Rachel McLean, the outreach worker, said she and others attended a conference on drug policy reform in 1999 where an Italian man gave a presentation on naloxone.\u003c/p>\n\u003cp>“None of us could even understand what he was saying because his accent was so strong. But we understood that he said that in Italy, community health workers give out naloxone on the street,” she said. “And all of us, our minds were just blown by that.”\u003c/p>\n\u003cp>At the conference, Dan Bigg with the Chicago Recovery Alliance brought a duffle bag full of naloxone.\u003c/p>\n\u003cp>“And people would just come and take it, and that’s how underground naloxone started in San Francisco,” McLean said.\u003c/p>\n\u003cfigure id=\"attachment_11911104\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911104\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png\" alt=\"\" width=\"800\" height=\"454\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-1020x579.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-160x91.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10.png 1522w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Naloxone education material used in San Francisco from the Massachusetts Department of Public Health. \u003ccite>(Courtesy of Joshua Bamberger)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s a mission that’s part Che Guevara, part Mother Teresa. The guerrillas aren’t doctors. Nonphysicians, obviously, are barred by law from handing out prescription drugs — it’s a felony that can carry up to 10 years in federal prison,” reads a 2003 article from A.C. Thompson in The San Francisco Bay Guardian on a visit to a San Francisco needle exchange site where volunteers were distributing naloxone. \u003c/span>\u003c/p>\n\u003cp>Critics said providing people who used drugs with naloxone, more commonly known by the brand name Narcan, would encourage drug use. Clinicians worried about \u003ca href=\"https://papers.ssrn.com/sol3/papers.cfm?abstract_id=286850\">liability\u003c/a> if people had an adverse reaction to the naloxone, or if they died even after naloxone was used.\u003c/p>\n\u003cp>While studying at San Francisco State University in the same year as the conference on drug policy reform, McLean was assigned to write a paper analyzing a public health problem. She drafted some ideas based on the knowledge she had absorbed from the community, and proposed opening safe injection rooms, testing drug supplies and training people who inject drugs in administering naloxone.\u003c/p>\n\u003cp>She presented the paper to members of a so-called “heroin subcommittee” created by the city to address overdose deaths, and members included the ideas in their final recommendations.\u003c/p>\n\u003cfigure id=\"attachment_11911100\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911100\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rachel McLean looks through her archive of flyers, zines, educational information, and research on harm reduction at her home on March 10, 2022. A photo of friend and colleague Pete Morse can be seen, as can a zine about Matty Luv, singer of the San Francisco punk band Hickey, who passed away from a heroin overdose in 2002. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Soon after turning in her paper, McLean graduated from college, quit her job as an outreach worker and went to Mexico for three months, burned out by the trauma. But she would sometimes wake up at night to scribble notes about what an overdose prevention program would look like.\u003c/p>\n\u003cp>“The fire was still there,” she said.\u003c/p>\n\u003cp class=\"p1\">Members of the heroin subcommittee ended up calling McLean. They remembered her recommendations from several years before and asked McLean if she would implement some of her ideas.\u003c/p>\n\u003cp>With a $30,000 annual budget, the Drug Overdose Prevention and Education (DOPE) Project began in a makeshift office in McLean’s kitchen in 2002. She started making phone calls to overdose prevention workers, and put together a curriculum to teach drug and alcohol treatment providers, sheriffs and deputies, the probation department, homeless shelter staff, and others how to reverse overdoses through rescue breathing. Without naloxone widely available, rescue breathing was something anyone could do to reverse overdoses, with some training.\u003c/p>\n\u003ch2>Heroin overdose deaths plummet\u003c/h2>\n\u003cp>Alex Kral, then a researcher with the Urban Health Study at UCSF, conducted a pilot study with other researchers in 2001 to 2002, training 24 people to use naloxone. There were 20 overdoses during the study. Trainees reversed all of them, 15 with naloxone, and most of those with an additional rescue method. The researchers presented the findings to the county’s public health director.\u003c/p>\n\u003cp>“We said, ‘Look … you’ve got people dying of overdoses and you’re not able to do anything about that,'” said Kral, who is now an epidemiologist with the nonprofit health research institute RTI International. “‘Why don’t you do something about it?’ And [the director] said, ‘Yeah, let’s do it.'”\u003c/p>\n\u003cp>One year later, the San Francisco Department of Public Health partnered with the DOPE Project to distribute naloxone at syringe-exchange programs, SROs, reentry programs and other sites in the community.\u003c/p>\n\u003cp>Joshua Bamberger, who oversaw the program with San Francisco’s DPH, said heroin overdose deaths dropped “unbelievably down,” plummeting from a peak of 155 in 1995 to 10 in 2010.\u003c/p>\n\u003cfigure id=\"attachment_11911101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911101\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">An altar includes a candle from a memorial for Pete Morse on the mantel of Rachel McLean’s home on March 10, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Nothing’s gonna reduce death to the extent that getting 10,000 doses of naloxone out there in San Francisco in the early 2000s will ever do,” Bamberger said.\u003c/p>\n\u003cp>McLean, who now works for the state health department, still keeps a picture on her mantel of Pete Morse, who was at the forefront of bringing naloxone to the streets of San Francisco. He died of a drug overdose in 2007.\u003c/p>\n\u003cp>“I think about him all the time. I want to make sure that his contributions are remembered,” McLean said. “I don’t want to say that it broke my heart the most because I don’t want to compare it to all of the other deaths, but it’s still with me.”\u003c/p>\n\u003ch2>The fentanyl overdose crisis\u003c/h2>\n\u003cp>Naloxone has become a key tool in reducing overdose deaths nationwide. For years, it helped stave off the worst of the opioid crisis in San Francisco. But geography also helped for a time. On the West Coast, black tar heroin was the most common type of heroin, and that black color made it more difficult to hide white-powdered fentanyl inside.\u003c/p>\n\u003cp>Still, the number of people who injected drugs in San Francisco — mostly heroin — more than doubled early in this century, from 10,158 in 2005 to 22,000 in 2012.\u003c/p>\n\u003cp>By 2017, fentanyl had crept in to begin its rampage. That year, the city reported 36 deaths linked to fentanyl. That jumped to 90 in 2018. In 2020, the number of fentanyl-related deaths skyrocketed to 518.\u003c/p>\n\u003cp>An estimated 650 people overdosed and died in San Francisco last year, a spike driven by fentanyl, according to data from the San Francisco Medical Examiner’s Office.\u003c/p>\n\u003cfigure id=\"attachment_11911293\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911293\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png\" alt=\"\" width=\"800\" height=\"384\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1020x489.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-160x77.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1536x737.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1.png 1626w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Data on fentanyl-related and non-fentanyl-related overdose deaths from the San Francisco Department of Public Health and San Francisco Medical Examiner’s Office. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I lost so many people to just fentanyl,” said Joel Webber, who goes by Turtle. He sat on a curb recently near Hotel Whitcomb, a city-run hotel on Market Street. People regularly gather nearby to use or sell drugs.\u003c/p>\n\u003cp>Webber said he received methadone treatment for 22 years, then started using fentanyl when he stopped his methadone treatment.\u003c/p>\n\u003cp>“If I could, I would blow up every f—ing fentanyl lab up with a button and end it. I’d get sick, but I’ll take it,” Webber said. “I just want it gone.”\u003c/p>\n\u003cp>Drugs like fentanyl are unlikely to disappear, and that means the city will need to try new strategies to prevent overdoses. A river of naloxone is not enough to confront the crisis, said Keith Humphreys, an addiction researcher at Stanford University School of Medicine.\u003c/p>\n\u003cp>One dose of naloxone often is not enough to reverse a fentanyl overdose.\u003c/p>\n\u003cp>“Maybe we can’t make fentanyl use safe,” he said. “Let’s say you make it twice as safe. It’s still just so deadly it just overwhelms the capacity of what we know how to do.”\u003c/p>\n\u003ch2>Community and trauma in harm-reduction work\u003c/h2>\n\u003cp>In 2021, President Joe Biden became the first president to make expanding harm reduction one of his drug-policy priorities. But people still argue that harm reduction encourages drug use. Several city leaders in San Francisco have criticized an overreliance on harm-reduction services and a lack of abstinence-based treatment options.\u003c/p>\n\u003cfigure id=\"attachment_11911102\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911102\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kristen Marshall and the Dope Project team pose for a portrait during Overdose Awareness Day in 2020. The event gathers providers and community members to hold space for those lost and celebrate people still with them. \u003ccite>(Courtesy of Kristen Marshall)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kristen Marshall was the program manager for the DOPE Project until last winter.\u003c/p>\n\u003cp>“When you do this work, it’s your life, even if you try to fight it. It’s a lot of grief, it’s a lot of pain, it’s a lot of trauma. And that breaks a person down,” she said. “It feels really hard for me as someone who is in this position when suddenly people are like, ‘Well, this is your job. If overdose prevention is your job, what do you do? Harm reduction must not work.'”\u003c/p>\n\u003cp>Still, because of the vast supply of naloxone in the community, people are reversing more drug overdoses, many fentanyl-related, in San Francisco than ever before. The DOPE Project reported 81 overdose reversals in 2006. In the year 2021 alone, the group reported 8,985 reversals. Many of those overdoses were reversed by people who use drugs. In comparison, San Francisco police, who by then were carrying naloxone, reversed 144 overdoses in 2021.\u003c/p>\n\u003cfigure id=\"attachment_11911286\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911286\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png\" alt=\"\" width=\"800\" height=\"581\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1020x740.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-160x116.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1536x1115.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco.png 1634w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Reporting data from the Drug Overdose Prevention and Education Project, as documented in a San Francisco Department of Public Health report. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Marshall said the larger question she keeps asking herself is what happens after overdoses are reversed.\u003c/p>\n\u003cp>“So they go to treatment, then what? Where’s their housing? So they go right back outside,” she said.\u003c/p>\n\u003cp>She believes overdose prevention efforts will inevitably fall short until root causes such as poverty, racism and isolation are addressed.\u003c/p>\n\u003cp>“We’re giving people Narcan and saying, ‘Live, live, live, live — you have to live,’” she said. “The question that I want to ask everyone is, ‘What are we living for? What is there for people to grasp?’”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This reporting was produced as a project for the USC Annenberg Center for Health Journalism’s 2021 Data Fellowship. KQED’s Kate Wolffe contributed to this story. \u003c/em>\u003c/p>\n\n",
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"excerpt": "The use of Narcan to reverse drug overdoses in San Francisco began as an underground movement more than two decades ago. It's part of a long history of harm reduction that stretches from the Summer of Love in 1967 to today's fentanyl crisis.",
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"title": "From the Underground to Public Health Policy: A History of Harm Reduction in San Francisco | KQED",
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"headline": "From the Underground to Public Health Policy: A History of Harm Reduction in San Francisco",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was 1998, and San Francisco was in the midst of a heroin overdose crisis. Rachel McLean was an outreach worker in the Haight, and she says it felt like a war zone.\u003c/p>\n\u003cp>When youth in the neighborhood fatally overdosed, outreach workers would host memorials by a bench in Golden Gate Park’s Panhandle.\u003c/p>\n\u003cp>They’d order pizza, tell stories, make zines and write poetry. But then came one three-week stretch with a new overdose death each week.\u003c/p>\n\u003cp>“And by the time we got to the third memorial, no one could even talk about what they loved and remembered about that person because it was just too much,” McLean said. “And I remember a bunch of kids were like, ‘You know, ‘eff this, I’m just going to go and get high.'”\u003c/p>\n\u003cp>Heroin prices had dropped and the purity had doubled. From 1997 to 2000, 384 people died from heroin-related causes in San Francisco, making it the city’s single-largest cause of accidental death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2000, the San Francisco Health Commission made harm reduction — a philosophy that advocates for making it safer to use drugs rather than criminalizing those who do — an official public health policy. It’s an approach with roots spanning from the Summer of Love in 1967, to the beginning of the AIDS pandemic in the 1980s, to the present-day fight to open sites in San Francisco for people to use drugs safely.\u003c/p>\n\u003cfigure id=\"attachment_11911094\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911094\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54198_007_KQED_VitkaEisenHealthRight360_03092022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Vitka Eisen, president and CEO of HealthRIGHT 360, poses for a portrait at the medical clinic in San Francisco on March 9, 2022. HealthRIGHT 360 is a health care provider for lower-income and otherwise marginalized Californians. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Inside a ‘hippie’ clinic, health care was a right\u003c/h2>\n\u003cp>The Haight Ashbury Free Medical Clinic opened its doors in 1967, committed to an ethos where health care was a right, not a privilege. Tens of thousands of flower children and teenage runaways were flocking to San Francisco to “drop out” of everyday society and experiment with drugs, sex and rock ‘n’ roll.\u003c/p>\n\u003cp>The clinic offered people who used drugs health care at a time when the city’s health department worried compassion would encourage the hippies to stay. It provided a safe space for people dealing with bad trips and heroin withdrawal and, later, for veterans returning from Vietnam with post-traumatic stress disorder.\u003c/p>\n\u003cp>Founder Dr. David Smith said it was illegal for physicians to treat people with substance use disorder with prescription drugs in the 1960s. Clinic volunteers were so worried police would shut the clinic down if people used drugs inside that the door was painted to read: “No dealing!/No holding drugs/No using drugs/No alcohol/No pets/Any of these can close the clinic/We Love You.”\u003c/p>\n\u003cp>When the Summer of Love ended, many people went home, but generations of people searching for meaning stayed behind in San Francisco, where the hard drugs moved in and people’s health care needs overwhelmed the clinic.\u003c/p>\n\u003cfigure id=\"attachment_11611310\" class=\"wp-caption alignright\" style=\"max-width: 355px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11611310\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg\" alt=\"\" width=\"355\" height=\"800\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut.jpg 355w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-160x361.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/08/RS26138_Detox-Door-Trimed-2-DSC_0018-qut-240x541.jpg 240w\" sizes=\"(max-width: 355px) 100vw, 355px\">\u003cfigcaption class=\"wp-caption-text\">This painted door marked the entrance to the Haight Ashbury Free Medical Clinic. \u003ccite>(Courtesy of David Smith archives)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“More than three years of life in the Haight, once the flower pot of America, now shattered into fragments of terror and despair, a ‘behavioral sink’ of pathologies feeding off the pill and the needle,” read a 1971 New York Times piece.\u003c/p>\n\u003cp>Still, the philosophy of the clinic — not only that health care is a right but also that addiction can be treated with medicine — persisted.\u003c/p>\n\u003cp>“It was harm reduction before there was such a term. It was never like, ‘When are you going to get your shit together?’ It was always, ‘Hey, can I see what’s going on?'” said Vitka Eisen, who was a patient at the Haight Ashbury Free Medical Clinic, as it was called in the 1980s.\u003c/p>\n\u003cp>The clinic smelled of patchouli, and a counselor walked around in a leather fringe jacket, Eisen recalled. She would go to the clinic before visiting her family in New York because she didn’t want to be strung out on heroin when she went to see them. She’d pick up a “kick pack” of medicine to fight stomach cramping and nausea, and to help her sleep during withdrawal.\u003c/p>\n\u003cp>“After the seventh or eighth time, I was like, ‘I can’t do this anymore,’” she said.\u003c/p>\n\u003cp>She got treatment at Walden House, an addiction and mental health treatment program in San Francisco, and said she never used drugs again. Now she runs the treatment provider HealthRIGHT 360, the umbrella organization that includes what is known today as the Haight Ashbury Free Clinics.\u003c/p>\n\u003ch2>‘Carrying bleach was like having aspirin’\u003c/h2>\n\u003cp>The philosophy of harm reduction spread internationally when activists and caregivers sought ways to reduce suffering and health risks during the AIDS crisis in the ’80s. Volunteers handed out clean needles and encouraged cleaning needles with bleach.\u003c/p>\n\u003cp>Maia Szalavitz, the author of “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,” says she was addicted to cocaine and heroin at the time. She was unaware that sharing needles put her at risk of contracting HIV until 1986, when she met Maureen Gammon with the San Francisco-based group Mid-City Consortium to Combat AIDS.\u003c/p>\n\u003cfigure id=\"attachment_11911096\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911096\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg\" alt=\"\" width=\"800\" height=\"846\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-800x846.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1020x1079.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-160x169.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1-1452x1536.jpeg 1452w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Maia-wig-85-or-86-1.jpeg 1859w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Maia Szalavitz, author of ‘Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction,’ in the 1980s. \u003ccite>(Courtesy of Maia Szalavitz)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“She told me I shouldn’t share, but if you have to share, clean the needle with bleach and then with water,” Szalavitz said. “Shooting up is a pretty compulsive thing, so I immediately incorporated this into my compulsive routine and she probably saved my life.”\u003c/p>\n\u003cp>Gammon said carrying bleach was as common as having aspirin.\u003c/p>\n\u003cp>“People just had [bleach], and it was not unusual to go into a corner store or taqueria or bar and ask for a bottle of beach and be able to get it,” Gammon said.\u003c/p>\n\u003ch2>Inside the Ambassador Hotel\u003c/h2>\n\u003cp>The AIDS crisis also forged a new generation of physicians, said Joshua Bamberger, an associate clinical professor of family and community medicine at UCSF.\u003c/p>\n\u003cp>He began his residency at San Francisco General Hospital in 1989, and said all his energy and focus went into caring for men who were dying of AIDS.\u003c/p>\n\u003cp>“Much of my work was really holding men in my arms as they died,” he said. “And as awful as that was, it also created an era of physicians and other healers who bonded over the important things in medicine, which isn’t necessarily slinging medication but providing love and care for people who are really suffering.”\u003c/p>\n\u003cp>Some hospices refused to take in people who had a history of drug use, or had clauses saying they’d only accept people on the condition they’d been sober for six months before being referred. But the people who needed to be referred often had two or three months left to live.\u003c/p>\n\u003cp>So, many people found refuge at the Ambassador Hotel, an SRO in the Tenderloin run by gay rights activist Hank Wilson beginning in 1978. It became one of the few places where AIDS patients who used drugs could live without having to die on the streets. In the 1996 documentary “Life and Death at the Ambassador Hotel,” the site is described as a model in harm-reduction housing.\u003c/p>\n\u003cp>“The Ambassador was sort of a de facto AIDS hospital,” said Bamberger, who did rounds there, providing care alongside community members and friends of those dying. “When treatment options were limited, and [people] didn’t have a home, the Ambassador was a place where they could land.”\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/5XiwqOu_R7I'\n title='//www.youtube.com/embed/5XiwqOu_R7I'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Val Robb, a nurse at the Ambassador Hotel, said she had to learn the culture of the people who stayed there. Many people who used drugs were distrustful of a health care system that considered them not worth treating.\u003c/p>\n\u003cp>“I started speaking the language more, which is, ‘Let me work out a deal. You need me to do this. I want you to do that,'” Robb said. “I need you to go to the doctor. If you go to the doctor, if you let them examine you, then let’s get you some codeine. It wasn’t like, ‘I’m Nurse Nancy doing this thing for you.'”\u003c/p>\n\u003cp>There were times Robb had to go against what she knew about health, such as offering guests cigarettes if they would let her examine them. But she said she still had to draw the line.\u003c/p>\n\u003cp>“Another guy, he says, ‘Val, I’m trying to get high, and my partner couldn’t hit the vein. Can’t you?’ I said, ‘No, I’m a nurse with kids and a license, I can’t do that,'” she recalled.\u003c/p>\n\u003cp>It took years before the city approved or funded some of the harm-reduction practices happening underground. The AIDS crisis hit its peak in San Francisco in 1992, and the following year Mayor Frank Jordan declared a state of emergency and announced that San Francisco would back a program to give clean needles to people who used drugs.\u003c/p>\n\u003ch2>‘Call it Lazarus in a hypodermic’\u003c/h2>\n\u003cp>Meanwhile, naloxone, the medication used to reverse overdoses, was still only widely available in medical settings. Rachel McLean, the outreach worker, said she and others attended a conference on drug policy reform in 1999 where an Italian man gave a presentation on naloxone.\u003c/p>\n\u003cp>“None of us could even understand what he was saying because his accent was so strong. But we understood that he said that in Italy, community health workers give out naloxone on the street,” she said. “And all of us, our minds were just blown by that.”\u003c/p>\n\u003cp>At the conference, Dan Bigg with the Chicago Recovery Alliance brought a duffle bag full of naloxone.\u003c/p>\n\u003cp>“And people would just come and take it, and that’s how underground naloxone started in San Francisco,” McLean said.\u003c/p>\n\u003cfigure id=\"attachment_11911104\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911104\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png\" alt=\"\" width=\"800\" height=\"454\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-800x454.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-1020x579.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10-160x91.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/Screenshot-2022-04-14-at-06.42.10.png 1522w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Naloxone education material used in San Francisco from the Massachusetts Department of Public Health. \u003ccite>(Courtesy of Joshua Bamberger)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s a mission that’s part Che Guevara, part Mother Teresa. The guerrillas aren’t doctors. Nonphysicians, obviously, are barred by law from handing out prescription drugs — it’s a felony that can carry up to 10 years in federal prison,” reads a 2003 article from A.C. Thompson in The San Francisco Bay Guardian on a visit to a San Francisco needle exchange site where volunteers were distributing naloxone. \u003c/span>\u003c/p>\n\u003cp>Critics said providing people who used drugs with naloxone, more commonly known by the brand name Narcan, would encourage drug use. Clinicians worried about \u003ca href=\"https://papers.ssrn.com/sol3/papers.cfm?abstract_id=286850\">liability\u003c/a> if people had an adverse reaction to the naloxone, or if they died even after naloxone was used.\u003c/p>\n\u003cp>While studying at San Francisco State University in the same year as the conference on drug policy reform, McLean was assigned to write a paper analyzing a public health problem. She drafted some ideas based on the knowledge she had absorbed from the community, and proposed opening safe injection rooms, testing drug supplies and training people who inject drugs in administering naloxone.\u003c/p>\n\u003cp>She presented the paper to members of a so-called “heroin subcommittee” created by the city to address overdose deaths, and members included the ideas in their final recommendations.\u003c/p>\n\u003cfigure id=\"attachment_11911100\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911100\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54296_009_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Rachel McLean looks through her archive of flyers, zines, educational information, and research on harm reduction at her home on March 10, 2022. A photo of friend and colleague Pete Morse can be seen, as can a zine about Matty Luv, singer of the San Francisco punk band Hickey, who passed away from a heroin overdose in 2002. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Soon after turning in her paper, McLean graduated from college, quit her job as an outreach worker and went to Mexico for three months, burned out by the trauma. But she would sometimes wake up at night to scribble notes about what an overdose prevention program would look like.\u003c/p>\n\u003cp>“The fire was still there,” she said.\u003c/p>\n\u003cp class=\"p1\">Members of the heroin subcommittee ended up calling McLean. They remembered her recommendations from several years before and asked McLean if she would implement some of her ideas.\u003c/p>\n\u003cp>With a $30,000 annual budget, the Drug Overdose Prevention and Education (DOPE) Project began in a makeshift office in McLean’s kitchen in 2002. She started making phone calls to overdose prevention workers, and put together a curriculum to teach drug and alcohol treatment providers, sheriffs and deputies, the probation department, homeless shelter staff, and others how to reverse overdoses through rescue breathing. Without naloxone widely available, rescue breathing was something anyone could do to reverse overdoses, with some training.\u003c/p>\n\u003ch2>Heroin overdose deaths plummet\u003c/h2>\n\u003cp>Alex Kral, then a researcher with the Urban Health Study at UCSF, conducted a pilot study with other researchers in 2001 to 2002, training 24 people to use naloxone. There were 20 overdoses during the study. Trainees reversed all of them, 15 with naloxone, and most of those with an additional rescue method. The researchers presented the findings to the county’s public health director.\u003c/p>\n\u003cp>“We said, ‘Look … you’ve got people dying of overdoses and you’re not able to do anything about that,'” said Kral, who is now an epidemiologist with the nonprofit health research institute RTI International. “‘Why don’t you do something about it?’ And [the director] said, ‘Yeah, let’s do it.'”\u003c/p>\n\u003cp>One year later, the San Francisco Department of Public Health partnered with the DOPE Project to distribute naloxone at syringe-exchange programs, SROs, reentry programs and other sites in the community.\u003c/p>\n\u003cp>Joshua Bamberger, who oversaw the program with San Francisco’s DPH, said heroin overdose deaths dropped “unbelievably down,” plummeting from a peak of 155 in 1995 to 10 in 2010.\u003c/p>\n\u003cfigure id=\"attachment_11911101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911101\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54290_003_KQED_RachelMcLeanHarmReduction_03102022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">An altar includes a candle from a memorial for Pete Morse on the mantel of Rachel McLean’s home on March 10, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Nothing’s gonna reduce death to the extent that getting 10,000 doses of naloxone out there in San Francisco in the early 2000s will ever do,” Bamberger said.\u003c/p>\n\u003cp>McLean, who now works for the state health department, still keeps a picture on her mantel of Pete Morse, who was at the forefront of bringing naloxone to the streets of San Francisco. He died of a drug overdose in 2007.\u003c/p>\n\u003cp>“I think about him all the time. I want to make sure that his contributions are remembered,” McLean said. “I don’t want to say that it broke my heart the most because I don’t want to compare it to all of the other deaths, but it’s still with me.”\u003c/p>\n\u003ch2>The fentanyl overdose crisis\u003c/h2>\n\u003cp>Naloxone has become a key tool in reducing overdose deaths nationwide. For years, it helped stave off the worst of the opioid crisis in San Francisco. But geography also helped for a time. On the West Coast, black tar heroin was the most common type of heroin, and that black color made it more difficult to hide white-powdered fentanyl inside.\u003c/p>\n\u003cp>Still, the number of people who injected drugs in San Francisco — mostly heroin — more than doubled early in this century, from 10,158 in 2005 to 22,000 in 2012.\u003c/p>\n\u003cp>By 2017, fentanyl had crept in to begin its rampage. That year, the city reported 36 deaths linked to fentanyl. That jumped to 90 in 2018. In 2020, the number of fentanyl-related deaths skyrocketed to 518.\u003c/p>\n\u003cp>An estimated 650 people overdosed and died in San Francisco last year, a spike driven by fentanyl, according to data from the San Francisco Medical Examiner’s Office.\u003c/p>\n\u003cfigure id=\"attachment_11911293\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911293\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png\" alt=\"\" width=\"800\" height=\"384\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-800x384.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1020x489.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-160x77.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1-1536x737.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/n3ivi-sf-overdose-deaths-from-fentanyl-and-other-drugs-nbsp-__2_-1.png 1626w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Data on fentanyl-related and non-fentanyl-related overdose deaths from the San Francisco Department of Public Health and San Francisco Medical Examiner’s Office. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I lost so many people to just fentanyl,” said Joel Webber, who goes by Turtle. He sat on a curb recently near Hotel Whitcomb, a city-run hotel on Market Street. People regularly gather nearby to use or sell drugs.\u003c/p>\n\u003cp>Webber said he received methadone treatment for 22 years, then started using fentanyl when he stopped his methadone treatment.\u003c/p>\n\u003cp>“If I could, I would blow up every f—ing fentanyl lab up with a button and end it. I’d get sick, but I’ll take it,” Webber said. “I just want it gone.”\u003c/p>\n\u003cp>Drugs like fentanyl are unlikely to disappear, and that means the city will need to try new strategies to prevent overdoses. A river of naloxone is not enough to confront the crisis, said Keith Humphreys, an addiction researcher at Stanford University School of Medicine.\u003c/p>\n\u003cp>One dose of naloxone often is not enough to reverse a fentanyl overdose.\u003c/p>\n\u003cp>“Maybe we can’t make fentanyl use safe,” he said. “Let’s say you make it twice as safe. It’s still just so deadly it just overwhelms the capacity of what we know how to do.”\u003c/p>\n\u003ch2>Community and trauma in harm-reduction work\u003c/h2>\n\u003cp>In 2021, President Joe Biden became the first president to make expanding harm reduction one of his drug-policy priorities. But people still argue that harm reduction encourages drug use. Several city leaders in San Francisco have criticized an overreliance on harm-reduction services and a lack of abstinence-based treatment options.\u003c/p>\n\u003cfigure id=\"attachment_11911102\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911102\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut-1536x1025.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/RS54382_TheDopeProjectSF2020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kristen Marshall and the Dope Project team pose for a portrait during Overdose Awareness Day in 2020. The event gathers providers and community members to hold space for those lost and celebrate people still with them. \u003ccite>(Courtesy of Kristen Marshall)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kristen Marshall was the program manager for the DOPE Project until last winter.\u003c/p>\n\u003cp>“When you do this work, it’s your life, even if you try to fight it. It’s a lot of grief, it’s a lot of pain, it’s a lot of trauma. And that breaks a person down,” she said. “It feels really hard for me as someone who is in this position when suddenly people are like, ‘Well, this is your job. If overdose prevention is your job, what do you do? Harm reduction must not work.'”\u003c/p>\n\u003cp>Still, because of the vast supply of naloxone in the community, people are reversing more drug overdoses, many fentanyl-related, in San Francisco than ever before. The DOPE Project reported 81 overdose reversals in 2006. In the year 2021 alone, the group reported 8,985 reversals. Many of those overdoses were reversed by people who use drugs. In comparison, San Francisco police, who by then were carrying naloxone, reversed 144 overdoses in 2021.\u003c/p>\n\u003cfigure id=\"attachment_11911286\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11911286\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png\" alt=\"\" width=\"800\" height=\"581\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-800x581.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1020x740.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-160x116.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco-1536x1115.png 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/04/xHw1R-narcan-refills-and-reversals-in-san-francisco.png 1634w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Reporting data from the Drug Overdose Prevention and Education Project, as documented in a San Francisco Department of Public Health report. \u003ccite>(Chart by Matthew Green/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Marshall said the larger question she keeps asking herself is what happens after overdoses are reversed.\u003c/p>\n\u003cp>“So they go to treatment, then what? Where’s their housing? So they go right back outside,” she said.\u003c/p>\n\u003cp>She believes overdose prevention efforts will inevitably fall short until root causes such as poverty, racism and isolation are addressed.\u003c/p>\n\u003cp>“We’re giving people Narcan and saying, ‘Live, live, live, live — you have to live,’” she said. “The question that I want to ask everyone is, ‘What are we living for? What is there for people to grasp?’”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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