Marin County is redoubling its efforts to get naloxone into the hands of people who need it to prevent drug overdoses.
Over the summer, the county added three new vending machines that supply naloxone kits free of charge, increasing the number of machines in the county to eight.
The county has also boosted the number of “nalox boxes” throughout the county to 13. The boxes, which are typically mounted on a wall, each contain about four to 10 doses of naloxone, while each vending machine holds 100 kits.
Naloxone, sometimes sold under the trade name Narcan, blocks the effects of opioids, which if administered in too large a dose can prove fatal by depressing the central nervous and respiratory systems.
“Naloxone basically sweeps the opioid off those central nervous system receptors,” said Dr. Matt Willis, Marin County public health officer. “The person will awaken sometimes very quickly and dramatically.”
Overdose is the leading cause of death for Marin County residents 55 and younger. In 2023, the county had 60 fatal overdoses, one fewer than the year before. Fatal overdoses in the county peaked at 65 cases in 2021.
The county recorded 463 non-fatal overdoses last year, up from 452 in 2022.
“In 46 of those cases, a bystander administered naloxone before an ambulance arrived,” Willis said. “That’s great, but our hope is to get much closer to 100%.”
Naloxone is administered as a nasal spray and is easy to use.
“We think the vending machines are one of the best strategies,” Willis said, “because it’s a no-questions-asked, totally free access point.”
People with private insurance or Medi-Cal can obtain naloxone free through their physicians. The kits in the vending machines are intended for people lacking insurance.
“Widespread availability of naloxone is a key strategy to save lives from overdose in Marin County,” said Dr. Todd Schirmer, director of Behavioral Health and Recovery Services, a county agency. “We’re excited to expand the availability of naloxone throughout the county.”
The new machines have been placed at the Marin Community Clinics campus at 6100 Redwood Blvd. in Novato, the Kaiser Permanente medical offices at 1650 Los Gamos Drive in San Rafael and the Marin City fire station at 850 Drake Ave.
The county made its first naloxone vending machine available in the lobby of the Marin County Jail in San Rafael in 2021.
“We’ve been adding them sequentially over the years,” Willis said.
The other four machines are located at the Ritter Center at 16 Ritter St. in San Rafael and at county health offices at 1 Sixth St. in Point Reyes Station, 120 N. Redwood Drive in San Rafael and 3240 Kerner Blvd. in San Rafael.
“Over 11,000 naloxone kits have been distributed over the past four years in vending machines in Marin County,” Willis said.
The kits, which cost about $20 to purchase over the counter in a drug store, and the vending machines, which cost about $6,000 each, are being paid for by the state’s Naloxone Distribution Project, which in turn receives funding from settlement agreements with pharmaceutical and drug distribution companies blamed for fueling the opioid epidemic.
As part of the program, the state also provides free fentanyl test strip kits so people can determine whether the drugs they’re taking contain fentanyl. Fentanyl is associated with approximately 60% of Marin County’s overdose deaths.
Willis said fentanyl is so powerful that it might take more than one dose of naloxone to counter its effects.
Willis said that Ritter Center is already distributing test kits. He said the county is eager to begin distributing the kits in the vending machines, but it needs to find a test kit that is sized to function with the machines.
Marin’s public health office began testing local wastewater last year to get an idea of the level of fentanyl use in the county. Willis said the level has remained fairly constant since then, although there have been peaks and valleys. When levels spike, local health workers are alerted to be on the lookout for more overdoses.
Willis said figures on overdoses in Marin this year are not yet available, but preliminary indications are that the numbers haven’t changed much from 2023.
