Fatal & Non-Fatal Opioid Overdoses in Marin County: Using EMS and county data to locate the presence of fentanyl, naloxone distribution, and repeat overdoses events

In recent years, the United States has been greatly affected by prescription drug overdose deaths, 68% of which are caused by opioids. Like many communities nationwide, Marin County in California is deeply affected by the opioid epidemic with accidental overdose being one of the leading causes of injury-related death. This study examines how fatal and non-fatal opioid overdoses in Marin County are associated with factors such as suspected fentanyl involvement, naloxone administration (EMS and in the community), and repeat overdose events. A cross-sectional study was conducted by Marin County’s Health and Human Services using data collected from EMS dispatch calls and vital statistical records. Logistic regression was used to study the relationship between fatal and non-fatal overdoses and factors associated with the EMS event such as suspected fentanyl involvement, use of naloxone, and repeat suspect overdose. A spatial analysis was conducted using a Geographical Information System software examining the distribution of fatal and non-fatal overdoses in Marin County in relation to three variables: suspected fentanyl involvement, presence of naloxone, and whether the incident was a repeat overdose. With the findings of the study, the authors hope to suggest effective interventions to address fentanyl hot spots and increase the distribution of naloxone especially in areas with high risk of fatal and non-fatal overdoses. Additionally, these results will inform on-going efforts locally to offer naloxone trainings to communities affected by the hot spots to teach of its harm reduction properties and how to properly use a kit when encountering an overdose. Trusted messengers and case managers can be utilized in hard-to-reach communities such as the homeless community to easily access trainings. Lastly, understanding factors associated with repeat non-fatal overdoses in Marin County will allow health professionals to understand and predict patterns in overdoses.