‘Fentanyl is no joke’: San Mateo County leaders talk risks and tools for addressing fentanyl crisis

Becker was joined by a panel of experts Thursday for a discussion about the dangers of fentanyl, a highly potent synthetic painkiller, and what’s being done to address the risks of the drug.

On the panel was county Superintendent Nancy Magee, Santa Clara County Supervisor Otto Lee, Dr. Windy McNerney, a clinical assistant professor at Psychiatry and Behavioral Sciences at Stanford School of Medicine and research health specialist at the VA Palo Alto’s Sierra Pacific Mental Illness Research, Education, and Clinical Center, and parent activists Ed Ternan, with Songs for Charlie, and Elizabeth Walker, with the Colin Walker Foundation.

Though coming from differing backgrounds, the panelists largely agreed access to drug testing strips and naloxone, a treatment for preventing overdose, needs to be expanded and parents need to be better equipped to talk to their children about the risks of consuming drugs that may be laced with fentanyl.

The drug has dramatically changed the overdose crisis, Lee said. In the past, officials and experts were focused on implementing interventions to pull people out of addiction before overdosing. Now, Lee said fentanyl’s ever-growing presence on the street drug scene is leading to more deaths among younger and first-time users given that only a very small amount is needed to cause an overdose.

Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine, Becker said. People often turn to the drug because of its strength, helping to numb various mental, emotional or physical pains, McNerney said. But it’s also extremely addictive, she noted, and as a person uses the painkiller they grow immune to its effects requiring greater amounts to reach the same effect.

Nationally, Becker said drug overdoses increased by 30% between 2019-20 and 15% between 2020-21. Overdose deaths increased by 94% among people ages 14 to 18 from 2019-20 and 20% the following year, he said. In San Mateo County, 134 people died by overdose in 2021, Becker said, noting that number dropped in 2022.

“Many of us have stood beside friends and family members battling the grip of opioid use. The fentanyl crisis ranks among the most formidable challenges to public health and safety in our time and it compels us to dive deeper into nuances,” Becker said.

Personal impacts

Walker and Ternan both lost their sons to fentanyl poisoning, “a club no parent wants to belong to,” Ternan said. Ternan’s son Charlie died after taking a laced Percocet while Walker, a San Carlos resident, lost her son Colin after he took cocaine laced with fentanyl.

Both parents turned their tragedies into community education campaigns aimed at encouraging young people to turn toward healthier coping mechanisms than drugs and educating parents on how to talk to their children about the rising dangers of consuming illicit drugs they say kids are now easily accessing through social media platforms.

Rather than the “just say no” campaigns previously employed to steer kids away from drugs, Ternan said a more effective and realistic approach is to educate kids on the facts of drugs without exaggerations. A key method for getting through to young people is to encourage them to keep an eye on the safety of their friends, he said.

“Have the conversations, study up, learn the facts, cut through the white noise and misinformation. Have factual, honest conversations as families and as schools and as communities. That’s what we can control and that’s what’s going to have a real impact on the demand side if we just focus on making each other smarter about this and protecting ourselves from this new risk,” Ternan said.

Addressing the crisis

The panel also agreed that young people and the adults around them should be well informed on harm reduction and overdose intervention tools including when and how to use drug testing strips and naloxone, commonly referred to by its brand name Narcan.

Naloxone is becoming more widely available, the panelists noted. Pharmacies have been given the green light to sell the medication over the counter and should begin doing so in a few weeks and many medical centers, hospitals and other community sites offer the medication and training on how to use it to the public for free.

Magee, who shared that her son also struggled with drug addiction beginning in high school, said every school campus in the county is now equipped with the medication and all school employees have been educated on how to administer it. No campus has asked for additional overdose kits since they were distributed in January, Magee said, noting that while that’s a good sign, it doesn’t mean students aren’t using drugs.

Similar measures are being taken in Santa Clara County. Lee said jurisdictions need to go further to protect their communities by ensuring every bar and other gathering space is equipped with testing strips and overdose kits.

Beyond public spaces, Lee said every person should carry naloxone with them either on their person or in their car, especially if they or their friends use drugs. He also implored those who do have naloxone to use it immediately if they believe someone may be suffering from an overdose, noting the medication is easy to administer and won’t harm someone if they’re not experiencing an overdose.

“Fentanyl is no joke,” Lee said. “You just don’t know when [naloxone] will come in handy to save somebody’s life.”

Anyone who does administer naloxone should immediately call an ambulance and be prepared to possibly administer a second dose, McNerney said. She noted hospitals in Oakland are now sending anyone who enters a hospital for an overdose home with educational materials on addiction and naloxone, and shared hope the practice will be adopted more widely.

As for drug testing strips, she and other panelists noted that while they’re an important harm reduction tool, they’re not foolproof. They can’t determine how much fentanyl is present and testing a pressed pill would require destroying the pill given that fentanyl could be concentrated in one part of a pill and not the other. If one pill comes back negative for fentanyl another pill purchased in the same bunch could be laced, they also noted.

Moving forward, Mcnerney also underscored the importance of combating stigmas around consuming other medications for treating drug addiction like Buprenorphine and Methadone, seeking care at treatment facilities and making access to such treatments easier.

“We are in the most innovative region in the world and I think if we come together and we talk about the biology, and the sociology and the policy, this is where we’re going to come up with a solution that works,” McNerney said. “So I hope that everyone on this call is completely motivated just to get busy, get thinking and start saving lives.”