Coconino County Health and Human Services hopes to reduce overdoses. The CCHHS’ Opioid Overdose Prevention program is a harm reduction plan that distributes free at-home kits containing two doses of Narcan — a naloxone nasal spray — three fentanyl test strips, a CPR barrier mask and resource information for those struggling with opioid addiction.
The program was launched in 2017 and is likely to expand with an expected influx of funds from legal settlements with pharmaceutical and healthcare companies including Cardinal Health and Johnson & Johnson.
In 2011, approximately 2,600 deaths in the country were attributed to fentanyl and its derivatives. Last year 1,773 Arizonans died from opioid overdoses, with the majority of those deaths involving synthetic opioids such as fentanyl, according to a statement made by Gov. Katie Hobbs on March 21.
Arizona Gov. Doug Ducey declared the popularly-termed opioid crisis to be a public health emergency in 2017, and since then, programs like Coconino County’s have received grants from the Arizona Department of Health Services, the Centers for Disease Control and Prevention and other agencies to provide tools such as the Narcan kits and education to residents free of charge.
“Generally, 75% of our opioid-related deaths involve fentanyl,” program manager Candice Koenker said. “Everyone makes bad choices, but that doesn’t mean you should die as a result. These kits are saving lives and are allowing people the opportunity to get clean.”
CCHHS has been designated the lead agency for distributing nearly $4 million of the county’s share of settlement funds over the next 18 years. A total of $542 million has been awarded across Arizona so far.
“Coconino County’s share in the settlement … will be distributed among local governments to fund programs to aid in treatment, prevent overdose deaths and reduce other harms caused by substance use,” the county said in a March 30 press release. In addition, Coconino County is part of opioid settlements with Allergan, CVS, Teva and Walgreens and anticipates an additional award of $3 million.
The CCHHS Opioid Overdose Prevention program focuses on providing resources that can reduce harm for individuals experiencing addiction to opioids. These includes opioid overdose response kits containing Narcan and test strips, which can be picked up at or mailed from the CCHHS office in Flagstaff, or provided by peer support staff who work directly with people struggling with addiction.
Narcan is a powerful tool because it doesn’t have any side effects and can’t be overused, Koenker said. It has the ability to immediately reverse an opioid overdose, and has been in use in hospitals and by paramedics since 1971. Combined with prompt medical attention, it can prevent some opioid-related deaths. Its ubiquity is likely to increase after a recent decision by the Food & Drug Administration to allow it to be sold as an over-the-counter drug.
“At the county health department we have Narcan nasal sprays available free of charge for all Coconino County residents,” Koekner said. “We usually ask anyone who obtains a kit that they go through a quick training that we do that [is] one-on-one, it’ll often be five to 10 minutes, but we also provide more in-depth training for larger groups.”
The CCHHS kits also include fentanyl test strips that can detect the presence but not the amount of fentanyl in a substance. The kits feature the warning, “A negative result does not guarantee there is no fentanyl.”
CCHHS provides training on their use and also provides three single-use test strips.
“Oftentimes people buy drugs, not intending to [use] fentanyl, they might think it’s cocaine,” Koenker said. “But in reality that drug may contain fentanyl, because it was manufactured somewhere illegally.”
Fentanyl overdoses have been increasing, according to the Drug Enforcement Administration, due to the adulteration of other drugs with the more potent chemical, which can cause overdoses at low levels in those who have never used opioids.
In general, fentanyl is not readily absorbed into the bloodstream through the skin as long as the skin is dry, Koenker pointed out.
“If you have some kind of powder on your hand, you want to avoid touching your eyes, mouth or nose,” Koenker said. “If people come into contact with a pill and they’re not sure what it is or if they know it’s fentanyl, they should wash their hands with [soap and] water and not use hand sanitizer.”
CCHHS’ other harm reduction strategies include providing free deterra, or small bags with charcoal inside that deactivate drugs when water is added, allowing the drugs to be thrown away safely rather than flushed down a toilet, and prescription drug disposal drop boxes.
“We also have medication lock boxes available free of charge because we know that some people do have prescription opioids that they use [daily] for pain management,” Koenker said. “So they can lock those up so that people aren’t able to steal them, but also to prevent accidental poisonings if a kid should get a hold of that medication.”
Similar efforts have been made recently with Yavapai County’s Partners Against Narcotics Trafficking and MATForce’s Naloxone Leave Behind program, through which law enforcement now gives opioid treatment options along with Narcan when arriving at the scene of a suspected overdose. Last year, PANT responded to 145 reported overdoses and administered naloxone in 73 cases, according to Yavapai County.
Generally, CCHHS sets up appointments with agents in Flagstaff to conduct the training and issue Narcan and the test strips; however, everyone has the option to take the training over Zoom and have the kits mailed to them, Koenker said.
To locate a Narcan distribution site near you visit www.naloxoneaz.com
Additionally, for those residents wary of having to administer Narcan, on Monday, April 10, the state approved House Bill 2168, a new Good Samaritan law sponsored by Arizona Rep. Quang Nguyen [R-District 1], who represents the Verde Valley. Signed into law by Hobbs, HB 2168 protects people against prosecution if they provide naxolone treatment in good faith. Nguyen lauded this in a press release as an example of good policy that will help save lives in the face of a divided government.
Residents who want to obtain the kits should contact CCHHS at (928) 679-7264 or by email at jgormley@coconino.az.gov.
