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in El Dorado County

El Dorado COPE created a Fighting Fentanyl in EDC campaign to address the national, state-wide, & local increases in fentanyl substance use & fentanyl-related overdoses. It provides the EDC community with comprehensive & easily-accessible information regarding fentanyl, substance use disorders, treatment, and how to respond when someone overdoses. The information can be easily accessed and distributed via our campaign graphics: a brochure, wallet cards, social media graphics, and the El Dorado COPE website campaign page.

CAMPAIGN BROCHURE

THE FIGHTING FENTANYL CAMPAIGN

 

ABOUT FENTANYL

 

“Over 150 people die every day from overdoses related to synthetic opioids like fentanyl.”

Fentanyl is NOT
NARCAN/Naloxone resistant.
A
...it just might take a little more NARCAN/Naloxone

Powdered fentanyl looks just like many other drugs. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids.

Fentanyl is a synthetic opioid that can be:

40xs

stronger than heroin

100xs

stronger than morphine

you do not always know what/ how much you are using

Street names for IMF include:

Apache

•Dance Fever

•Friend

•Goodfellas

•Jackpot

•Murder 8

•Tango & Cash

Merriam-Webster defines fentanyl as:

a synthetic opioid narcotic analgesic with pharmacological action like morphine that is administered transdermally as a skin patch and in the form of its citrate where it is administered orally or by injection.
(as it relates to medicinally purposes)

Two types of fentanyl: 
pharmaceutical fentanyl & illicitly manufactured fentanyl (IMF) 

Pharmaceutical fentanyl is prescribed by doctors to treat severe pain. Most recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl. It's often added to other drugs because of its extreme potency. This makes it cheaper and more powerful, addictive, and dangerous.

Rainbow Fentanyl –fentanyl pills and powder comes in a variety of bright colors, shapes, and sizes. (www.DEA.gov)

Where do we
see fentanyl?

  • Alone as a “crumbly” powder

  • Adulterated in heroin (very little heroin in EDC)

  • Illicit pills

  • Cocaine and methamphetamines – driving increase in stimulant overdose deaths

What is "illicit" fentanyl?

  • Synthetic opioid

  • Not detected on most urine drug screens

  • Significant variation in type, potency & purity which increases risk of overdose

  • Repeated use leads to accumulation in adipose tissue –slowly leaves fat stores 

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FENTANYL TEST STRIPS

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FENTANYL IN EL DORADO COUNTY

 

“Welcome to the California Overdose Surveillance Dashboard.” CA Overdose Dashboard, California Department of Public Health, https://skylab.cdph.ca.gov/ODdash/?tab=CTY

FENTANYL IN

CALIFORNIA

FENTANYL IN

THE UNITED

STATES

TERMS + DEFINITIONS 

 
  • BUPRENORPHINE

    • ​Buprenorphine is a medication approved by the Food and Drug Administration (FDA) to treat Opioid Use Disorder (OUD) as a medication-assisted treatment (MAT). As with all medications used in MAT, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to provide patients with a whole-person approach. (Substance Abuse and Mental Health Services Administration, SAMHSA)

  • FENTANYL:

    • **insert defintion here**​​

  • HARM REDUCTION: 

    • Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs. (National Harm Reduction Coalition) 

  • MEDICATION ASSISTED TREATMENT: 

    • ​Medication Assisted Treatment Service is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.

  • METHADONE:

    • Methadone is a medication approved by the Food and Drug Administration (FDA) to treat Opioid Use Disorder (OUD) as a medication-assisted treatment (MAT), as well as for pain management. When taken as prescribed, methadone is safe and effective. Methadone helps individuals achieve and sustain recovery and to reclaim active and meaningful lives. Methadone is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies to provide patients with a whole-person approach. (Substance Abuse and Mental Health Services Administration, SAMHSA)

  • NARCAN/Naloxone:

    • Naloxone is a medication approved by the Food and Drug Administration (FDA) designed to rapidly reverse opioid overdose. The medication can be given by intranasal spray (into the nose), intramuscular (into the muscle), subcutaneous (under the skin), or intravenous injection. (Substance Abuse and Mental Health Services Administration, SAMHSA)

  • OPIOID OVERDOSE:

    • Opioid intake to the point of respiratory depression.

      • Respiratory depression, refers to slow, shallow, and ineffective breathing. (Banyan Treatment Center)

  • RECOVERY: 

    • A process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. (Substance Abuse and Mental Health Services Administration, SAMHSA)

      • Guiding Principle: Hope, the belief that these challenges and conditions can be overcome, is the foundation of recovery.

  • STIGMA:​

    • A strong feeling of disapproval that most people in a society have about something, especially when this is unfair. (Cambridge Dictionary)

    • An attribute, behavior, or reputation that is socially discrediting, and substance-related problems appear to be particularly susceptible to stigma. (International Journal on Drug Policy)

  • SUBOXONE:

    • ​SUBOXONE (buprenorphine and naloxone) Sublingual Film® (CIII) is a prescription medicine used to treat opioid addiction in adults and is part of a complete treatment program that also includes counseling and behavioral therapy. (www.suboxone.com)

  •  SUBSTANCE USE DISORDER (SUD): 

    • A Substance Use Disorder (SUD) is a dependence on alcohol, street drugs or prescriptions medications for non-medical purposes.

  • SUD SERVICES:

    • Substance Use Disorder Services are drug and alcohol counseling, medication assisted treatment, detoxification and inpatient and outpatient rehabilitation​

WHAT IS STIGMA?

A strong feeling of disapproval that most people in a society have about something, especially when this is unfair. (Cambridge Dictionary)

An attribute, behavior, or reputation that is socially discrediting, and substance-related problems appear to be particularly susceptible to stigma.

(International Journal on Drug Policy)

  • MORE than just Stereotyping 

    • Ideas and attitudes that generalize and label groups 

  • MORE than just Prejudice 

    • Endorsing and promoting harmful beliefs within stereotypes 

  • MORE than just Discrimination 

    • Practices and behaviors that promote inequity toward labeled groups

Stigma on 3 levels: 

  1. Structural-Stigma: laws, regulations, politics

    • EX: State health agency boards who make decisions, with no representation of individuals with lived experience 

  2. Public-Stigma: attitudes, beliefs, and behaviors of individuals and groups 

    • EX: Neighborhood perspectives regarding the presence of drug activity

  3. Self-Stigma: internalized negative stereotypes

    • EX: Believing that you’re not worth treatment

STIGMA IMPACTS 
RECOVERY

  • Reduces willingness to seek professional support: 

    • Fear of being looked down upon, stereotyped, etc. 

  • Causes reluctance + aversion to attend treatment 

  • Limits access to healthcare, housing, aftercare, community support, + employment

Impacts on Stigmatized Populations:

  • Increase in adverse outcomes 

  • Diminished self-esteem 

  • Affects personal relationships at a time they are needed the most

  • Increases involvement in risky behaviors

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WHAT IS HARM REDUCTION?

Examples of Harm Reduction:

  • Overdose Prevention

  • Syringe exchange

  • Disease testing

  • Disposal containers

  • NARCAN/Naloxone training

  • Referral to treatment + resources 

"Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, + respect for, the rights of people who use drugs."

-National Harm Reduction Coalition 

The National Harm Reduction Coalition: 

"Harm reduction incorporates a spectrum of strategies that includes safer use, managed use, abstinence, meeting people who use drugs “where they’re at,” and addressing conditions of use along with the use itself.

Because harm reduction demands that interventions and policies designed to serve people who use drugs reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction."

-National Harm Reduction Coalition 

Some Principles of Harm Reduction:

  1. Accepts, for better or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them

  2. Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm

  3. Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm

  4. Does not attempt to minimize or ignore the real and tragic harm and danger that can be associated with illicit drug use

SIGNS OF AN OVERDOSE

 

Are they High or Overdosing?

(on opioids)

    a. Are they responsive?

    b. Are they breathing?

If yes to both, they’re just high

Here are some things to look for:

  • Small, constricted “pinpoint pupils”

  • Falling asleep or losing consciousness

  • Slow, weak, or no breathing

  • Choking or gurgling sounds

  • Limp body

  • Cold and/or clammy skin

  • Discolored skin (especially in lips & nails)

    • Caucasian: Blue/Purple

    • BIPOC: Grey-ish 

"Recognizing the signs of opioid overdose can save a life."

WHAT TO DO IF SOMEONE OVERDOSES
(on opioids)

 
  1. ASSESS AND STIMULATE 

    1.  Asses yourself and the situation   

      1.  Are you able to assist at the moment?

      2.  Is it safe for you to assist? ​​

    2. Stimulate 

      1.  VERBAL: YELL. Explain what you're doing before doing it.

        1.  Ex: "I am going to give you NARCAN if you don't wake up!"

      2.  PHYSICAL: Arm pinch, sternum rub, etc. 

  2.  CALLING 911

    1.  Give minimal information: 

      1.  Location ​

      2.  Say "We have a person down. They are not breathing. Suspect an overdose."​

        1.  This will ACTIVATE the Good Samaritan Law​ and your protections

        2.  Do NOT interfere with first responders, step back. You will be risking your Good Samaritan Law protections otherwise

    2.  If you're by yourself:​

      1.  Call 911 

      2.  Retrieve and Administer NARCAN/Naloxone

      3. Preform RESUCE BREATHING

    3.  If you're in a group:

      1.  Delegate roles​

      2. Point to someone and say "Call 9ll"

      3. YELL out "Does anyone have NARCAN/Naloxone?"​

        1. Retrieve and Administer NARCAN/Naloxone

      4. Preform RESCUE BREATHING

  3.  ADMINISTER NARCAN/NALOXONE 

    1.  Nasal NARCAN Tip:​

      1.  Do NOT test (one dose per bottle)​

      2.  3-5 minutes to work 

    2. Intramuscular Naloxone Tip:​

      1.  Draw ALL fluid into the needle​

      2.  Inject needle straight into the upper side of the arm or middle side of the thigh (do not inject into the butt)

  4.  PUT THE PERSON IN THE RECOVERY POSITION​

    1.  Lay them on their side with the bottom arm extended out, the top arm under the head, and the top knee supporting them on their side​

  5.  STAY WITH THE PERSON UNTIL EMERGENCY ASSISTANCE  ARRIVES

    1.  If you must leave, leave the person in THE RECOVERY POSITION 

THE RECOVERY POSITION

WHEN TO ADMINISTER A 2ND DOSE OF NARCAN

If the person is not awake in 2.55-3 minutes OR stops breathing

again... 

 


Administer another dose in the other nostril
 


(repeat process)

HOW TO ADMINISTER NARCAN/Naloxone

  1. Remove NARCAN/Naloxone spray from the box
  2. Peel Back the tab with the circle to open 
  3. Place your thumb on the bottom and your middle/index fingers on either side of the top
  4. Tilt the persons head back and support the under the neck with your hand 
  5. Insert entirely into the nostril and press plunger to administer the full dose
AdministeringNARCAN.jpg

What is NARCAN / Naloxone?

Naloxone is a medication approved by the Food and Drug Administration (FDA) designed to rapidly reverse opioid overdose.

WHERE TO GET
NARCAN
+ NALOXONE

FREE

Marshall Medical Center -Emergency Department

  • Only in the Emergency Department or Hospital 

  • Patients, family, friends

El Dorado Community Health Center 

  • All clinic locations 

  • Walk-in requests welcome

Sierra Harm Reduction Coalition

  • Delivery

Shingle Springs Health & Wellness Center

  • ***TBD***

PREFORMING RESCUE BREATHING

  1. Place face shield **optional**
  2. Tilt head back, lift chin, & pinch nose
  3. Give one breath into the mouth every  seconds 
  4. Administer a second dose if:
    1. There is no breathing after 2-3 minutes
    2. If the person stops breathing again
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KNOW YOUR RIGHTS

 

THE GOOD
SAMARITAIN
LAW

California’s 911 Good Samaritan Law provides limited protection from arrest, charge and prosecution for people who seek emergency medical assistance at the scene of a suspected drug overdose.

When calling 911 services, say:

**Give Location**

"We have a person down. They are not breathing. Suspect an overdose."​

This will activate the Good Samaritan Law​ and your protections

​Do not interfere with first responders.

Step Back.

You will be risking your Good Samaritan Law protections otherwise

​Witnesses are protected  even if they exhibit...

  • Under the influence of drugs 

  • In possession of small amounts of drugs 

  • In possession of drug paraphernalia 

RESOURCES + TREATMENT

 

MEDICATION-ASSISTED
TREATMENT

IN EL DORADO COUNTY

(530) 543-5623

2201 South Avenue, South Lake Tahoe

(530) 387-4185

5168 Honpie Road,

Placerville

(530) 621-7965

1045 Marshall Way, 

Placerville

(530) 621-7700

4327 Golden Center Drive, Placerville

4641 Missouri Flat Road,

Placerville

Definition of Medication Assisted Treatment: 

 

Medication Assisted Treatment Service is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.

SUBSTANCE USE DISORDER SERVICES
IN EL DORADO COUNTY

1-800-929-1955

929 Spring Street,

Placerville

1900 Lake Tahoe Blvd,

South Lake Tahoe

(530) 626-9240

2844 Coloma Street,

Placerville

RECOVERY IN ACTION

(530) 344-7633

485 Pleasant Valley Rd, Diamond Springs

NARCAN/Naloxone FREE
IN EL DORADO COUNTY

HOTLINE:

(530) 212-0279

Delivery Only

(530) 387-4185

5168 Honpie Road, Placerville

  • TBD

(530) 543-5623

2201 South Avenue, South Lake Tahoe

  • TBD

(530) 621-7965

1045 Marshall Way, Placerville

  • Only in the Emergency Department or Hospital 

  • Patients, family, friends

(530) 621-7700

4327 Golden Center Drive,

Placerville

4641 Missouri Flat Road,

Placerville

  • All clinic locations 

  • Walk-in requests welcome

Definition of  NARCAN / Naloxone: 

 

Naloxone is a medication approved by the Food and Drug Administration (FDA) designed to rapidly reverse opioid overdose.

The medication can be given into the nose, into the muscle, under the skin, or intravenous injection.

HARM REDUCTION SERVICES
IN EL DORADO COUNTY

Sierra Harm Reduction Coalition (SHRC) services provide positive reinforcement to catalyze change for individuals using drugs in the unique community of EDC.

 

Their commitment is to scrape away the barriers created by stigma & discrimination towards drug users.

Their services include:

  • Safer Using Kit Distribution

  • Syringe exchange

  • Litter cleanup

  • Disease testing

  • Disposal containers

  • Naloxone training

  • Referrals to essential services 

HOTLINE
(530) 212-0279

CAMPAIGN GRAPHICS (ENGLISH)

 

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CAMPAIGN PARTNERS

 

CAMPAIGN CITATIONS

 

“Buprenorphine.” Substance Abuse and Mental Health Services Administration , SAMHSA, 27 Sept. 2022, https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine.

“Dea Warns of Brightly-Colored Fentanyl Used to Target Young Americans.” DEA, United States Drug Enforcement Administration, 30 Aug. 2022, https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans.

 

“DOPE Project Monthly Overdose Prevention & Naloxone Administration Training.” DOPE Project, 16 Aug. 2022.

“Fentanyl.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/fentanyl. Accessed 25 Oct. 2022.

 

“Fentanyl Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Feb. 2022, https://www.cdc.gov/stopoverdose/fentanyl/index.html

 

"Fentanyl and Overdose Prevention." Jay, D, Marshall Medical Center. [PPT]. 2022

“For Opioid Dependence: SUBOXONE (Buprenorphine and Naloxone) Sublingual Film® (CIII).” Patient Information for SUBOXONE® (Buprenorphine and Naloxone) Sublingual Film (CIII), Indivior PLC, https://www.suboxone.com/

"The Good Samaritan Law." Ewing, Tom, Sierra Harm Reduction Coalition. [PDF]. 2021

“Good Samaritan Laws.” County of Santa Clara Behavioral Health Services , County of Santa Clara , https://bhsd.sccgov.org/information-resources/opioid-overdose-prevention-project/good-samaritan-laws 

"Know Your Rights." Ewing, Tom, Sierra Harm Reduction Coalition. [PDF]. 2021

“Methadone.” Substance Abuse and Mental Health Services Administration , SAMHSA, 27 Sept. 2022, https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone 

"Naloxone." Substance Abuse and Mental Health Services Administration , SAMHSA, 27 Sept. 2022,  https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone

“Naloxone in New Hampshire .” Anyone. Anytime. New Hampshire, Anyone.Anytime.NH, https://anyoneanytimenh.org/naloxone-in-new-hampshire/

“National Harm Reduction Coalition.” Principles of Harm Reduction , National Harm Reduction Coalition, 31 Oct. 2022, https://harmreduction.org/about-us/principles-of-harm-reduction/

"Preventing and Disrupting Stigma Associated with Substance Use Disorders." Wrangham, Nigel, Northwest PTTC. [PPT]. (2022).

 

"Recovery and Recovery Support." Substance Abuse and Mental Health Services Administration , SAMHSA, 13 Sept. 2022, https://www.samhsa.gov/find-help/recovery 

“Stigma.” Cambridge Dictionary, Cambridge University Press, https://dictionary.cambridge.org/us/dictionary/english/stigma

"Testing For Fentanyl." Ewing, Tom, Sierra Harm Reduction Coalition. [PDF]. 2022

"Using Narcan (Naloxone)." Ewing, Tom, Sierra Harm Reduction. [PDF]. 2022

“Welcome to the California Overdose Surveillance Dashboard.” CA Overdose Dashboard, California Department of Public Health, https://skylab.cdph.ca.gov/ODdash/?tab=CTY

“What Drugs Cause Respiratory Depression?” Shapper, Alyssa, Banyan Treatment Centers, 29 Dec. 2021, https://www.banyantreatmentcenter.com/2021/11/23/respiratory-depression-caused-by-drugs/

“Words Matter - Terms to Use and Avoid When Talking About Addiction.” National Institutes of Health, U.S. Department of Health and Human Services, 29 Nov. 2021, https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction.