San Luis Obispo County racked up opioid overdose deaths at a rate that's 55 percent higher than California's, according to a New Times analysis of California Department of Public Health data.

The worrying statistic caused local opioid overdose awareness groups to commemorate International Overdose Awareness Day at Mitchell Park on Aug. 31.

"I think the increase could be attributed to the collision of fentanyl's presence in the drug supply rising and the COVID-19 pandemic. Fentanyl was already starting to increase prior to the pandemic, particularly here on the West Coast. Then adding the stressors of the pandemic (financial, social, health, etc.) certainly affected substance use and treatment/recovery," said SLO Opioid Safety Coalition Coordinator Jennifer Rhoads.

Fentanyl is a cheap and sometimes deadly synthetic opioid that other drugs are often cut with. Rhoads said that opioid overdose deaths rose all over California. But fatal overdoses in SLO County during 2020 almost quadrupled from 2019, according to data from the SLO County Sheriff's Office.

It's not just the dose that can make fentanyl deadly: It's mostly used in small quantities, Rhoads said, which is why it's a financially lucrative option. Fentanyl's combination with other drugs packs a lethal one-two punch, she said.

"It's very difficult for the FDA to regulate it. But they cannot keep banning all these chemicals because the chemicals inherently aren't bad. They could be used for wonderful medications that we need," Rhoads said.

Anecdotally, Rhoads and her team believe that prescription drug use went down during the pandemic, meaning that there were fewer instances of new users who could potentially develop opioid dependence. They say that a different kind of climb took place.

"Folks who were already using different substances, their use increased," she said.

In general, people use substances as self-medication or as a coping strategy, Rhoads said.

"But the pandemic probably included some barriers to treatment, whether it was the fear of going out, not knowing how to access telehealth treatment if that was available to them, transportation to get to in-person appointments," she said.

In addition, the pandemic-induced lockdown likely caused some people who were on the fence about getting treatment to put it off, Rhoads said. The Aug. 31 Mitchell Park gathering aimed to increase awareness about the importance of treatment.

SLO Bangers, a community initiative that focuses on harm reduction, gave out free naloxone (Narcan) during the gathering and provided tutorials on how to administer it. Narcan is an opioid antidote that's taken nasally or intra-muscularly to neutralize the effects of an overdose.

"It's kind of a wonder drug. It's really important to use and for people to have [stocked up]," said SLO Bangers Narcan trainer and Communicable Disease Investigator Maya Lavorando.

Narcan triggers the feelings of withdrawal, which is why Lavorando recommended that people should be supervised for 24 to 90 minutes because the urge to use opioids would kick in during that time.

"Learning how Narcan works and having it available at your house helps, because you never know," said SLO County Overdose Awareness founder Kim Lacey, who lost her son to fatal overdose five years ago. "My son was a guest at somebody else's home when he overdosed. They weren't using, and they didn't know that my son was using. So they certainly didn't have naloxone in the house. By the time they called 911, it was too late."

Lacey learned that she wasn't alone in her grief when she banded together with community members to provide free resources to the public who are going through problems with opioids.

"We want to try to meet people where they are. It's very hard to make people make what you think are good choices. Listening is the greatest gift because sometimes people don't want you to fix their problems. They just want to be heard," she said.

Her organization also aims to educate people to approach others with opioid dependency without judgment. Rhoads mentioned that they strive to present the problem as a medical condition rather than a moral choice.

"Ways that have been helpful for me are to think about people who have diabetes or heart disease. We're better as a society about not judging people for that. We treat it, and give them another a chance to live and to maybe do better the next day," Lacey said. Δ