Title
City of Phoenix Naloxone Program: Administration and Community Take-Home Distribution
Description
This report provides the Economic Development and Housing subcommittee an update on implementation of the City of Phoenix naloxone program. This update covers the first quarter including the months of July, August, and September 2023.
THIS ITEM IS FOR INFORMATION AND DISCUSSION.
Report
Summary
In August of 2021, the City of Phoenix joined cities, towns, and counties across Arizona in signing on to the One Arizona Opioid Settlement Memorandum of Understanding (“One Arizona agreement”). The One Arizona Agreement outlines the distribution of the estimated $542 million dollars that Arizona will receive over 18 years. As part of the spending framework, 56 percent of the total settlement will be disbursed to local governments and 44 percent of the total settlement will remain with the State to fund future opioid programs and response efforts. The City of Phoenix receives 21.28 percent of the funding received by Maricopa County dispersed annually.
Under the One Arizona Opioid Settlement, funds must be used for future opioid strategies that are nationally recognized. Approved uses include evidence-based, evidence-informed strategies addressing:
- Treatment of Opioid Use Disorder (OUD).
- Support for people in treatment and recovery.
- Support for people who have or are at risk of developing OUD.
- Prevention of overdose deaths and other harms.
- Prevention of opioid misuse.
In 2022, there were approximately 991 fatal overdoses in the City of Phoenix accounting for more than half of all overdoses within Maricopa County. Majority of the overdose deaths in the city involved an opioid. Naloxone, commonly known as the brand Narcan® is a type of medication that can reverse an opioid overdose. Naloxone is an evidence-based and nationally recognized strategy to prevent opioid overdose deaths, highlighted by the Center for Disease (CDC) as one of the top 10 actions communities can take to prevent overdose fatalities.
In April of 2023, the Public Health staff presented to the Community and Cultural Investment (CCI) Subcommittee outlining activities and actions to be taken as part of the City’s opioid response planning including investigating the expansion of naloxone access through City departments and outreach opportunities.
The City of Phoenix Naloxone Program
The City of Phoenix launched the Naloxone Program Administrative Regulation (A.R.) 1.99 on July 17, 2023. The program expands upon the existing naloxone programs within the City and across Arizona supported by the Arizona Department of Health Services (ADHS) to make naloxone accessible to people who use drugs (PWUD), their friends, family, and those whose work brings them in contact with PWUD.
The City of Phoenix naloxone program includes training on opioid overdose and the use of naloxone and the following distribution methods:
Administration: Employees and non-employee volunteers elect to carry naloxone or have quick access to naloxone for overdose response. Participants are trained and can administer naloxone to someone experiencing an overdose.
Take-Home: Residents are provided a free naloxone kit through participating City of Phoenix departments via direct outreach or through physical City locations.
The goal of the Naloxone Program is to:
- Increase awareness of the signs and symptoms of opioid overdose.
- Increase awareness of naloxone for opioid overdose.
- Increase accessibility of naloxone.
- Increase efficacy for responding to overdose.
- Decrease overdose fatalities in Phoenix.
Opioid Overdose and Naloxone Training
Public Health staff developed opioid overdose and naloxone training in collaboration with Phoenix Fire, Human Resources, Phoenix TV, Communications and PHXYou. All City employees and non-employee volunteers are encouraged to complete the training. As of Oct. 1, 2023, 2,448, employees and non-employee volunteers have completed the training. Training will be reviewed and renewed on an annual basis.
Naloxone Distribution
On Aug. 14, 2023, the City publicly launched the Naloxone Program providing naloxone kits directly to residents through existing programs and services including at the City’s 17 library locations.
The following departments, offices, and programs are participating in one or both aspects of the Naloxone Program:
- Libraries
- Parks and Recreation
- Community Assistance Program (CAP)
- Housing
- Aviation
- Human Services
- Heat Response and Mitigation
- Homeless Solutions
- Neighborhood Services
To date 2,073 naloxone kits have been distributed through the Naloxone Program (includes administration and take-home). Kits through the program include:
- Two doses (4 mg) of Narcan® nasal spray;
- One pair of nitrile gloves;
- One breathing shield for CPR rescue breaths; and,
- An instructional pamphlet in English and Spanish.
The kits are free and there is no requirement to provide ID or documentation to receive one.
Overall, community response to the program has been positive. Library distribution has been in high demand and while the Public Health staff continue to restock on a month-to-month basis, supplies run out quickly. To support the program, naloxone has been provided on a limited basis by Maricopa County Department of Public Health (MCDPH) and monthly through the ADHS. Public Health staff anticipate needing to purchase annually to sustain the Program and ensure that critical programs serving PWUD, such as the Community Assistance Program and the Homeless Solutions staff, have a consistent supply. Pubic Health staff are currently working on creating a forecast and plan to determine an annual budget.
Financial Impact
To support the Naloxone Program, Public Health staff orders naloxone monthly at no cost through the ADHS. In addition, the City received a one-time order of naloxone through limited grant funds provided by the MCDPH, which assisted in establishing the program across departments.
The remainder of materials to support the program including kit materials, printing, advertising etc., are funded through the City’s One Arizona Settlement dollars. Naloxone is an approved abatement strategy and allowable expense under this agreement. To date, approximately $20,000 dollars have been spent to support the Naloxone Program. Public Health staff anticipate the total cost of the program for the Fiscal Year 2023-24 to be approximately $300,000 dollars. This budget allows for the purchase of kit materials, program promotion and ordering a limited supply of nasal naloxone as described in this report.
Concurrence/Previous Council Action
- The Office of Public Health staff presented to the Community and Cultural Investment Subcommittee on April 5, 2023, providing an update on the plan for a naloxone program expansion within the City of Phoenix with a proposed launch of summer 2023.
Department
Responsible Department
This item is submitted by Assistant City Manager Lori Bays and the Office of Public Health.