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Center Point DAAC and the uphill fight to bring addiction treatment out of the abyss Keeping Recovery From Rock Bottom
Inside
56 Pulling treatment from the abyss 58 Lives in the balance 60 Going to the MAT 61 Vehicle for change 63 Second Chance in a Small Box
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Pulling treatment from the abyss I t’s challenging enough getting a person afflicted by addiction into recovery just once. Kai Denis, of Santa Rosa treatment nonprofit Center Point DAAC, will never forget the man who came back again and again. And again. The man was on parole and enrolled in the recovery center’s intensive outpatient program, recalls Denis, DAAC’s (Drug Abuse Alternatives Center) current By Jason Walsh [DAAC’s] resources were out there [for his own benefit]—he knew he had no excuse not to use it.” Today, the man has a “pretty decent
With addiction at a crisis point, Center Point DAAC looks to take its recovery model statewide
Santa Rosa this fall. Founded in Santa Rosa in 1969, DAAC emerged at a time when substance abuse was growing in the region and effective treatment and recovery services were limited. More than five decades later, the organization has expanded its services while continuing to adapt to changing trends in addiction and recovery. Today, DAAC leaders believe the organization's combination of medication-assisted treatment, medical oversight and long-term recovery support has created a framework that could serve as a model for treatment providers throughout California. High-quality, low cost Center Point DAAC has invested heavily in medication-assisted treatment and medically managed withdrawal services, offering care to Medi-Cal patients that advocates say is often difficult to find elsewhere in Northern California. Center Point DAAC leaders believe the organization's approach not only improves recovery outcomes locally, but could also serve as a model for treatment providers elsewhere in California. The goal has been to make comprehensive, evidence- based addiction treatment accessible to all patients, regardless of income. Central to that approach is DAAC's medically managed withdrawal program, supported by 24- hour nursing staff, an addiction-certified medical director and a deputy medical director. The organization takes a holistic approach to treatment, offering evaluations for anxiety and depression, blood and laboratory testing, physical health assessments and ongoing recovery support. When patients require services beyond DAAC's scope of care, staff coordinate referrals to the appropriate medical providers. By integrating medical, behavioral and recovery services under one umbrella, DAAC aims to provide a level of comprehensive care that is often difficult for Medi-Cal patients to access. David Panush is president of California Health Policy Strategies, a Sacramento-based consulting firm shaping policies to improve the state health- care system. He’s worked with Center Point DAAC on honing its treatment approach and views it as “part of what the system could be.” He juxtaposes the way traditional recovery treatment works versus other serious health conditions. “If you went to an emergency room
paying” job in the transportation industry, says Denis. Unfortunately, not every user is as committed to climbing their way out of addiction—and delivering the message about what recovery centers such as Center Point DAAC have to offer is a critical priority for the nonprofit. Expanding Access to Care Despite expanded treatment options and growing awareness of substance use disorders, many people still struggle to access care before their addiction reaches a crisis point. Center Point DAAC leaders say improving access to treatment and reducing barriers to entry remain among the organization's highest priorities. Center Point DAAC (Drug Abuse Alternatives Center and Center Point, Inc. merged in 2012), which along with a host of diversion and outpatient services operates the residential Dr. Sushma D. Taylor Recovery Center, has spent decades refining its approach to addiction treatment. The $7.6 million facility celebrates its first anniversary in
director of medication assisted treatment, who was the man’s counselor at the time. Disillusioned by a lack of employment, money and prospects, he would place Denis on the receiving end of his loud frustrations—angrily vowing to give up his recovery efforts and be sent back to prison, which would be “easier than doing all this.” Despite his initial dedication to the program, within a few months the man suffered a relapse. But he pulled himself together, re-enrolled in the program and graduated. Six months later, he suffered another relapse. But, again, he re-enrolled in treatment—this time in DAAC’s residential program. By this time, the man was so familiar with the program, “he could almost run the place himself,” says Denis. The staff was invested in his success and held him to a high standard, while newer DAAC clients looked to him as a role model. After nearly three years of struggle to overcome the grip of addiction, this time his recovery stuck. “It was significant,” Denis says of that success story. Because not all people who need treatment are as determined to make treatment work. “He was aware that
Staff at Center Point DAAC
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The Dr. Sushma D. Taylor Recovery Center celebrates its 1-year anniversary this fall 2025. [Duncan Garrett Photography]
for a heart attack, you’d expect to have follow-up care,” says Panush. “[The medical team] would find out what’s going on, have a treatment regime for you, and they would track that.” But if someone goes to an emergency department with an overdose, he points out, there’s rarely adequate managed care after they’re discharged. “If two-thirds of people coming into an emergency department with an overdose are not getting follow up, that needs addressing,” says Panush. “No other disease sees this kind of lack of follow-up care.” Adds Panush: “[Center Point DAAC] is not only addressing this from a communication standpoint but is actually bringing people together—they’re developing the relationships so you can have follow-up care, or [preventative] so people don’t wind up in the emergency room to begin with.” One of those relationships is with Sonoma County Behavioral Health Services, which oversees contracts for the various programs partnered with the county—and Center Point DAAC is among its largest contractors. When users seek admittance to DAAC’s residential program, the state requires county authorization within 24 hours, a tight window subject to bureaucratic delays. Will Gayowski, program manager at Sonoma County Behavioral Health Services, says they’ve worked with DAAC to streamline the admittance process and recent averages have been under 24 hours. Gayowski describes the county’s work with DAAC as “long and fruitful,” and that “in terms of value of service and quality it’s probably the best it’s been in years.” Gayowski credits DAAC’s growth to its ability to attract “higher quality employees.” “DAAC has a really strong partnership with our federally qualified health centers, so they get good MDs,” says Gayowski. “They’ve built up their medical model and are having a more medically directed and supported withdrawal experience that’s safer and more effective.”
Rising Demand, Uncertain Funding Center Point DAAC leaders say client safety remains the guiding principle behind treatment decisions, even as potential funding challenges loom. But that lens could become foggier in 2026 when changes to federal spending on health care go into effect. More than $1 trillion in cuts to Medicaid spending are expected over the next 10 years, according to data from the Congressional Budget Office’s analysis of the recent legislation known as the One Big Beautiful Bill Act. Those cuts will trickle down to such state programs as Medi-Cal, potentially making it challenging for Center Point DAAC to sustain the high level of care that makes its programs successful. Meanwhile, at the top of DAAC’s priorities is public outreach—to let people know their services are available, far and wide. “The more information we can bring, the better,” says Denis. There’s misinformation about “the fear of withdrawal— how bad it’s going to be—which could be enough to scare people away from taking the first step.” But medication-assisted treatment mitigates all that, he says, and “there are a lot of people who are simply not aware.” Establishing a network Beyond Sonoma County, DAAC has an agreement with Partnership Health Plan of California—a nonprofit which networks with local providers such as DAAC to administer Medi-Cal benefits—to take client referrals from seven Northern California counties. It’s part of DAAC’s vision to address addiction from a statewide perspective; the nonprofit is working under the theory that many of the bureaucratic problems in recovery stem from local agencies working in silos, not as part of a broader network with the same goals. Through its partnership with Partnership Health Plan of California, DAAC now accepts referrals from seven Northern California counties. The effort reflects the organization's broader goal of
creating stronger referral networks and reducing barriers to treatment across county lines. Once DAAC establishes its data of improved treatment outcomes, they can convert that model to counties similarly situated to Sonoma—such as Fresno, another medium-sized county surrounded by rural counties. By tracking treatment outcomes and identifying successful practices, DAAC hopes to create a model that could be replicated in other regions facing similar addiction challenges. Meanwhile, the synthetic opioid crisis continues to claim lives. An estimated 7,137 people died from a fentanyl overdose in California in 2023, according to the California Department of Public Health. While the 2024 fentanyl-related deaths were down to just under 5,000 statewide, health experts are cautious to assume the tide has turned on the opioid epidemic, says Kristin Kolbinski, clinical director at Center Point DAAC. For instance, she says, a certain amount of fentanyl-related deaths may have been replaced by those from other emerging drugs like kratom. If anything, the opioid crisis is becoming more urgent. Kolbinski says the evolving drug landscape means treatment providers cannot afford to become complacent. While fentanyl-related deaths have declined from recent highs, the need for treatment, education and early intervention remains urgent. For Denis, the work comes back to the clients who return again and again until recovery finally takes hold. The path is rarely linear, but every successful recovery demonstrates what is possible when treatment remains available, accessible and persistent. "The resources are there," Denis says. "The important thing is helping people take that first step." n
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Lives in the balance
Getting users into treatment is the crucial step toward recovery
M elvy Ramos made a call about a dozen years ago that changed her life—personally and professionally. The North Bay woman reached out to Center Point DAAC (Drug Abuse Alternatives Center) when she hit what she bills as her “rock bottom.” Ramos, 38, became both a patient and eventually an employee for the Santa Rosa facility that focuses on offering comprehensive and compassionate treatment for substance abuse and addiction. That’s how much she believes in the mission of the center established in 1969 by a Sonoma County group concerned about the growth in drug abuse and led by Dr. Sushma Taylor. Drug addiction for Ramos started at 16 years old. “I remember it like yesterday. I was cutting classes and ended up in the woods [of Marin County],” she says. When someone whipped out a pipe and asked her to try it, she obliged. By Susan Wood
Reaching those who need help Ramos' story is not unique. Recovery professionals say many people
“It was all fun and games,” she says, adding her drug of choice was methamphetamine.
Her mother didn’t suspect she had a problem because she was an honor roll student, and Ramos demonstrated she had energy. “She was surprised the house was so clean,” Ramos says. But her drug use followed her into adulthood. The single mother of two lost nearly everything around 2012. Precious belongings dating back to her childhood were wiped away from a storage unit “in the blink of an eye.” She was also evicted from the hotel room she was living in, and says her roommate “tricked her” into signing over her car to the supposed “friend.” She was caught in a downward spiral. Facing the harsh reality of living on the streets, Ramos knew the situation would be devastating to her family. Despite her addiction, Ramos still had some fight in her. She maintained a job, so she felt somewhat functional. But she spent much of her money on drugs. “I didn’t think I had a problem,” she says. “It was like I was living two separate lives.” Something had to change. One of the managers at the Chipotle where she worked was a graduate of Center Point DAAC and suggested she consider the nonprofit’s treatment programs, saying the company would support her efforts. “I let them know my truth,” she says of her employer. And she entered into treatment at DAAC with the notion the life- altering experience would be short-lived. “I thought I was going to be there only 30 days.” It turned into a way of life. Her sobriety has lasted 12 years, and she now works at Center Point DAAC as an outpatient program manager. “This is not what I envisioned for a career,” she says. “I’m a new person.”
who enter treatment have spent years struggling with substance use before seeking help, often after reaching a personal or financial crisis point. Addiction and homelessness are often closely linked, with substance use disorders both contributing to and being exacerbated by housing instability and untreated mental health challenges. Despite a recent uptick in meth use, the dominant culprit of drug abuse today remains fentanyl, a potent synthetic opioid. The problem with the substance approved by the U.S. Food and Drug Administration for pain relief is it’s 100 times more potent than morphine and 50 times more than heroin, according to the U.S. Drug Enforcement Administration. Even small amounts can prove fatal. The problem is compounded when other drugs are cut with fentanyl, allowing the synthetic opioid to go undetected by users who may not realize they are consuming it. Across California and the nation, numerous overdose deaths have been linked to substances sold as cocaine, counterfeit pills and other drugs that were unknowingly laced with fentanyl. The increased availability of Narcan, a medication used to reverse opioid overdoses, has also become an important tool in preventing fatalities. Staff at Center Point DAAC recall a recent incident in which a man rushed into one of the organization's facilities seeking Narcan after believing a Melvy Ramos, outpatient program manager for women and children services.
Kai Denis and Alisha Pepper inside the MAT van
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The Dr. Sushma D. Taylor Recovery Center, at 790 Sonoma Ave. in Santa Rosa, is the newest facility in DAAC’s $12 million annual operation. [Duncan Garrett Photography]
user to come and go from their daily activities. n Residential, which at a more intensive level of treatment, houses the client in a more structured environment with 10 beds available. n Medication-assisted treatment (MAT) that combines medications with counseling and behavioral therapies to promote long-term recovery. n Counseling and therapy, whether individual or group, makes for an integral part of recovery. n Family support, which integrates family members into the healing process. The combined organization (Center Point and DAAC merged in 2012) receives 90% of its funding from Medicaid and Medi-
friend was overdosing. The medication was administered in time to save the individual's life. Challenges ahead Center Point DAAC’s “census,” as in its client and patient population, stands at about 400 people, consisting of residents under treatment. The bulk of those who use the service are considered “outpatient” clients. Operating as the management company with a $20 million annual budget and three locations, DAAC provides an assortment of substance disorder treatment services. They include: n Assessment and evaluation as an initial examination. n Outpatient programs that allow the
began Oct. 1. Like many treatment providers, Center Point DAAC is closely monitoring potential changes to Medicaid funding. Because the organization receives approximately 90% of its funding through Medicaid and Medi- Cal programs, any reductions could affect addiction treatment services statewide. Treatment providers are also facing workforce challenges, including shortages of intake staff and the lengthy credentialing and training processes required before new employees can begin serving clients. Those constraints can contribute to longer wait times for individuals seeking treatment. Despite those challenges, Center Point DAAC's staff remains focused on expanding access to treatment and reducing barriers to care. One concept gaining attention is "treatment on demand," an approach designed to connect individuals with services as soon as they seek help, rather than placing them on waiting lists or requiring multiple appointments before treatment can begin. Advocates say reducing delays is critical, as individuals are often most receptive to treatment during a narrow window when they decide they are ready to seek help. n
Cal, along with some private pay accounts. The verdict is out on how proposed Medicaid cuts will play out since the current federal budget calls for reductions starting next year. U.S. Senate Democrats cite cuts to Medicaid as the reason they didn’t vote for a resolution to fund the federal government, resulting in a shutdown that
Learn more at cpdaac.org
The 10-bed residential program offers a structured recovery environment. [Duncan Garrett Photography]
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Going to the MAT Why recovery programs like Center Point DAAC champion medication-assisted treatment By Susan Wood W ith substance use growing, North Bay health officials and managers with treatment services want to provide a shot in the arm to combat the body—thus reducing the euphoric highs and lows n Buprenorphine, a partial agonist that lacks the full effects of other semi-synthetic opioids in the same class, but it’s long-acting, works slowly and prevents cravings McKibbin, Center Point DAAC substance use disorder counselor.
Methadone, for instance, was developed by a German
problem. That’s why medication-assisted treatment (MAT) has become a potential solution for helping users recover from drug addiction. MAT uses medications approved by the U.S. Food and Drug Administration in combination with counseling and behavioral therapies to treat the disorder. It involves either prescription or illicit opioids, according to the U.S. Centers for Disease Control and Prevention.
n Naltrexone, an antagonist that blocks the euphoric and sedative effects of opioids and may be prescribed outside an opioid treatment program A typical length of time for remedies ranges from months to years—with long-term treatment recommended to prevent relapses. Still, not all treatment systems employ MAT methods. Established groups such as Alcoholics or Narcotics Anonymous (AA or NA), for instance, have long believed successful recovery means a user refrain from replacing one substance for another. “That’s the biggest barrier, overcoming that stigma,” Gayowski says. “But the evidence has been there for ages. Methadone has been saving lives for 50 years. The average Joe needs to know more about it. But the effectiveness is so profound, California requires us to have a MAT policy.” As technology rapidly improves brain and body research, advances arise. For example, Gayowski highlights a new drug, Brixadi, which is an injectable prescription medicine given once monthly or weekly to lower opioid addiction— whether moderate or severe. By comparison, methadone is doled out daily. “Part of my job is to expand options,” he says. Whether through block grants or legal settlements, Sonoma County is putting substantial funding behind the growing problem of addiction. For one, plans are underway for the construction of a $7 million drug rehabilitation center awarded by the state to the county. The county also contracts with the nonprofit Center Point DAAC to provide drug treatment services for low-income residents. Currently, there are three primary pathways for receiving substance use disorder treatment: Local clinics such as West County Health Centers; physician offices compliant with the practice; and drug treatment programs like Center Point DAAC, which offers a MAT program. Treatments such as MAT and attitudes toward substance use have come a long way through the years. MAT’s been around for decades, says Tama
pharmaceutical company in the 1930s; its use in addiction treatment was pioneered by American doctors in the 1960s. Kai Denis, director of the MAT program at DAAC, says several
Kai Denis, director of DAAC’s MAT program.
medications can be effective in medically managed withdrawal regimens, including people suffering from alcohol addiction. The key is that it can mitigate the cravings, he says. McKibbin, who’s worked in the industry for 16 years, concedes that in some circles using medication to cure drug use still comes with uncertainty. But those views are changing as evidence of its effectiveness grows. McKibbin notes several occasions in which she has “run into clients” who have gone through the program while she’s out in public. “I’ve seen them out and about at the grocery store, and they’ll check in with me,” she says. “It’s rewarding.” The insurance industry is also slowly coming around to accept contemporary methods of treating substance abuse. The Affordable Care Act requires most insurers to cover treatment for substance use disorder. Plus, the Mental Health Parity and Addiction Equity Act of 2008 mandates health insurers and group health plans provide benefits for behavioral health services at the same level as primary care. However, insurers may not cover all types of treatment for substance-use disorder, the CDC in coordination with the National Institute for Occupational Safety and Health indicates. At last count, the CDC reported 54,743 opioid- involved overdose fatalities in 2024—with more Americans dying from ODs than motor vehicle crashes. To learn more about MAT treatment, visit cpdaac.org/medication-assisted-treatment. n
The need is there. In fiscal year 2024-25 ending June 30, the rate of people receiving substance use disorder treatment in Sonoma County increased by over 33% to 2,119. But that may be only part of the picture, says Will Gayowski of the Sonoma County Department of Health Services—because the uptick in treatment could be down to variety of factors. “There are more treatment options available since Sonoma County became a drug Medi-Cal- organized delivery system [last December],” says Gayowski, a Sonoma County substance use disorder and community recovery services section manager. “So it is impossible to say how much of this increase is due to worsening drug problems in the community versus increased access to and payment for treatment services.” MAT-endorsed medications work to reduce the cravings and the euphoria associated with experiencing opioids. Some medications have also been found to decrease the risk of overdose, the CDC reports. Common MAT therapies include: n Methadone, a full agonist that reacts in a similar manner to other opioids such as heroin, morphine or fentanyl but at a much slower pace in the
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Vehicle for change Through free safety products and mobile emergency units, Center Point DAAC is bringing life-saving opioid treatment to those in crisis By Rosie Padilla W hen a man suffering from a fentanyl-related emergency sought help near Center Point DAAC's Santa Rosa recovery center, staff quickly sprang
into action. According to employees, the man and a friend had been using opioids nearby when one of them suffered a potentially fatal overdose. Knowing the nonprofit provided free Narcan, the survivor ran across the parking lot seeking assistance. According to DAAC employees, the man and a friend had been nearby taking opioids when the friend suffered a potentially fatal overdose. Knowing DAAC provides free life- saving Narcan, the man sprinted across the lot to the recovery center, which administered the medication known to reverse the effects of a fentanyl overdose. The incident illustrates both the growing prevalence of fentanyl in Sonoma County and the critical role harm-reduction tools such as Narcan play in preventing overdose deaths. According to county data released in August 2025, an average of 12 people die of drug overdose each month in Sonoma County. Statewide, there were 486 drug overdose deaths in June alone—with 231 of those being a direct result of fentanyl, according to the California Department of Public Health. Counties are responsible for notifying local
By meeting people where they are, Center Point DAAC's Mobile Health Clinic expands access to care for individuals who may otherwise face barriers to treatment and support.
recovery centers, as well as the general public, when they identify notable drug-related warning statistics. And in the first two weeks of June 2025 there were twice the number of overdoses than are normally reported. Health professionals note that sudden increases in overdoses can sometimes indicate unusually potent batches of fentanyl circulating in the community or the presence of fentanyl mixed into other substances without users' knowledge. County data shows that although overdose death rates for men and women fell to 22.4 per 100,000 residents
has seen an overall increase in fentanyl deaths of 900% since 2018. The report highlights the Russian River area as the local region hardest hit by opioid overdoses, and notes that people experiencing homelessness represent roughly 10% of all OD deaths, despite making up only about 1% of the county’s population. In August 2025, the Sonoma County Board of Supervisors approved $5 million in opioid settlement funds for substance use disorder projects, awarding 10% to DAAC to expand its Wellness on Wheels (WOW) program—a mobile unit for bringing life-saving treatment to those without means of transportation to DAAC’s Santa Rosa treatment center. This van delivers health and safety products to rural areas of the community including food, water, hygiene products and STD prevention items. Beyond the WOW vehicle, Center Point DAAC also has a mobile care clinic, which provides Medication Assisted Treatment (MAT), a withdrawal management regimen. Helmed by Dr. Marie Mulligan, this mobile unit provides items such as safe needles and Narcan. Introduced in March, the MAT mobile unit expands access to potentially life-saving treatment to individuals across Sonoma County no matter their location or circumstances— particularly important in treating opioid
between 2022 and 2024, the numbers remain higher than before the pandemic and nearly match averages across the state, which
Recovery is a lifelong journey, strengthened by access to treatment, support and community
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N arcan is the brand name for Naloxone, a widely used “opioid antagonist,” a medication administered when an individual is suffering from an opioid overdose. Typical signs of an overdose may include unresponsiveness, slow or shallow breathing, a weak or absent pulse, constricted (“pinpoint”) pupils, pale or bluish skin tone and choking or gurgling sounds. Immediately call 911 if you suspect someone is experiencing an overdose and then administer the Narcan Nasal Spray. To use Narcan Nasal Spray, place your thumb on the bottom of the plunger and your fingers on either side of the nozzle. Tilt the person’s head back, insert the nozzle into one nostril, and press firmly to release the dose. Afterward, turn them onto their side to prevent choking and give a second dose in the other nostril if there’s no response within a few minutes. Stay with the person and wait for emergency services— Narcan’s effects may wear off within 30 to 90 minutes, and symptoms can return. Narcan: The spray that could save a life
Alisha Pepper, a psychiatric nurse practicioner, and Dr. Marie Mulligan, in the MAT mobile unit.
emergencies, which are often concentrated in rural areas with underserved populations. Kai Denis, director of MAT services at DAAC, says the new mobile unit run by Dr. Marie Mulligan will be crucial for reaching those on the outskirts. “To be able to travel out to rural areas and remote parts of the community to bring information and harm reduction services to people who don’t have access is vital,” says Denis. To further combat the increasing rates of fentanyl overdoses, DAAC also offers free Fentanyl Testing Strips. Fentanyl cannot be detected by sight, smell or taste and the synthetic opioid is often mixed with drugs such as cocaine, methamphetamine or heroin to increase the potency at a lower cost. The Center Point DAAC website, cpdaac.org , has a page on how the public can access the Fentanyl Test Strips, as well as how to use them to detect whether drugs are laced with fentanyl.
Meanwhile, Narcan is the brand name for Naloxone, a widely used “opioid antagonist,” a medication administered when an individual is suffering from an opioid overdose— like the individual who recently received emergency assistance outside Center Point DAAC's Santa Rosa facility. According to DAAC staff, emergency responders said the rapid administration of Narcan likely saved the individual's life. Through a combination of modes of outreach—from administrative networking to word-of-mouth communication to connecting with distant communities via the mobile units—the DAAC team hopes to slowly stem the rise of opioids in the North Bay and beyond. As Denis says: “We want to help [those] who struggle with opioid addiction to regain their lives—to overcome that driving need. “To establish a normal routine and get back to functioning normally. To have a normal healthy life.” n m
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A Second Chance in a Small Box How Narcan became one of the most important tools in the fight against opioid overdoses
F or much of the public, Narcan is a familiar name but a misunderstood one. The small nasal spray has become a fixture in conversations about the nation's opioid epidemic, appearing in public health campaigns, school districts, pharmacies and community events. It is carried by first responders, healthcare workers and outreach teams. Increasingly, it is also being tucked into purses, backpacks, glove compartments and medicine cabinets by everyday people. The reason is simple: Narcan saves lives. Known generically as naloxone, Narcan is an opioid antagonist, meaning it can rapidly reverse the effects of an opioid overdose. Administered in the critical moments when someone stops breathing or becomes unresponsive, the medication can restore normal breathing and buy precious time until emergency medical personnel arrive. In an era when fentanyl has transformed the overdose crisis, that ability to act quickly can mean the difference between life and death. What makes Narcan unique is not just its effectiveness, but its accessibility. Unlike many emergency medical interventions, Narcan does not require advanced training, specialized equipment or a medical license. It was designed to be used by ordinary people in extraordinary circumstances. And that accessibility is changing the way communities respond to overdoses. The changing face of the opioid crisis The opioid epidemic has evolved dramatically over the past two decades. What began largely as a crisis tied to prescription painkillers eventually expanded to include heroin and, more recently, synthetic opioids such as fentanyl. Today, fentanyl has become one of the most significant drivers of overdose deaths across the United States. By Rosie Padilla
Fentanyl has reshaped the overdose crisis, making education, prevention and treatment more important than ever.
A tool anyone can use One of the most remarkable aspects of Narcan is how simple it is to administer. The medication is commonly distributed as a nasal spray. There are no needles involved and no complicated instructions to memorize. If a person is suspected of experiencing an opioid overdose, the first step is to call 911. Narcan can then be administered by placing the nozzle into one nostril and pressing the plunger to release the medication. The process takes only seconds. After administration, the individual should be monitored closely while emergency services are en route. If there is no response within a few minutes, a second dose may be given. The medication works by temporarily blocking opioid receptors in the brain, reversing the respiratory depression that often causes overdose fatalities.
The drug is estimated to be many times more potent than morphine and can be lethal in extremely small quantities. Compounding the danger is the fact that fentanyl is often mixed into other substances or pressed into counterfeit pills designed to resemble legitimate medications. As a result, many overdoses no longer fit outdated stereotypes. Overdoses can occur in homes, workplaces, parking lots, schools and public spaces. They can involve long-term opioid users, but they can also involve individuals who may not realize they have consumed fentanyl at all. The unpredictability of the modern drug supply has created a new reality: anyone may find themselves in a position to respond to an overdose emergency. That reality has fueled a growing movement to place Narcan in the hands of as many people as possible.
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Importantly, Narcan is considered safe to administer even if an overdose is only suspected. If opioids are not present in a person's system, the medication generally has no effect. That safety profile has made it a cornerstone of overdose prevention efforts nationwide. Advocates often compare carrying Narcan to carrying a fire extinguisher or knowing CPR. Most people hope they will never need to use it, but having it available when an emergency occurs can make all the difference.
organizations and community outreach programs. Training events and educational workshops have helped demystify the medication and encourage broader participation in overdose prevention efforts. Schools, libraries, shelters and community organizations across the country have also begun incorporating Narcan into emergency preparedness plans. The shift reflects a growing recognition
fingernails • Choking, snoring or gurgling sounds • Weak or absent pulse When in doubt, experts encourage people to treat the situation as a medical emergency. Call 911 immediately. Administer Narcan if available. Stay with the person until emergency responders arrive. Because Narcan's effects can
wear off after 30 to 90 minutes, professional medical evaluation remains essential even if the individual initially appears to recover. More than a medication At its core, Narcan represents something larger than a pharmaceutical product. It represents a shift in how communities respond to crisis. For decades, public health campaigns have focused on teaching ordinary people how to intervene during emergencies. CPR training, automated external
Breaking down stigma For many years, conversations surrounding addiction were often clouded by stigma. Substance use disorders were frequently viewed through a lens of personal failure rather than as complex medical conditions influenced by biological, psychological and social factors. That stigma sometimes extended to overdose response efforts as well. Today, public health professionals increasingly frame Narcan as a
Widely available throughout California, Narcan has become a critical tool in responding to opioid overdoses.
practical healthcare tool rather than a political or philosophical statement. The reasoning is straightforward. A person cannot seek treatment, reconnect with loved ones or begin recovery if they do not survive the overdose. Narcan does not cure addiction. It does not replace treatment. It does not address the underlying causes of substance use disorders. What it does provide is an opportunity. For some individuals, that opportunity becomes the first step toward recovery. For others, it provides another chance to access support services, counseling or medication-assisted treatment. The medication's role is not to solve every aspect of the crisis. Its role is to preserve life long enough for those next steps to become possible. Expanding access In recent years, efforts to increase access to Narcan have expanded significantly. The medication is now available in many pharmacies and is frequently distributed through public health agencies, nonprofit
that overdoses can occur anywhere and that rapid intervention matters. Experts often emphasize that brain injury or death can occur within minutes when breathing stops. Emergency medical responders play a critical role, but those first few minutes are often in the hands of family members, friends, coworkers or bystanders. The more people who know how to recognize an overdose and respond appropriately, the greater the chances of survival. Recognizing the warning signs While Narcan is easy to use, recognizing an overdose remains an important skill. Common warning signs may include: • Unresponsiveness or inability to wake the person • Slow, shallow or absent breathing • Pinpoint pupils • Pale, gray or bluish skin tone, lips or
defibrillators and first-aid education all reflect the belief that community members can play a meaningful role before professional help arrives. Narcan follows that same philosophy. It empowers people to act rather than stand helplessly on the sidelines. It transforms bystanders into responders. It creates an opportunity for intervention during a moment when every second matters. The medication itself may come in a small box, but its impact can be enormous. For families, it may mean another birthday, another holiday or another chance to rebuild relationships. For individuals struggling with substance use, it may mean another opportunity to seek treatment and pursue recovery. And for communities confronting the ongoing challenges of the opioid epidemic, it serves as a reminder that sometimes the most powerful tools are also the simplest. A single spray cannot solve a public health crisis. But it can save a life and sometimes, that's where recovery begins. n
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