Our History
2013 to Present
Introduction
The history of OD Free Marin extends over a decade. One of the longest standing overdose prevention coalitions in the state, OD Free Marin has adapted its structure and name to match changes in the opioid crisis. The seeds of the coalition were planted in 2012, when a group of concerned residents formed the Marin County Prescription Drug Abuse Task Force. Recognizing this as an emerging public health crisis in 2013, Marin County Health and Human Services expanded on this grassroots effort to form RxSafe Marin. Since its inception, RxSafe Marin has served as a model for collaboration between community and government using a method known as Collective Impact. Because the primary drivers of overdose have shifted from prescription opioids to illicit fentanyl and other substances, the initiative was renamed OD Free Marin in 2023. The coalition remains dedicated to cross-sector collaboration to protect residents from the harms of drug overdose.
This timeline is intended to capture important milestones in the coalition’s evolution, memorialize successes, and honor the shared leadership of community members and government going back over a decade.
We recognize that we cannot possibly capture and document every contribution and effort made within this community-based coalition. However, we hope that this timeline reflects the profound history, significant work, and investments made by our community. While it is beyond our capacity to individually acknowledge everyone, we wish to acknowledge selected founding members and community partners. Their profound dedication and invaluable contributions have been pivotal to the coalition’s efforts.
Historical Timeline
RX Design Team Meets to Expand on Community Grassroots Efforts to Addresss Prescription Drug Misuse In Our Community
The RX Design Team’s meeting at Marin County Health and Human Services (Marin County HHS) marks the start of strategic planning to address prescription drug misuse. This meeting initiates the Marin County Prevention Hub’s Prescription Drug Initiative, with discussions on three potential models for strategy development.
First Community-Wide Prescription Drug Misuse Strategic Planning Meeting
With support from Marin County HHS and the Board of Supervisors, more than 100 Marin residents spanning generations, ethnic groups, and areas of expertise convene to better understand the scope and complexities of the prescription drug problem, and to develop a plan of action. By reviewing current data and sharing personal stories, the community creates a set of goals and a structure through which to achieve them – an effort that would become RxSafe Marin. Using the Collective Impact and HE/AL frameworks, this kickstarts and establishes the foundation of a coalition-driven initiative against prescription drug misuse.
Launch of RxSafe Marin, Marin County Prescription Drug Misuse & Abuse Initiative
RxSafe Marin officially launches as a coalition of community and public health experts, with Marin HHS serving as the backbone support to move the initiative forward. Organized into five focused Action Teams, the coalition directs its efforts through Community-Based Prevention, Prescribers and Pharmacists, Data Collection and Monitoring, Treatment and Recovery, and Law Enforcement. Building on the work of community activists, Marin HHS, Marin County District Attorney’s Office, Marin County Public Defender’s Office and Marin County Office of Education each have officials co-leading the RxSafe Marin action teams alongside families, youth, pharmacists and health providers.
RxSafe Marin Report Card Developed
The Data Action Team develops a county-wide “report card” to describe the scope of the prescription misuse problem and track progress towards established goals. An inclusive process for selecting common metrics ensures relevance to all partners.
County-Wide Safe Prescribing Standards Adopted
To support the Prescribers & Pharmacists Action Team goal to reduce opioid prescribing, county-wide safe prescribing standards for all Emergency Departments and Primary Care are developed and adopted.
RxSafe Marin Recommends Medication Disposal Stewardship Ordinance
RxSafe Marin recommends the Marin County Board of Supervisors adopt a Medication Disposal Stewardship Ordinance. The Stewardship Plan, funded by pharmaceutical manufacturers & producers, would place Take Back Bins in pharmacies, hospitals and police stations – keeping unwanted, unused or expired medications from our waste system and out of the hands of unintended users.
RxSafe Marin Strategy Replicated by Several CA Community Coalitions
Acknowledging the CDC’s call for multi-sector efforts to tackle prescription drug abuse, RxSafe Marin has been highlighted as being among the first such models to demonstrate success of the Collective Impact model in action, and is being replicated in other communities statewide to adopt similar strategies. The Data Action Team shares their process for developing the community dashboard at national and state conferences.
Prescription Drug Take-Back Ordinance Passes
The Board of Supervisors approves the Marin County Safe Drug Disposal Ordinance, requiring any producer of prescription and over-the-counter drugs offered for sale in Marin County to participate in an approved drug stewardship program for collection and disposal of unwanted medications.
Marin County Public Health Establishes New Guidelines for Treating Chronic Pain
In collaboration with local hospitals and the San Francisco Marin Medical Society, coupled with intensive community education about the potential harms of opioids, new chronic pain management guidelines for local prescribers and pharmacists emphasize the importance of monitoring patient prescriptions, including through a state database to prevent patients from acquiring multiple prescriptions.
Law Enforcement Action Team Pioneers Letter for Prescribers
A new communications strategy has been implemented in which the District Attorney sends letters to prescribers if a patient is discovered misusing prescription medications. This approach aims to alert and involve prescribers directly in preventing medication misuse.
New Data Indicates Efforts May Be Having Some Effect in Marin, but Caution Against Complacency
The number of accidental drug overdose deaths attributed to Marin County declined to 10 in 2014, down from 27 accidental drug overdose deaths in 2012 and 2013. Second, average narcotic prescription doses drop 41 percent since 2013 among Marin’s Medi-Cal population, according to Partnership HealthPlan of California.
Community-Based Prevention Action Team Increases Media and Messaging Campaigns
The Community-Based Prevention Action Team innovates the use of social media and advertisements to raise public awareness and mobilize community and elected officials to support policy solutions.
RxSafe Marin Receives 2017 Inny Award
RxSafe Marin is the recipient of the Inny Award, recognizing employees and partners who innovate and adapt in Marin County’s rapidly changing work environments.
Recognized as Most Innovative Program in Health & Human Services out of 58 CA Counties
The California State Association of Counties (CSAC) recognizes RxSafe Marin with a Challenge Award for creating and leading the first comprehensive program anywhere in the state of California that is successfully reducing opioid prescriptions, overdoses, and deaths.
Awarded the 2017 Heart of Marin Award
RxSafe Marin is awarded the Excellence in Innovation Award by the Center for Nonprofit and Volunteer Leadership, recognizing the coalition’s significant impact in reducing prescription drug misuse and abuse in Marin County through its collaborative efforts.
RxSafe Marin Hosts Free Continuing Education for Pharmacists
A 3 hour training and free continuing education is offered to pharmacists to educate and provide new tools to combat the opioid epidemic.
Collective Impact Initiative Becomes a Model for Other Counties in California
32 other counties are modeling RxSafe Marin with similar multi-faceted programs to address the opioid crisis.
RxSafe Marin Partners with Local Pain Physicians for a Healthy Pain Management Forum
RxSafe Marin collaborates with pain specialists from Marin General Hospital, Kaiser Permanente, and Marin Community Clinic to inform the community and fellow doctors about their initiatives to explore safer alternatives and emerging non-opioid methods for managing pain. They discuss evidence-based concerns related to the dangers and risks of utilizing opioids for long-term pain control, in addition to offering educational resources to healthcare professionals on the consequences of opioid prescriptions.
Awarded the 2018 California Association of Public Information Officials EPIC Award
RxSafe Marin wins the 2018 California Association of Public Information Officials (CAPIO) EPIC Award for an infographic the community coalition designed and implemented to talk about the dangers of opioid misuse.
Marin County Recognizes August 31st as International Overdose Awareness Day
The Marin County Board of Supervisors passed a resolution recognizing August 31st as International Overdose Awareness Day.
Free Narcan Kits and Training Provided to the Public for the First Time
RxSafe Marin, in partnership with Dominican University, organizes a public discussion forum concerning Marin’s evolving opioid epidemic. While there has been a decline in prescription opioid-related overdoses, the county is witnessing a corresponding rise in overdoses linked to illicit opioids such as heroin and fentanyl. The urgency of providing naloxone to community members is increasingly critical.
Initiation of Law Enforcement Opioid Training at Marin County of Education
RxSafe Marin hosts a conference for 120 law enforcement officers and over 70 search-and-rescue volunteers who are eager to learn more about trends in addressing the national opioid epidemic.
Prevention Efforts Implemented in Marin Schools
The Marin County Office of Education, in partnership with RxSafe Marin, has implemented the Safe Schools and Prevention Program to reduce drug use among school-age children. The program provides substance abuse education to students, parents, and guardians. Estimates from county officials indicate approximately 5,000 parents and students have received substance use education by county health staff through community forums and town halls.
RxSafe Marin Partners with Ross Valley Sanitary District for Safe Drug Disposal
Ross Valley Sanitary District and RxSafe Marin have partnered and created an informational video. This partnership educates the public about not flushing unused or expired medications down the sink or toilet and the importance of disposing unused medications responsibly.
Surveillance System for Non-fatal Opioid Overdoses Implemented
Marin County Public Health, Emergency Medical Services, and HHS’ Behavioral Health and Recovery Services are partnering to use 9-1-1 records to identify overdose events and connect survivors with substance-use treatment. A surveillance system is implemented for non-fatal overdose events in all Marin Emergency Departments, with a reporting interval of no greater than one week. A After the initiation of this outreach program, the number of opioid overdose survivors contacted for treatment within one week of an event has increased from 9 to 21 percent.
Data over 5 years Shows Progress of RxSafe Marin and Community Partners
Since 2014, opioid prescribing in Marin has seen a 48 percent reduction. By 2018, there was a 30 percent drop in fatal drug overdoses in the county since 2013. This decline in prescriptions, coupled with an increase in the safe disposal of medications, has contributed to a decrease in the availability of opioids in the community.
Increasing Efforts to Make Narcan Accessible for Administration by Nonmedical Personnel
Through the efforts of RxSafe Marin, the county has made Narcan available for administration by police officers, firefighters, and family members of known substance users. Narcan has also been made available without prescription in pharmacies, libraries, and schools.
Formal Creation of Youth Action Team
The Youth Opioid Response Action Team is formed, empowering Marin’s youth to engage in the efforts to address the opioid crisis
Free Narcan Vending Machine Launched in Marin County Jail Lobby
RxSafe Marin and Behavioral Health & Recovery Services are able to use State Opioid Response grant funds to purchase a vending machine, as well as access free naloxone kits through a Naloxone Distribution Grant from the California Department of Health Care Services.
New Toolkit Created to Help Curb Underage Substance Use
A new community education toolkit called Let’s Talk is available now to parents and preteens. In collaboration between RxSafe Marin, Marin HHS and Behavioral Health Recovery Services, Marin County of Education, Marin Prevention Network, and Marin Healthy Youth Partnerships, Let’s Talk provides facts that will really help families have important conversations that could be life-saving for our youth. Printed versions of Let’s Talk booklets are provided to every sixth-grade and ninth-grade family in Marin public schools in English and Spanish.
RxSafe Marin Transitions to OD Free Marin
Responding to the changing face of the opioid crisis and overdose rates in Marin County, RxSafe Marin will change to OD Free Marin to better represent the biggest threat to public safety: overdoses from synthetic opioids like fentanyl.
OD Free Marin Summit Held to Define Goals to End Overdoses in Marin
After successfully reducing the harm of prescription opioids in Marin County, OD Free Marin hosts a summit to set new goals to reduce drug overdoses, with a special focus on fentanyl, in 2023. Organizers of the coalition, including County of Marin staff and community partners, establish Smart Goals for 5 action teams to approach the growing crisis from different angles.
3 Additional Free Narcan® Vending Machines are Installed
In partnership with Behavioral Health & Recovery Services (BHRS), Narcan® vending machines were installed at the HHS Wellness Campus, Ritter Center, and West Marin HHS Resource Center. 3,891 kits were dispensed through Marin’s vending machines.
Over 10,000 Narcan Kits Distributed to Residents of Marin County
In addition to the 4,000 Narcan kits distributed in vending machines, OD Free Marin and its partners give out over 6,000 Narcan® kits through events and other channels, amounting to a total of 10,000 kits in 2023. Each kit has a bilingual pocket card for easy instructions on how to use the lifesaving nasal spray.
Where’s the Fentanyl? Campaign Launched
OD Free Marin joined Marin Community Foundation, Marin Independent Journal, and Good Stuff Partners to launch a campaign on the dangers of fentanyl in Marin County. A free toolkit with graphics and videos were shared across the country to spread awareness.
Historical Timeline of the Marin Community-Based Overdose Prevention Coalition Unveiled
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