MALONE — Franklin County director of public health Kathleen Strack addressed the human resources committee of the legislature Thursday prior to their regular meeting at the courthouse and updated lawmakers on her department’s work to make harm reduction tools such as Narcan more widely available to county residents.

The county is seeing an upward trend of overdoses this year, when compared with overdose numbers at this time last year, Strack said, and interventions like Narcan, an easy-to-administer nasal spray that can arrest an opioid overdose, can save lives. Narcan, the brand name for nalaxone helps restore breathing to a person overdosing on opioid drugs such as oxycontin, oxycodone, and fentanyl, or illicit opiates like heroin.

Strack said her goal is to get Narcan into every possible public space and get as many area residents trained in its use as possible, as the risk of overdose is not limited to illicit drug users.

“The point of harm reduction is not necessarily to change behavior, but at least make it safe, rather than deadly,” Strack told legislators. “It became deadly with the addition of fentanyl. There’s a lot of potential for people to lose their life.”

Opioids are a class of drug used to reduce moderate to severe pain that are often abused. As opioids are synthetic opiates, prescribed drugs such as oxycodone, hydrocodone, morphine, and fentanyl carry the same risk of overdose as street drugs like heroin. A preponderance of black market fentanyl across the country has fed a high number of overdoses nationwide in recent years.

Strack said to combat that reality, the county will benefit from making Narcan as widely available as possible.

“The point is, get it all over the place,” Strack said. She added that Narcan carries no risk if administered in someone not experiencing an overdose.

“If you’re not on opioids, Narcan’s not going to do anything for you. The only thing Narcan is going to do is substitute the opioid out of your receptor,” Strack explained. “If you’re diabetic and in a coma, Narcan’s not going to hurt you.”

This means that in cases where people have lost consciousness and bystanders or first responders suspect an overdose, there is no risk to the person in the administration of Narcan, she said. Furthermore, anyone who administers Narcan is protected under New York State’s 911 Good Samaritan Law, which protects anyone seeking medical help for themselves or someone else experiencing a suspected overdose. Both the person experiencing the overdose as well as anyone trying to help save that life is protected, Strack said.

“It’s not harmful in case you make a mistake,” Strack said. “And not only is it not harmful, but you’re protected under New York State’s Good Samaritan law.”

County manager Donna Kissane said that wide availability of Narcan is crucial for the county.

“We are at a point in our communities where Narcan is necessary not just for people that are using opioids,” Kissane said. “People are coming into contact with opioids and other drugs. We need to stress that it can be anytime, anywhere, and anybody. Yes, it’s about saving lives of people that are using, but it’s also the accidental deaths we need to be thinking about in our communities.

“It’s here, and it’s out there.”

Strack said that between January and May of this year there were 11 overdoses with two fatalities, and in at least six cases, multiple doses of Narcan were administered. In 2022, there were a total of nine overdoses, two deaths, and six cases where multiple doses were administered. She said these numbers do not include unreported overdoses or Narcan administrations, or situations when overdose victims refused treatment.

“Medical use of fentanyl is two milligrams,” Strack told lawmakers. “They’re finding 10 to 15 milligrams in fatal cases.” While Narcan can arrest an overdose of opioids like fentanyl, it has no effect for people who have knowingly or unknowingly ingested xylazine, a powerful sedative that the U.S. Food and Drug Administration has approved for veterinary use that is increasingly appearing in street drugs.

Strack went on to display overdose response kits she would like to make as widely available as possible. Those kits would contain Narcan, a rescue breathing face shield, drug disposal bags, resources to help people find treatment, a copy of the Good Samaritan law, and a certificate of completion of Narcan training. She said in other counties, public health workers are attending public events to hold trainings and distribute the kits to the public, and she would like her department to begin doing the same.

A four minute video will be distributed to workers across the county that will train them in the use of Narcan, Strack said.

She went on to discuss a health kiosk her department hopes to make use of with help from an organization called Medication for Addiction Treatment & Electronic Referrals (MATTERS).

According to mattersnetwork.org, MATTERS began as a Buffalo, New York-based electronic referral platform to connect patients to medications for opioid use disorder (MOUDs). According to the website, the electronic referral platform efficiently refers patients with opioid use disorder from emergency departments, OB/GYN offices, correctional facilities, inpatient units, pre-hospital settings, and so forth to community-based clinics across New York State.

The health kiosk would work similarly to a vending machine and would be stocked with things like Narcan, test strips for fentanyl and xylazine, condoms, and other harm reduction tools and resources. People would be able to use the machine anonymously and also have access to referral information for nearby treatment providers. It would come at no cost to the county for the first three years, and $2,500 per year after that period. That cost would be for electricity, supplies, and software for the machines.

“It’s whatever the county has decided to put into their health kiosk,” Strack said. “What I want to do is get us a holding line for potentially receiving a health kiosk for Franklin County at no cost.”

She said early indications are that Tupper Lake would be best served by health kiosk, given the geography, as county workers can saturate less remote areas of the area with Narcan and test strips in central locations such as schools, adult centers, and the courthouse itself.

“We can flood all these areas. It’s Tupper without that supply,” Strack said.

Strack said her department does currently have fentanyl and xylazine test strips available, and will be distributing them to Malone Village Police, state troopers, and EMS workers. Saranac Lake Village Police are in possession of the tools already, she said.

Jonathan Sanger, director of the Franklin County Department of Probation, said Narcan is an invaluable tool that all of his officers are trained in the use of.

“As far as I’m concerned, the more Narcan that is out there and available, wherever it may be and wherever it comes from, the better off we are with it,” Sanger said. “I believe it should be in (the courthouse) for certain. You just never know, there’s a lot of it out there.”

Lawmakers expressed support for the measures, and Strack hopes to have possession of the health kiosk by December, while her department continues to distribute harm reduction tools and resources around the county. She said her staff would be trained as trainers later this month, and Narcan training will then expand to other workers and departments.

“We want to make it happen and get Narcan to as many people as we can,” Strack said.