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SF offering on-demand fentanyl treatment

Nils Wommelsdorf
Flickr / Creative Commons

The assessment came the same day that the Office of the Chief Medical Examiner said fentanyl was behind the majority of San Francisco's 66 drug overdose deaths in May.

A "Night Navigation street care team" walks the streets of the Tenderloin every night offering immediate drug addiction treatment to unhoused people addicted to fentanyl and other opioids, the health department said.

The team can connect users in real-time with a doctor who can prescribe medication by telephone. From March to May, 440 people were put in touch with doctors, and 369 got prescriptions. About 40 percent of those prescriptions were filled.

Most received buprenorphine, which is as effective as methadone but more accessible, said Dr. Hillary Kunins, director of behavioral health services and mental health at the department.

Methadone can only be dispensed by a licensed opioid treatment center, while buprenorphine can be prescribed by any medical provider and picked up at a pharmacy.

Buprenorphine is highly effective at controlling cravings, said Dr. Joanna Eveland, chief medical officer for people experiencing homelessness. However patients can experience withdrawal symptoms if they take too much, too early while they still have a strong opioid in their system, like fentanyl.

To combat this risk, the pilot program is instituting micro-dosing of buprenorphine, starting patients with a small dose and gradually increasing it each day.

Sunni M. Khalid is a veteran of more than 40 years in journalism, having worked in print, radio, television, and web journalism.