SAN FRANCISCO - The United States has an opioid abuse epidemic. More than two million people are dependent on, or abuse, prescription pain pills and street drugs.
That addiction can come with deadly consequences.
Ninety-One people a day die from opioid abuse in America each day. In San Francisco, they are trying to bring the number of deaths to zero, using another drug. It's been highly successful, and is now a life saver that is being used across the country.
San Francisco's main library in Civic Center is open to everyone. Even those who use it as a cover to do drugs.
Tom Fortin is the Chief Librarian at the Main Library. He told us, "Unfortunately, earlier this year we had an overdose incident where there was a fatality in the library."
As a precaution, librarians are now equipped with medication to help people when they overdose.
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San Francisco is not unique; other libraries across the country have reported similar problems. Libraries in Denver, Chicago, and Reading, Pennsylvania, have all reported opioid deaths.
Opioids are drugs formulated to replicate the pain reducing properties of opium. They include both legal painkillers like morphine, oxycodone, or hydrocodone prescribed by doctors for acute or chronic pain, as well as illegal drugs like heroin or illicitly made fentanyl.
According to the Centers for Disease Control and Prevention 63 percent of 52,404 drug overdose deaths in the U.S. involved an opioid.
"As the opiod crisis has reached a new level, both in San Francisco and across the country it means that we need to respond differently, it is at crisis level," said Fortin.
The library teamed up with the health department to train willing librarians to administer a drug called Naloxone, also known as Narcan. It is available as an injection or a nasal spray and reverses the effects of opioids almost immediately. Paramedics have carried it for years to reverse heroin overdoses.
"When somebody overdoses on heroin, there's some time to intervene. They don't die right away. It takes a little while; it takes at least 20 minutes, maybe three hours so you have plenty of time to intervene," said Phillip Coffin, Director of Substance Use Research for the San Francisco Department of Health.
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The city estimates that there are estimated to be 22,000 heroin users in San Francisco.
To address the growing epidemic of use, the San Francisco health department launched the most aggressive Naloxone distribution programs in the nation in 2003. It provides Naloxone to anyone in the city who asks for it at a number of distribution locations across the city.
"The idea is to try and get naloxone to anyone who might experience or witness an opioid overdose," said Coffin.
In 2014, there were 127 fatal opioid overdoses in San Francisco. The same year, there were 365 overdose reversals with naloxone.
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In 2016, the number of fatal overdoses dropped to just over 100 and number of reversals more than doubled to 877.
Coffin added, "We believe that we have really averted what would have otherwise been an explosion in opioid overdose mortality which the rest of the country saw, but San Francisco didn't see at all."
Back at San Francisco's main library, 65 librarians have now been trained to administer Naloxone.
Librarian Kelley Trahan said, "People can overdose anywhere, if it happens in the library, librarians are there, they are first on the scene before emergency responders so it makes sense that we would have it."
Fortunately, since the program started in June, San Francisco library staff hasn't had to use the lifesaving drug. But they say they will be ready if they need to be.
But help is available to anyone statewide. In 2015, the state legislature passed a law making it available to anyone who needs it without a prescription at any pharmacy.
Written and Produced by Ken Miguel