Philbrick: Fighting opioid overdoses on public transit systems

Opioid use is a national crisis that has affected almost every facet of existence.

We have seen drug use proliferate in our schools, on our transit systems and in our communities. Along with that proliferation is an increase in overdoses that have prompted the availability of naloxone (also known as Narcan), a medication used to quickly restore normal breathing during an opioid overdose, in sometimes unexpected places such as libraries, schools and on buses and in trains.

Transit stations and transit modes, such as light rail and buses, are increasingly becoming a draw for drug use. A recently published scientific study assessed the prevalence of fentanyl and methamphetamine in the air and on surfaces of transit vehicles in Oregon and Washington. The researchers analyzed findings from 78 air samples and 102 surface samples, and found that 25% of the air samples had detectable fentanyl and 100% had detectable methamphetamine. Of the 102 surface samples, 46% had detectable fentanyl and 98% had detectable methamphetamine.

The researchers posited that “there is no evidence of acute medical conditions resulting from passive exposure to fentanyl or methamphetamine (such as from touching contaminated surfaces or inhaling secondhand smoke),” which suggests that the general public and transit operators should not fear physical harm as a result of such exposure.

But it does mean that, once again, our transit operators on the frontline are in a position to deliver lifesaving assistance.

Recent increases in drug use and overdoses on transit prompted Washington D.C. Metro leaders to equip all active officers and crisis intervention specialists with Narcan—this after 43 suspected overdoses in 2022. Earlier this year, LA Metro workers were trained to administer Narcan as well.

In Santa Clara County, Cindy Chavez, co-chair for VTA’s board of directors, has proposed making Narcan available in all VTA buses, light rail and transit centers to save lives.

In the Bay Area thus far in 2023, 20 people have died on trains, in stations or somewhere else on BART property. These presumed overdoses are referred to as “unattended deaths” and in response BART has 19 crisis intervention specialists that patrol stations and trains to respond to those in trouble, as well as to serve as a general deterrent to the presence of drugs. BART staff members are equipped with Narcan, and many of them have already used it to prevent potential overdoses and deaths.

It seems likely VTA will follow the examples set by BART, DC Metro, LA Metro and others. To that end, the VTA board first discussed Chavez’s proposal to have VTA workers carry Narcan in September, an idea that received some public support at the board meeting. It resulted in the board directing VTA staff to work with the county’s Behavioral Health Services Department to make progress toward making Narcan available at all VTA transit centers, buses and light rail.

We must consider the awful realities and serious implications of the opioid crisis for the public and for transit workers. While we struggle with the larger picture of getting the national crisis under control, we can take immediate steps in our communities to prevent harm and save lives.

San José Spotlight columnist Karen E. Philbrick is the executive director of the Mineta Transportation Institute, a research institute focusing on multimodal surface transportation policy and management issues.