Graduation Date


Document Type

Senior Thesis


Bachelor of Science

Primary Major

Global Public Health

Primary Minor

Community Action and Social Change

Program Director

Patti Culross, MPH, MD

Thesis Advisor

Michaela George, MPH, PhD


Background. In recent years, the United States has been greatly affected by prescription drug overdose deaths, 68% of which are caused by opioids. Like many communities nationwide, Marin County in California is deeply affected by the opioid epidemic with accidental overdose being one of the leading causes of injury-related death. This study examines how fatal and non-fatal opioid overdoses in Marin County are associated with factors such as suspected fentanyl involvement, naloxone administration (EMS), and repeat overdose events.

Methods. A cross-sectional study was conducted by Marin County’s Health and Human Services using data collected from EMS dispatch calls and vital statistical records. Logistic regression was used to study the relationship between fatal and non-fatal overdoses and factors associated with the EMS event such as suspected fentanyl involvement, use of naloxone, and repeat suspect overdose. A spatial analysis was conducted using a Geographical Information System software examining the distribution of fatal and non-fatal overdoses in Marin County in relation to three variables: suspected fentanyl involvement, presence of naloxone, and whether the incident was a repeat overdose.

Results. This multivariate regression model shows that individuals who are 45 years old and over are 6 times more likely to die from any overdose (OR=6.19, 95% CI=3.99-9.60). Individuals who did not receive naloxone at the time of the EMS event were more likely to die from an opioid overdose (OR=0.51. 95% CI=0.33-0.79). Lastly, individuals were 3 times more likely to die from their first overdose compared to individuals who had already experienced an overdose in the past (OR=3.1, 95% CI=1.19-8.20).

Discussion. EMS and death county data are helpful in examining fatal and non-fatal overdoses. The statistically significant findings show that fatal overdoses are associated with older age, first-time overdoses, and naloxone administration.

Available for download on Wednesday, June 01, 2022