The opioid epidemic hasn’t ravaged California the way it has other parts of the country but that doesn’t mean it isn’t a problem, or that there aren’t groups fighting it.
The California Opioid Safety Network, a group made of local coalitions, is working to combat the problem and make sure it doesn’t get worse.
The California Opioid Safety Network was founded by the California Health Care Foundation (CHCF) in 2015. CHCF funded support for the first two years, but the Public Health Initiative took over as a guarantee six months ago.
The group has a multi-pronged strategy to fight the epidemic, according to CHCF director Dr. Kelly Pfeifer. Initiatives include preventing people from starting opioids, having doctors recommend lower doses for shorter durations, better treatment for chronic pain, identifying and treating addiction and harm reduction, stopping deaths by getting drugs like Narcan, which help reverse an overdose, out there and adding more needle exchange facilities.
The California Opioid Safety Network’s Los Angeles coalition member is Safe Med LA, a group chaired by Gary Tsai. Tsai is the medical director and science officer at the County of Los Angeles’ Department of Public Health. Safe Med LA was established two years ago.
“The opioid epidemic is complex and has a lot of different contributing factors,” Tsai said. “We felt a blanket approach was the best way to approach this and address all contributing factors at once.”
The group has focused on getting organizations in different cities the information they need to be successful, said Carmen Rita Nevarez, the vice president for external relations, preventive medicine advisor and director of the Center for Health Leadership and Practice at the Public Health Institute.
“We know that people have great aspiration. Transferring it into impact is a big reach,” she said. “There are certain skill sets necessary to be effective but coalitions don’t grow that way naturally.”
Pfeifer said the California Opioid Safety Network has also worked to share information across California’s various cities.
Opioid impact in California
The California opioid death rate has held steady for the last two years. Deaths from prescription opioids and heroin were stable, but fentanyl deaths increased 47 percent last year, according to the California Department of Public Health.
In the country, the opioid death rate increased 28 percent in 2016, according to the Kaiser Family Foundation.
California’s lower rate may be because of its diversity and big cities.
“We believe cultural diversity is protective,” Tsai said. “Certain cultural groups, in particular Asians and Latinos, reach for medications less often than other cultural groups. The opioid epidemic has really started with prescription drug abuse.”
In 2015, some California counties were just as bad as Ohio.
“The epidemic hits urban centers differently than it hit rural centers,” Pfeifer said.
The Network has worked to get centers to use drugs like Methadone to treat addiction.
“Medication with addiction treatment is the only way to keep people in treatment and keep people alive,” Pfeifer said.
Pfeifer said only 6 percent of people stay clean in a year if they are in a drug-free treatment program. That percent, she said “goes way up” if medication is added, making it the group’s biggest push right now.
They also want to make getting treatment easy.
Tsai said Los Angeles has a more robust substance abuse treatment network and more methadone clinics then other areas.
Other counties, he said, have no treatment and people have to travel far, making them less likely to participate.
He added that Medi-Cal waivers now cover a broader scope of services, making access to treatment easier.
Nevarez said the California Opioid Safety Network is also working to make people understand that “substance abuse is a disease, not a character flaw.”