Years after opioid-blocking drugs were hailed as the gold standard for
combating opioid addiction, less than half of Orange County’s
addiction treatment centers currently offer it, according to a new study by the county that
details the results of — and some possible solutions to —
the opioid epidemic.
Though the total number of all opioid-related deaths dropped slightly since
2016 — coinciding with a drop in opioid prescriptions — heroin
and fentanyl overdoses have climbed in Orange County, where the concentration
of rehab centers and sober living homes is so high that the county is
known in treatment circles as the center of the Rehab Riviera.
The report, titled “Addressing the Opioid Crisis in Orange County,”
noted that overdose deaths are more common along the coast and in south
county, where the vast majority of state-licensed treatment centers and
unregulated sober living homes are located.
It also found that the dead were overwhelmingly white and male and that
the rate of opioid-overdose deaths in O.C. far eclipsed that of Los Angeles,
Riverside, San Bernardino, San Diego, Ventura and Santa Barbara counties,
as well as California as a whole.
County officials laid out plans for a more muscular private-public response
to the health care crisis over the next several years, including a heavy
emphasis on medication-assisted treatment and community education. But
controversial ideas that have reduced deaths elsewhere, such as needle
exchanges and safe-injection sites, were not on the immediate to-do list.
The report left some critics yearning for a broad overhaul of addiction
treatment — something state legislators from Orange and Los Angeles
counties support — frustrated.
“They completely ignore the for-profit treatment sector, and there’s
no discussion of the exploitation that happens there at all,” said
Laurie Girand of Advocates for Responsible Treatment in San Juan Capistrano.
“Orange County has a massive surplus of ineffective, for-profit (rehab)
providers which are contributing to the opioid crisis, the homelessness
crisis, and deaths,” Girand added. “The county does not need
more of the same.”
Prevention
Early next year, the county will launch opioid overdose and misuse prevention
campaigns aimed at adults and youth. They’ll include education and
targeted messaging for high-risk groups using social, digital,and print
media, the report said.
There’s also targeted prevention for physicians who prescribe drugs,
including guidelines and monitoring, as part of SaferRX OC, a collaborative
on prescription drug abuse coordinated through UCI Health. The report
noted that there were nearly 1.5 million opioid prescriptions written
last year in Orange County, down from an average of about 1.7 million
a year from 2014 through 2017.
The report also noted that to reduce opioid deaths, the county has increased
access to Narcan, a nasal spray version of the medication naloxone. The
drug can reverse the effects of an opioid overdose — essentially
reviving a user who otherwise might die — by knocking opioid molecules
off the brain’s opioid receptors.
Treatment
The county joined California’s Drug Medi-Cal Organized Delivery System
in July 2018 as part of a pilot program designed to restructure treatment services.
It set up county-funded outpatient treatment programs, increased access
to medication-assisted
treatment and expanded overall capacity, the report said. The county now funds 14
outpatient treatment sites, eight residential treatment sites, three detox
facilities, four medication-assisted treatment facilities and six sober
living homes.
And, in perhaps its boldest move, the county is partnering with Kaiser
Permanente, Hoag, Providence St. Joseph Health, and CalOptima to develop
a public-private Be Well Orange County Regional Behavioral Health Campus.
It is expected to open in early 2021 and will provide “a spectrum of
mental health and addiction treatment services” to Orange County residents regardless
of the type of insurance they have and make sure care continues when they
leave hospitals or treatment centers.
More help is on the way to prevent drug-related deaths in county jails,
as well, according to the report.
“We are only a few months young, but we’re very, very hopeful
we can increase access to treatment that’s effective for the entire
county,” said Clayton Chau, a doctor with the Be Well OC initiative.
Medication Stigma
The report, which surveyed drug users and treatment providers, among others,
pointed to a wish list of items that could reduce opioid-related deaths
— more youth-focused prevention programs, more low (or no) cost
, evidence-based drug treatment services and more programs that help people
who suffer from both drug addiction and mental health problems.
But it also found that medication assisted treatment, now widely viewed
as a key to helping people overcome addiction, isn’t yet universally
accepted in Orange County. While 56% of the stakeholders surveyed by the
county support medical treatment for opioid addiction, 34% are unsure
about it and 10% oppose it.
To shift those views, the report said the Orange County Health Care Agency,
health plans and others “should collaborate to develop a (medicine-assisted
treatment) educational anti-stigma campaign,” to get more people
to use that treatment model.
“All treatment and health professionals, regardless of the type of
treatment or setting, should provide or link consumers to (medicine-assisted
treatment) when clinically indicated.”
That’s exactly what Be Well OC aspires to do, Chau said.
“In the treatment community there are two camps — the people
who believe medication-assisted treatment is a life-saving advance, and
the people who don’t believe in chemical alterations of any kind.
The stigma is really, really strong. That’s what we’re facing.
“We’re working hard to educate the community, overcome the
stigma, and get these life-saving treatments to the people who need them,”
he said. “MAT alone isn’t the answer — but in combination
with other supports, it can make a huge difference. It can save lives.”
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Orange County Register article, please click
here.