Monday, June 25, 2018

[Contra Costa County] Grand Jury report pushes for more treatment for opioid abuse in Contra Costa County

MARTINEZ — The county’s civil grand jury is calling for more addiction treatment programs and trained clinicians following a report on how the national opioid crisis is affecting Contra Costa County.
What the jurors found was that there were not enough resources in the county to treat people addicted to opioids, there are far more opioids prescribed county-wide than drugs used in treatment and that the opioid epidemic will continue in this county for the next decade.
In 2015 and 2016, more than 100 residents of Contra Costa County died from opioid overdoses and an estimated 54,000 have misused opioids in the county and approximately 9,700 people have an opioid use disorder, which includes abuse or dependence. Opioids killed 64,000 people in the United States in 2016, which is more people killed than the HIV/AIDS epidemic at its peak in 1995.
The epidemic was identified as “particularly devastating” in Contra Costa County, according to a federal lawsuit filed by Contra Costa County and 29 other counties against drug distributors.
The report focused specifically on the treatment of addiction, excluding any judgments or analysis on prevention, enforcement or harm reduction.
Jurors interviewed recovering addicts, staff from County Health Services and the County Office of Education, the director of a private opioid treatment center in the county and through attending Nar-Anon and Narcotics Anonymous meetings.
Use often starts with a prescription for painkillers, but when that prescriptions runs out and the pain remains or the addiction remains, people turn to illegal opioids that can be purchased without a prescription.
One driving factor behind increased mortality rates is that many drug dealers have mixed cheap and potent drugs such as Fentanyl, which is significantly more potent than morphine or heroin and is inexpensive, in with other opioids. As a result, a person using what they think to be a nonlethal dose of heroin may overdose.
One life-saving drug, buprenorphine, can be used to treat opioid dependence and manage cravings, and can be prescribed in a Medication Assisted Treatment (MAT) program.
In 2016, there were 760,000 prescriptions for opioids in Contra Costa County, excluding buprenorphine, a medication used to treat opioid dependence. However, only 3.2 percent of those medical providers have acquired a waiver to prescribe buprenorphine.
Around 3,562 to 6,597 of those with an opioid use disorder do not have access to treatment, according to the Urban Institute’s report issued on March 19.
The grand jury recommended that the county seek funds and motivate more physicians to complete qualifications to prescribe and dispense buprenorphine in 2019.
Currently, the county has taken a system-wide approach to the crisis and is bringing in all divisions to combat the issue. They’ve expanded access to the Medication Assisted Treatment Program, which is called Choosing Change, which is currently serving 400 clients and is in the process of serving an additional 200 more.
In a partnership with Alameda, the county has adopted best practice guidelines for prescribing opioids.
The EMS, Public Health and Behavioral Health divisions are working to make Naloxone, a drug which can save a life during an acute overdose, more available across the county. A grant from the state has allowed them to distribute 800 doses and another 800 should be arriving in July.
“We have grown to deeply appreciate that drug addiction is a very complex social issue that requires us to work collaboratively as a system, in an attempt to address a myriad of clinical, behavioral and underlying social issues that are connected,” Daniel Peddycord, CCHS Public Health director, said.
June 22, 2018
East Bay Times
By Aaron Davis


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