[Margaret Williams, Health and Human Services Agency]
(Placerville, CA) – In October 2017, President Donald Trump declared a national public health emergency due to the alarming number of American deaths from opioid drug overdoses. Every day in the U.S., more than 90 Americans die after overdosing on opioids, according to the National Institute on Drug Abuse (NIDA). In 2016, 1,925 Californians, seven of whom were El Dorado County residents, died as result of opioid overdose, including prescription opioids, heroin and illegally manufactured fentanyl.
Although California's overall opioid-related death rates are lower than the national average, health officials are still concerned. Between the years 2008 to 2016, the California Opioid Overdose Surveillance Dashboard showed that a total of 17,128 California residents lost their lives due to opioid overdose; 85 of those deaths occurred in El Dorado County, 657 in Sacramento County, and 93 in Placer County during that timeframe.
To address the opioid epidemic, the State of California is focusing on the following state-wide strategies: 1) Safe Prescribing; 2) Access to Treatment; 3) Naloxone Distribution; 4) Public Education; and 5) Data Informed/Driven Interventions. A Statewide Opioid Safety Workgroup and Prescription Drug Overdose Prevention Program have been established, and targeted initiatives are being developed around the state-wide strategies in communities across the state.
Local Efforts to Combat Opioids
In El Dorado County, numerous agencies and individuals are working, together and independently, to raise awareness, increase access to treatment and prevent overdoses. These agencies include Marshall Medical Center, Barton Health, the El Dorado Community Health Centers, the El Dorado County Health and Human Services Agency (HHSA), El Dorado County Sheriff's Office, Placerville Police Department, South Lake Tahoe Police Department, local schools, treatment providers, community drug-free coalitions, and others.
According to Dr. Nancy Williams, El Dorado County Public Health Officer, educating the community about the risks associated with opioids and empowering residents to take steps to reduce these risks is critically important. "Many more opioids are prescribed in the U.S. than appear to be required to treat pain, leaving many extra pills available for misuse," said Williams. "The majority of heroin users today start with the abuse of prescription opioids. To get in front of this problem, we have to encourage each person to be an advocate for their own health and to talk with their health care provider about the benefits vs. risks of taking prescription opioids. Whenever possible, the doctor will help individuals limit the use of prescription opioids to only a short period of time and offer less risky but still effective alternatives to opioids for managing pain. In addition, it's important that unused and outdated prescription opioids be safely disposed of to prevent misuse by others."
To increase access to treatment, health care providers and agency representatives in El Dorado County are reviewing their processes so that people with opioid problems who show up in emergency rooms or at health care facilities receive appropriate referrals. El Dorado County is also now part of a regional effort to work with health care providers to expand opioid treatment options. This new "Hub and Spoke" project, through a grant from the California Department of Health Care Services using federal funds, is being implemented locally by Aegis Treatment Centers in collaboration with local health care facilities.
To prevent opioid overdoses, health care providers are reminding individuals of the availability of Naloxone. Naloxone is a lifesaving drug that can temporarily reverse the effects of an opioid overdose until emergency assistance can be obtained. Family members and close friends of those who have had opioid overdoses, or who struggle with opioid addiction, may want to consider keeping Naloxone on hand.
Other local efforts to combat the opioid problem include community events, such as prescription drug take-back days, distribution of medication lock bags, and education for parents and others about the importance of safely storing prescription drugs.
About Opioids and Ways to Prevent Opioid Misuse
Opioids are powerful pain killers that can be highly addictive. Opioids come in various forms, including the prescription drugs oxycodone (e.g., Percocet or OxyContin), hydrocodone (Vicodin), codeine (used to treat pain or cough, such as Tylenol #3) and morphine (Kadian or MS Contin), as well as heroin and fentanyl (a powerful synthetic opioid). Opioids are typically prescribed to manage pain after surgery or serious injury, but the drugs are sometimes prescribed to manage chronic pain. While opioids may effectively manage pain, some people can quickly become dependent on the drugs, leading them to full blown addiction and seeking out heroin or fentanyl when they cannot get prescriptions for the drugs.
Opioids are addictive because they dramatically decrease dopamine in the reward system of the brain over time, causing constant and severe feelings of craving and withdrawal. Opioids also depress the breathing rate. During an overdose, the user can stop breathing completely and die.
To prevent the misuse of opioid prescription drugs, the federal Centers for Disease Control and Prevention (CDC) recommends the following:
- Work with your doctor to create a plan to manage your pain. Know your options and consider ways to manage your pain that do not include opioids.
- Talk to your doctor about side effects and concerns. Make the most informed decision with your doctor and follow up regularly with your doctor.
- Never take opioids in greater amounts or more often than prescribed.
- Never sell or share prescription opioids.
- Store prescription opioids in a secure place, out of reach of others (including children, family, friends, and visitors).
- If you have unused prescription opioids, find your community drug take-back program or your pharmacy mail-back program, or dispose of them following guidance from the Food and Drug Administration (www.fda.gov/Drugs/ResourcesForYou).
- Don't take opioids with alcohol and other medications such as benzodiazepines, muscle relaxants, hypnotics and other prescription opioids.
Where to Get More Information
The CDC has additional information about opioids, including video testimonials of people who have struggled with opioid addiction, on its website at - https://www.cdc.gov/rxawareness/
Individuals needing treatment for opioid addiction are encouraged to check with their health insurance carriers to see if they offer treatment services. Those who don't have health insurance, or who are uncertain about available substance abuse treatment services in El Dorado County, as well as those individuals interested in information about local community education and prevention services, can contact the Alcohol and Drug Programs of El Dorado County HHSA at (530) 621-6207.
Health care providers with questions about the Hub and Spoke grant project in El Dorado may contact John Salvador with Aegis Treatment Centers at (818) 398-8549.
