Opioids, the other public health emergency

The number 1 health emergency in the past 14 months has of course been the coronavirus pandemic. But the opioid epidemic that raged long before most of us heard of COVID-19 has not gone away.

In Sonoma County, among others, things have gotten worse.

Opioids are strong pain relievers with brand names like Vicodin and Percocet that doctors prescribe for severe injuries or end-of-life palliative care. The problem is that they are highly addicting. And when people become addicted, they often resort to illicit drugs like fentanyl, a particularly powerful synthetic opioid that is causing an increase in local overdose deaths.

In a sobering report released on Sunday, staff member Nashelly Chavez describes the fentanyl epidemic in North Bay, its tragic impact on local families and the burden on drug counselors and law enforcement officers.

“It has gripped this country,” said Santa Rosa Police Sgt. Brian Boettger told Chavez. “It’s the focus of most of our investigation.”

Fentanyl is often mixed with other medicines so people may not know they are taking it. But even small amounts can be fatal.

In 2017, two people died of a fentanyl overdose in Sonoma County. In 2019 the number climbed to six. Last year it shot up to 29.

Fentanyl, along with other drugs, was identified in 12 fatal overdoses in Sonoma County in 2017. Last year it was 80, an almost seven-fold increase in just four years.

The numbers themselves are bleak. However, a per capita comparison with other California counties shows the extent of the local opioid crisis: In 2019, Sonoma County ranked third among 58 counties for fentanyl-related overdose deaths, behind San Francisco and Mendocino.

With the social isolation and economic instability that have accompanied the coronavirus, people are experiencing a lot of stress. Various polls suggest that drug abuse is on the rise, so it’s not entirely surprising that the number of overdose-related deaths increased in 2020.

But the trend was already established, locally and nationally.

The Centers for Disease Control and Prevention reported an unprecedented 81,000 drug overdose deaths in the United States between May 2019 and May 2020, a 12-month period that included only a brief overlap with the pandemic. About 70% of deaths from overdose are opioid-related, according to the CDC.

Police and prosecutors focus on manufacturers and human traffickers. Sonoma County’s Office of District Attorney Jill Ravitch has received a $ 340,000 grant from the US Department of Justice to assist with opioid-related cases.

A supply-side approach is important, but it only goes so far. It is also necessary to reduce the demand.

President Joe Biden’s US bailout plan allocates $ 1.5 billion to drug abuse treatment – money that supports community organizations like the Santa Rosa Treatment Program, which provides counseling and methadone to opioid users – that reduces cravings for illicit drugs like fentanyl .

Other potential solutions include improving chronic pain management programs to reduce the likelihood of self-medication and requiring health plans to include abuse-deterrent opioids, such as sustained-release tablets, in their medication plans. It is also important to remove the stigma of addiction so that people are less reluctant to seek help.

Coronavirus trendlines are pointing in the right direction: infections are declining, vaccinations have increased, and unless things change dramatically, most restrictions in California will be gone by mid-June.

But we need to focus on our other public health emergency: opioid abuse. Life depends on it.

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