A coalition of local health care representatives tackling opioid abuse in Del Norte County are making plans to begin distributing medication that can block the effects of an overdose.
Though it was created more than a year ago, the Rx Safe Del Norte Opioid Safety Coalition held its first meeting Monday. An offshoot of a similar coalition focusing on the opioid epidemic in Humboldt County, the Del Norte group was created through Open Door Community Health Centers, Partnership HealthPlan of California, which administers Medi-Cal benefits locally, and Aegis Treatment Centers, a statewide outfit that operates an opioid addiction clinic in Eureka, said Jermaine Brubaker, who was hired in November to facilitate the coalition.
Other local agencies, including the Del Norte County Sheriff’s Office, the Del Norte County Department of Health and Human Services as well as representatives of the Yurok Tribe have also become involved in Rx Safe Del Norte, Brubaker said.
“It doesn’t look the same as it does in Humboldt County,” she said of opioid use in Del Norte. “You don’t see people passed out on the streets, but our statistics are equally as bad and, especially if you’re looking at Native American populations, above the national average.”
Rx Safe Del Norte focuses on reducing use of opiates in Del Norte County, Brubaker said. This includes efforts to reduce heroin use as well as the issues of doctors overprescribing opiates and how to bring addiction treatment services to the area, she said.
One immediate focus for the coalition is to create a distribution plan for the first doses of Naloxone that are expected to be in Del Norte County in late January or early February, Brubaker said. Sold under the brand name Narcan, among others, Naloxone is used to bring someone out of an opioid overdose long enough to get treatment, she said.
“You don’t have to be a licensed (health) provider or a professional to get Naloxone,” Brubaker said. “They’re even currently starting to prescribe it for people when they get opioid prescriptions. Anyone can have it and anyone can use it. We especially want to get it to those families that know they might need it.”
The Del Norte County Public Health Branch, which has been part of the coalition since its inception in 2017, applied for a grant through the California Department of Public Health for 288 doses of Naloxone, said Program Manager Melody Cannon Cutts. She noted there are other avenues for people to obtain Naloxone, including through local pharmacies.
Open Door will hold the Naloxone doses until Rx Safe Del Norte develops its distribution plan, said Janis Polos, director of nursing for Open Door Community Health Center.
According to the California Department of Public Health, which operates the California Opioid Overdose Surveillance Dashboard, Del Norte County experienced four deaths due to opioid-related overdoses in 2017. The crude mortality rate during 2017 for Del Norte County was 10.9 per 100,000 residents, according to the dashboard. This is a 50 percent increase from 2015, according to the department.
Opioid-related overdoses were especially high in the Klamath area in 2017, according to the dashboard.
Statewide, California experienced 2,196 deaths due to opioid-related overdoses in 2017, according to the California Opioid Overdose Surveillance Dashboard. The annual crude mortality rate for the state was 5.6 per 100,000 residents, a 12 percent increase from 2015, according to the dashboard.
The 12-month death rate from prescription overdoses increased to 4 percent statewide in 2017 while the heroine quarterly death rate dropped from just above 1.6 to about 1.4 percent, according to the dashboard. Meanwhile the synthetic opioid quarterly death rate for 2017 statewide rose from 0.5 to above 1.5, according to the dashboard. Synthetic overdoses may be largely represented by fentanyl.
In Del Norte County, the coalition is just starting to “dig into” the data, Brubaker said. Citing CDPH’s dashboard, she noted that the 2017 rate of opioid prescriptions in Del Norte County is 1,031 per 100,000 residents compared to the statewide rate of opioid prescriptions of 508 per 100,000 residents.
Brubaker also addressed the 2017 age-adjusted death rate from opioid-related overdoses by ethnicity, noting that among Native Americans in Del Norte County the rate was 45 per 100,000 residents. The 2017 age-adjusted death rate for white residents in Del Norte was 27 per 100,000 residents, according to Brubaker.
In Del Norte County, the Department of Health and Human Services isn’t just concerned with opioids, according to Cannon Cutts. Clients seeking services through Health and Human Services are also impacted by long-time alcohol and methamphetamine use, she said.
“Definitely in our county we have more prescriptions than we do people,” Cannon Cutts said. “It’s a presence here. Fortunately what makes us unique are the overdose deaths are lower. Any overdose death is too many, but in comparison to many other counties in California, ours is lower. probably because the utilizers are of a slightly older age where we see alcohol and methamphetamine and other substances being used more in the younger sector.”
The Yurok Tribe is also working on an action plan to help individuals overcome opioid addiction and to prevent local youth from trying those drugs in the first place.
Opioid overdose deaths have increased by almost 300 percent in Humboldt County over the last decade, according to a tribal press release. In 2017, more than 250 residents between Weitchpec and Hoopa were hospitalized due to opioid-related complications, according to the tribe’s press release.
The Yurok Opioid Action Plan seeks to train tribal citizens to be certified alcohol and drug treatment counselors, expand services at the Yurok Wellness Court, offer family-oriented treatment services and improving the handling of child abuse cases in state court. The plan also calls for evaluating existing services, offering more education and training and providing re-entry housing, support services and expanded job training, according to the press release.
Polos said the Yurok Tribe has been active in both the Humboldt and Del Norte coalitions. Other major players in Rx Del Norte include Sutter Coast Hospital, the Tolowa Dee-ni’ Nation, California Highway Patrol and representatives of local ambulance services.
Cannon Cutts also noted that Rx Safe Del Norte also hopes to reach out to local community members and individuals.
“We’re hoping to have a town hall any time soon,” Cannon Cutts said. “Our role is health education and prevention. If a prescription is prescribed by your healthcare provider it should be safe and I don’t think that residents understand the risk of opioid use especially in the long term. Meaning that for some individuals addiction can be a problem. I don’t know that enough information around alternatives to utilizing opioids is present and so that would be our role is to help educate the community that there are alternatives to opioids for pain relief.”
Brubaker noted the coalition also wants families and former addicts to get involved, not just health care providers or local law enforcement.
“It’s hard for people to understand just how addictive they are and that no one chooses to be an opioid addict,” she said. “The ability to stop being an opioid addict is complicated and it’s a long process.”
For more information about Rx Safe Del Norte, visit www.facebook.com/RxSafeDelNorte/.
Reach Jessica Cejnar at firstname.lastname@example.org .