Recently, you may have heard a startling statistic: drug overdoses now kill more Americans than car accidents. For some years, the same holds true here in the San Joaquin Valley. The lion’s share of those overdoses are from opioids—street drugs and heavy-duty painkillers either derived from opium or made in a lab. Now, health officials are trying to prevent the problem from becoming worse.
Opioid drug addiction isn’t new. But as more doctors prescribe painkillers like Oxycontin and Vicodin, and as more patients turn from those to street drugs like heroin, the problem is evolving. One place to witness the changing face of addiction is Aegis Treatment Center, a clinic offering methadone, counseling and other services to drug addicts.
Dr. Marc Lasher is the medical director of Aegis centers in Fresno and Merced.
“When I first came, we saw the hardcore heroin addicts who had been doing it for 20, 30 years,” says Lasher, a wiry man in his 60s with a curly gray ponytail and a warm smile. He’s been with Aegis for over a dozen years. “Now we're getting to see all these young people. Day after 18, they're walking into this clinic—and some of them are asking to be stabilized so they can pass their biology class.”
Plus, national data from the CDC show whites are overdosing at a higher rate than any other race, and recent data out of Virginia Commonwealth University confirm that in the Valley.
You won’t find the state’s highest overdose rates here in the San Joaquin Valley. But the epidemic holds at a dull roar, with overdose rates still higher than the state average in every Valley county except one. In the six counties here, opioids claimed 151 lives in 2013, and 195 in 2014.*
Fresno County health officer Ken Bird says that’s too many. “If we're over the state average, I don't accept that,” he says. “That's how I see it.”
So, in late 2015, he helped create the Central Valley Opioid Safety Coalition. It’s a group of health officials, providers and advocates putting their heads together to combat the epidemic. Although they’re still relatively young, they’ve made themselves visible throughout the Valley with efforts to train doctors, educate the public and increase access to addiction treatment—now, before the problem gets worse.
“I can see the potential where this could really take off and go beyond what's happening nationwide,” he says.
The opioid epidemic is unique because it’s largely driven by the healthcare system. In the mid-90s, pain was introduced in American medicine as the “Fifth Vital Sign” with a ranking scale for patients from 1-10. Once the conversation about pain became easier, doctors began firing off more prescriptions for highly addictive opioid painkillers.
In 2012, even though the United States had less than 5% of the global population, it consumed 80% of the world’s opioids. In 2014, for every 1,000 residents of Fresno County, there were over 750 opioid prescriptions.
Like in other parts of the country, the epidemic showed up on radar screens here only recently. Ken Bird says the idea for the Coalition arose a few years ago. He was impressed with the work of Lock It Up, a local drug abuse prevention program from the California Health Collaborative.
“The right moment came when I had been attending a few of their Lock It Up meetings, and seeing that really they were the only ones really addressing the problem going on right here,” Bird says.
As they roll out opioid interventions, Bird says the coalition hopes to see improvements not just in overdose deaths, but also a “reduction in number of emergency room visits, hospitalizations that people are doing from this, and numbers of prescriptions and numbers of pills in those prescriptions.”
Dr. Kelly Pfeifer is a family doctor and a director at the California Health Care Foundation. She says coalitions like this have popped up all around the state, and they’re essential for getting to the root cause of the problem.
“The coalitions have been incredibly effective working with local clinicians, doctors, nurse practitioners, to figure out how to have similar community standards about when we should use opioids and for how long,” she says.
It’s the first step in making sure the Valley doesn’t rise any higher in national rankings.
What else are health officials doing to prevent deaths from opioid overdoses? We’ll explore that next week.
*In the broadcast piece, we estimated Valley deaths using death rates from the California Department of Public Health’s Opioid Overdose Surveillance Dashboard. We’ve updated the numbers in the text version of the story with more precise data provided by the CDPH.