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International Overdose Awareness Day on August 31, 2022, is the world’s largest annual campaign to end overdose and remember those who have died without stigma and acknowledge the grief of the family and friends left behind. The campaign raises awareness of overdose, which is one of the world’s worst public health crises and stimulates action and discussion about evidence-based overdose prevention and drug policy.

Learn more:

International Overdose Awareness Day

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August 31, 2022
DEPRESCRIBING IS GOOD PRESCRIBING

5:30–7:30 PM
Sterling Hills Golf Club, Camarillo

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Just as safe prescribing is an integral and effective strategy to prevent opioid use disorder, safe deprescribing is also key. In this workshop, we’ll discuss when, and how to safely and effectively taper patients from opioid usage. Is the deprescribing plan not working? Let’s talk about how to talk with patients about opioid use disorder and effective referrals to substance use treatment. 

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REGISTER HERE

• www.PrescribersCare.org

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PRESENTED BY

• Tipu V. Khan, MD, FAAFP, FASAM; Addiction Medicine Fellowship Director, VCMC
• Kyle Stephens, DO, Family Medicine Specialist, Primary Care
• George C. Chang Chien, DO, Director of Pain Management, Ventura County Medical Center

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For more information: Ashley.Nettles@ventura.org

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Prescribers are key to creating change in our community.

Thanks to exceptional local collaboration, Ventura County has seen a decrease in opioid prescribing in recent years – a 24% reduction between 2017 and 2020 – as providers have employed safe prescribing practices and increased use of non-narcotic pain management strategies.

Unfortunately, overdose deaths continue to climb, largely due to illegal fentanyl, which has replaced much of the local heroin use and is contributing to the rising number of overdose emergencies. As a concerned local provider, we invite you to join the Prescriber Discussion Series:

• Hear from local experts and discuss with peers the latest trends and best practices.
• Get provider-focused resources to reduce misuse and opioid use disorder (OUD).
• Learn the new State guidelines and latest tools for patient care and provider coordination.

Connecting because we care. For our patients and for our community.

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UPCOMING DISCUSSIONS IN THE SERIES‍

• September 21, 2022 • 5:30-7:30pm
  Person-Centered Strategies to Reduce Opioid Overdose

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PREVIOUS DISCUSSIONS

• May 11, 2022 • 5:30–7:30 PM
  Latest Trends in Overdose: What Prescribers Need to Know About Illicit Fentanyl

• June 8, 2022 • 5:30–7:30PM
  Evidence-based Safe Prescribing

‍LEARN MORE AND REGISTER:

• www.PrescribersCare.org

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June 8, 2022
EVIDENCE-BASED SAFE PRESCRIBING

5:30–7:30 PM
Sterling Hills Golf Club, Camarillo

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Join us for a review of local opioid prescribing trends. We’ll discuss how safe prescribing and use of CURES can prevent or reduce opioid misuse and opioid use disorder (OUD) in our patients. Hear from Tipu Khan MD, an author of the newest California Guidelines for Safe Opioid Prescribing, on how to utilize the newest guidelines in our practices. Learn how other local Primary Care and Pain Management Specialist use effective safe prescribing strategies to treat patients at risk of opioid misuse or opioid use disorder (OUD).

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REGISTER HERE

• www.PrescribersCare.org

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PRESENTED BY

• Tipu V. Khan, MD, FAAFP, FASAM; Addiction Medicine Fellowship Director, VCMC
• Kyle Stephens, DO, Family Medicine Specialist, Primary Care
• George Chang Chien, DO, Director of Pain Management, Ventura County Medical Center

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For more information: Ashley.Nettles@ventura.org

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Prescribers are key to creating change in our community.

Thanks to exceptional local collaboration, Ventura County has seen a decrease in opioid prescribing in recent years – a 24% reduction between 2017 and 2020 – as providers have employed safe prescribing practices and increased use of non-narcotic pain management strategies.

Unfortunately, overdose deaths continue to climb, largely due to illegal fentanyl, which has replaced much of the local heroin use and is contributing to the rising number of overdose emergencies. As a concerned local provider, we invite you to join the Prescriber Discussion Series:

• Hear from local experts and discuss with peers the latest trends and best practices.
• Get provider-focused resources to reduce misuse and opioid use disorder (OUD).
• Learn the new State guidelines and latest tools for patient care and provider coordination.

Connecting because we care. For our patients and for our community.

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UPCOMING DISCUSSIONS IN THE SERIES‍

• August 31, 2022 • 5:30 7:30 PM
  Deprescribing is Good Prescribing
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• September 21, 2022 • 5:30-7:30pm
  Person-Centered Strategies to Reduce Opioid Overdose

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PREVIOUS DISCUSSIONS

• May 11, 2022 • 5:30–7:30 PM
  Latest Trends in Overdose: What Prescribers Need to Know About Illicit Fentanyl

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‍LEARN MORE AND REGISTER:

• www.PrescribersCare.org

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The first ever National Fentanyl Awareness Day launches tomorrow, Tuesday, May 10, 2022. The purpose is to raise public awareness about the growing fentanyl public health crisis. People are dying at alarming rates due to illegally made fentanyl, a dangerous synthetic opioid. Founded by parents who have lost loved ones to the drug overdose epidemic, National Fentanyl Awareness Day is supported by a group of subject matter experts, corporations, nonprofits, schools, families, and elected officials who are coming together to amplify the issue via social media. The date was purposely set during Mental Health Awareness Month to amplify the warning message about self-medication at a time when counterfeit pills have flooded the illicit drug market. The goal is to leverage as many organizations and communication channels as possible to reach the most vulnerable demographics.

Learn more:

Fentanyl Awareness Day

SENATE RESOLUTION DESIGNATES MAY 10 AS NATIONAL FENTANYL AWARENESS DAY

Fentanyl is Forever Campaign

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Prescribers are key to creating change in our community.

Thanks to exceptional local collaboration, Ventura County has seen a decrease in opioid prescribing in recent years – a 24% reduction between 2017 and 2020 – as providers have employed safe prescribing practices and increased use of non-narcotic pain management strategies.

Unfortunately, overdose deaths continue to climb, largely due to illegal fentanyl, which has replaced much of the local heroin use and is contributing to the rising number of overdose emergencies. As a concerned local provider, we invite you to join the Prescriber Discussion Series:

• Hear from local experts and discuss with peers the latest trends and best practices.
• Get provider-focused resources to reduce misuse and opioid use disorder (OUD).
• Learn the new State guidelines and latest tools for patient care and provider coordination.

Connecting because we care. For our patients and for our community.

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LEARN MORE AND REGISTER

• www.PrescribersCare.org

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May 11, 2022
LATEST TRENDS IN OVERDOSE: WHAT PRESCRIBERS NEED TO KNOW ABOUT ILLICIT FENTANYL

5:30–7:30 PM
Sterling Hills Golf Club, Camarillo

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The CDC estimates that up to 83% of opioid overdose deaths in 2020 involved synthetic opioids. Join the discussion with other local medical leaders on what this means for local communities. Prescribers are key to preventing opioid misuse by patients that can progress to an opioid use disorder (OUD), illicit fentanyl use and subsequent death. If you are dedicated to improving health outcomes and patient well-being, please join the discussion.

Note: This session includes local law enforcement data on current illicit drug trends, terminology, and access, as well as provider tips for effectively communicating with patients at risk of opioid misuse or overdose.

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PRESENTED BY

• Chris Young, MD, Ventura County Chief Medical Examiner
• Tipu V. Khan, MD, FAAFP, FASAM; Addiction Medicine Fellowship Director, VCMC
• Sergeant John Hajducko, Ventura County Sheriff’s Department

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For more information: Ashley.Nettles@ventura.org

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UPCOMING DISCUSSIONS IN THE SERIES

• June 8, 2022, 5:30–7:30 PM
  Evidence-based Safe Prescribing
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• August 31, 2022, 5:30 7:30 PM
  Deprescribing is Good Prescribing

• September 21, 2022 • 5:30-7:30pm
  Person-Centered Strategies to Reduce Opioid Overdose

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The drug overdose epidemic in the United States is a clear and present public health, public safety, and national security threat. DEA’s National Prescription Drug Take Back Day reflects DEA’s commitment to Americans’ safety and health, encouraging the public to remove unneeded medications from their homes as a measure of preventing medication misuse and opioid addiction from ever starting.

In Ventura County, more than 200 people die each year from opioid overdoses. Prescription painkiller abuse, rising heroin use, fentanyl and accidental opioid overdoses are part of a nationwide crisis.

Ventura County is actively engaged and committed to preventing prescription drug misuse and abuse. One of the ways the County works to address the issue locally is by reducing access, especially to teens. The Ventura County Sheriff's Office (VCSO), in collaboration with Ventura County Behavioral Health (VCBH), established a countywide Rx disposal program that allows residents to safely dispose of unused, unwanted, or expired Rx medication via secure, confidential disposal bins. Learn the signs of overdose and how to take action. Find Disposal Bin locations near you.

Learn more:

Ventura County Responds – Safe Medication Disposal

DEA’s National Prescription Drug Take Back Day

A NIDA study of intentional drug overdose deaths, or suicides by an overdose of a medication or drug, found an overall decline in recent years in the U.S., but an increase in young people aged 15-24, older people aged 75-84, and non-Hispanic Black women. The study also found that women were consistently more likely than men to die from intentional drug overdoses, with the highest rates observed in women ages 45 to 64.

“The distinction between accidental and intentional overdose has important clinical implications, as we must implement strategies for preventing both,” said Nora Volkow, M.D., senior author on the study and director of NIDA. “To do so requires that we screen for suicidality among individuals who use opioids or other drugs, and that we provide treatment and support for those who need it, both for mental illnesses and for substance use disorders.”

Learn more:

NIDA. 2022, February 2. Suicides by drug overdose increased among young people, elderly people, and Black women, despite overall downward trend.

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COAST has enjoyed the collaboration of COAST Leads from agencies within Ventura County, including Public Health, Emergency Medical Services, Medical Examiner’s Office, Health Care Agency and Ventura County Sheriff’s Office. Today we are talking with Christopher Young, MD, Ventura County Medical Examiner.

Tell us about your background. Where did you grow up and where did you receive your education/training?

Dr. Young: I was a California kid. I grew up in Topanga Canyon and the San Fernando Valley and graduated from Chaminade High School in West Hills. Although I wasn’t from Ventura, I spent a great deal of time in the county surfing and boating. My undergraduate degree in biology was earned at Pepperdine University.

After graduating from Pepperdine, I left California for many years. Medical school was at UT in Houston, Texas. My residency training was at Oregon Health and Sciences University in Portland, Oregon. My forensics fellowship was in Dallas, Texas at the Southwestern Institute of Forensic Sciences. After completing my training, I lived in Portland, Oregon where I served as a forensic pathologist for the Oregon State Medical Examiner’s Office for 13 years. I was hired as the Chief Medical Examiner for Ventura County in July of 2017. After spending 23 years training and practicing in other states, it felt great to return home to California.

Ventura County is one of only a small number of California counties with a Medical Examiner rather than a Coroner. Explain the difference and why having a Medical Examiner is beneficial.

Dr. Young: Within the United States, there are two systems of death investigation: coroner and medical examiner. The coroner system dates to feudal England and the medical examiner system started in the early 1900’s in the U.S. While both offices employ forensic pathologists to perform autopsies, a coroner’s office is usually run by an elected person with no formal medical training while a medical examiner’s office is overseen by a physician, usually a forensic pathologist. While there are few federal regulations pertaining to death investigation, for the past 100 years, the federal government has repeatedly recommended replacing coroner’s offices with modern, independent medical examiner’s offices.

Of California’s 58 counties, Ventura County is one of only six counties with a modern medical examiner system of death investigation. Ventura County is especially progressive, having switched from coroner to medical examiner way back in 1974. Although only six counties have a medical examiner’s office, almost half of the state’s population is served this modern system of death investigation. It is the larger, more progressive counties that have made the change to a medical examiner system. The total combined population of the six medical examiner counties of Ventura, Los Angeles, San Diego, San Francisco, Santa Clara and San Joaquin comprise nearly half of the population for California.

Forensic pathologists play a vital role in communities and in the justice system concerning matters related to death. For death investigation to be done properly, investigations must be performed in an objective, neutral and independent setting. The investigation of deaths can become the focus of political or legal pressures by individuals or offices seeking to influence a pathologist’s findings.

Two of the primary reasons for the federal government to recommend the medical examiner model of death investigation are independence and medical oversight. Independence is critical as potential and inevitable conflicts of interest arise in offices run by elected officials and law enforcement. The most obvious and glaring example of conflict of interest occurs when in-custody death or police shooting death is investigated by the same law enforcement agency involved in the death.

Another distinguishing feature of a medical examiner office is that these offices are run by physicians with specialized training. An example where death investigation oversight by a physician is especially important is the opioid epidemic. In order to understand the opioid epidemic, the drugs which caused the death must be identified. In some California, non-medical examiner offices, a pathologist may conclude that a death is the result of a “combined drug overdose”. In these offices, the death certificate is often completed by a non-medical deputy investigator.

For these overdose cases the death certificate may indicate an overdose with no drugs listed or, alternatively, the deputy may attempt to include every drug listed in the toxicology report on the death certificate (including many drugs not related to the death). In Ventura County, every death certificate is certified by a physician.  When the death is the result of an overdose, only those specific drugs that contributed to death are listed on the death certificate. Medical opinion and certification are necessary to accurately identify and characterize individual overdose deaths; but are also critical to accurately define and understand the opioid epidemic as a whole. The Ventura County Medical Examiner’s Office has been complimented by state California Department of Public Health for the detailed information included on death certificates for overdose deaths.

COAST has focused on the opioid crisis in our county. What have you seen over the past three years?

Dr. Young: The opioid crisis is a complex and ongoing problem throughout the United States which has also affected Ventura County. Over the past three years, we have seen an unprecedented numbers of overdose deaths. The majority of these deaths were the result of opioids and methamphetamine. Opioid deaths include prescription opioids like oxycodone or codeine, but a large percentage of these deaths in Ventura were due to heroin and fentanyl. Prior to 2020, fentanyl overdoses were less common than heroin deaths. Overdose deaths increased dramatically in 2020 and the increase was almost entirely due to fentanyl. Comparing deaths from 2019 and 2020, the total number of overdose deaths in Ventura increased from 149 to 217. Comparing these same years, the number of fentanyl overdose deaths went from 33 to 87.

Fentanyl is an extremely potent opioid drug which causes respiratory depression. Historically, the illicit form of the drug was recognized as a white powder. Death investigations in Ventura over the past year and a half have shown that fentanyl can have many forms. In some instances, illicitly manufactured, counterfeit pills appear to be Xanax or Oxycontin but are, in fact, fentanyl. In other cases, tan, sticky material resembling heroin also turns out to be fentanyl. While many of the individuals who overdosed on fentanyl may have known that they were using fentanyl, many other people may have overdosed and died unknowingly.

COAST helped your office produce an ‘Overdose Do’s and Don’ts’ video to educate first responders in helping you do your job when there’s an overdose death investigation. What other support has Behavioral Health/COAST provided to the MEO in the past few years?

Dr. Young: The opioid epidemic is a community problem which affects people throughout our county. The only way to approach the monumental issue of opiate addiction, treatment and prevention is through teamwork. Behavioral Health and COAST have facilitated communication and cooperation between agencies and departments so that we can fight the epidemic as a team. The educational video for first responders at overdose scenes is just one example of how resources have been used to improve the county approach to the epidemic.

In addition to helping promote best practices at overdose scenes, the COAST team has also helped our office promote safe prescribing. COAST provided staffing resources to help our office identify prescribers whose patients died, and the prescribed drug contributed to the death. Oftentimes, a physician may not be informed about a patient’s death. For this group of overdose deaths, the physician receives a letter from the Medical Examiner’s Office. The purpose of these courtesy letters is to inform the doctor about the death and to provide resources for safe prescribing. The focus of these letters is not punitive, but the goal is to promote best practices and improve communication with providers.

Regarding the opioid crisis, I get especially excited to work with our partner organizations to prevent overdose deaths; work I like to refer to as “medical examiner prevention”. One way that the COAST team facilitated collaboration is through sharing data. Along with other agencies and departments, the Ventura Medical Examiner’s Office is sharing data with the COAST epidemiologists. Death investigation information like location of overdoses and location of death will be combined with location data from other sources to generate maps which will help guide our county's response toward prevention and treatment. If I start to feel discouraged by the increasing number of overdose deaths within the county, I find solace when I think about the hard work of caring individuals and organizations within our county working to prevent these deaths and I think about the lives saved by supplying naloxone.

How many investigators do you have on staff?

Dr. Young: The Ventura County Medical Examiner’s Office employs seven full time medicolegal death investigators. Over the past year, our office has seen a steady increase in caseload, in part due to both the COVID-19 pandemic and the opioid epidemic. In response to the increased workload, we have utilized one of our Forensic Pathology Technicians to assist in investigations. During the COVID-19 spike, the county provided our office with a disaster worker from human resources. She quickly integrated with our team and helped us through these tough times.

What prompted you to go into this field?  

Dr. Young: My father is a physician, specialized in treating people with burn injuries. As a pre-med, undergraduate student, I accompanied him to the hospital operating room and the county courtroom. In the operating room, I observed a team of physicians as they repaired life threatening and disfiguring burn wounds. In the court room, I observed my father as he provided expert medical testimony in child abuse burn cases. These experiences would play a large role in my decision to become a forensic pathologist years later.

I started medical school planning to become a family practice physician or surgeon and knew nothing about the specialty of forensic pathology. Like my fellow classmates, I knew that I wanted to use my abilities to help others and serve the community. I was drawn to surgical pathology because it required observational, deductive and hands on skills. Like others considering this field, I had reservations about becoming a surgical pathologist because most of the job is spent looking through a microscope, with little patient interaction. During a medical school surgical pathology rotation, I was invited to visit the medical examiner’s office in Houston, Texas. This was my first encounter with forensic pathology and almost instantly, I recognized that this was my calling.

After exploring this specialty further, I realized that my talents were well suited to this type of work. Forensic pathology requires hands on and observation skills but also requires communication skills to explain findings to others. The conclusions that I make as a forensic pathologist are based on autopsy observations, microscopic specimen evaluation and toxicology interpretation. The most rewarding aspect of the job is the interactions with other people. Clearly explaining findings and conclusions to family members, law enforcement officers, attorneys, jurors, insurance companies, reporters and other physicians requires communication skills, empathy, and patience.

At the end of the day, I became a doctor to help others and the community and forensic pathology fulfills these goals. The information generated from our investigations and autopsies can provide closure for family members, but this information can also save lives, for example when an inherited medical condition is identified. Providing physicians with details about how their patient died can help improve their practice of medicine. Medical expert testimony can help resolve criminal and civil issues within our justice system. Regarding the opiate epidemic, my hope is that information learned from our investigations and autopsies will help guide efforts to prevent future addiction, overdoses, and deaths.

Do you have any tips/advice that the general public could benefit from knowing in regard to opiate/fentanyl overdose?

Dr. Young: I think the best advice I can offer is to take action. The opioid crisis potentially affects everyone in our community, and we need to acknowledge the problem and take measures to protect our friends and family. Openly talking with our youth about the dangers of drug use and experimentation can go a long way toward preventing future addiction and deaths. Safely disposing of unused prescriptions will help prevent drug diversion where the drug is sold or used by someone else. If you or someone you know has an addiction or uses illicitly obtained drugs of any sort, there is always the possibility that the drug might contain fentanyl. Because any illicit drug might contain fentanyl, knowing the signs and symptoms of opioid toxicity and having naloxone on hand could save a life.

What else could benefit residents of Ventura County to know about the Medical Examiner's Office?

Dr. Young: I am proud to be the Chief Medical Examiner for Ventura County. The staff in my office have a difficult job to do and they are hardworking and care about the community that we serve. The county has shown our office a great deal of support allowing us carry out our duties in a timely, accurate and compassionate manner.

Thank you, Dr. Young, for sharing your valuable experience with us!

By Sheila Murphy, COAST Administrator

In October 2018, the Ventura County Behavioral Health Department was notified that its application for the Comprehensive Opioid Abuse Site-based Program, federal funding provided by the U.S. Department of Justice to combat opioid misuse, had been granted. The amount of the award was $935,401, and just under the $1 million maximum. The three-year grant was the largest award of two California county grants in the category.

The COAST Program – County Opioid Abuse Suppression Taskforce – has worked to address opioid abuse in Ventura County exclusively during the past three years, though Behavioral Health has been working tirelessly on this effort when the Ventura County Rx Abuse & Heroin Workgroup was launched in early 2012 to tackle the newly-identified opioid crisis.

COAST has worked closely with our stakeholders – the Ventura County Sheriff’s Office, Ventura County Medical Examiner’s Office, Ventura County Public Health and Ventura County EMS. With the creation of a Data Management Coordinator position earlier this year, COAST has been taking a deep dive on analyzing trends and targeted efforts to reduce local impacts.

The U.S. Department of Justice grant funding of COAST ended in October 2021, but the work, even more important during the past two years, continues, as a stand-alone program under the Substance Use Services division of Behavioral Health. The COAST Opioid Data Dashboard was developed to inform the public on important data such as opioid-related deaths over a five-year period (2016-2020), lives saved with naloxone (2014-2019), and prescriptions for opioids in the year 2018, among others. The Dashboard will be updated annually.

The emergence of fentanyl as the leading cause of overdose deaths, both in Ventura County and nationally, has taken the work of COAST to greater collaboration with the Ventura County Sheriff’s Office. We will continue to look for innovative ways to educate and inform residents of our county about the very real dangers of illicit drugs, and how they can keep themselves and their families safe and healthy. To learn more, www.coastventuracounty.org.

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Reflecting the United States struggles with tragic drug overdoses exceeding 100,000 deaths in 12 months, Ventura County’s local accidental fatal overdoses have also risen dramatically. In both cases, the increases are driven and sustained by illegal fentanyl, a powerful synthetic opioid that has flooded the illicit drug supply.

In response to the covert dangers of fentanyl, Ventura County Behavioral Health (VCBH) just released a new community campaign, Fentanyl is Forever (English) and El Fentanilo es para Siempre (Spanish). The prevention messages unfold through five diverse short stories that allow people to experience and understand the risks of fentanyl to their friends, families, and communities. In addition to warning the public about the dangers of fentanyl, viewers are then linked to local resources for more information and help.

The goals of the campaign are to increase awareness of fentanyl risks and its impact on communities, and to decrease the stigma related to talking about substance misuse and addiction. It complements messaging related to naloxone preparedness and substance use disorder treatment.

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Learn more:

Fentanyl is Forever

Ventura County Responds

November 17, 2021

Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy, hosted a press call with Secretary of Health and Human Services Xavier Becerra and other Biden-Harris Administration officials to discuss new and ongoing actions to address the overdose epidemic as well as the urgent need for Congress to fund President Biden’s FY 2022 budget to build on those actions. The call followed the release of CDC’s provisional drug overdose death data, which show a record number of 100,306 predicted overdose deaths in the 12-month period ending in April 2021.

Dr. Gupta also announced the release of a model law for states to help expand access to naloxone, which saves lives by reversing opioid overdoses. “This is a tragic, all hands on deck moment. Harm reduction policies that make life-saving tools, like naloxone and fentanyl test strips, readily available are just the beginning. We must continue working on bold, new solutions aimed at keeping Americans alive,” said HHS Assistant Secretary for Mental Health and Substance Use, Miriam E. Delphin-Rittmon, Ph.D.

Read the Press Release

November 17, 2021

“Today, new data reveal that our nation has reached a tragic milestone: more than 100,000 lives were lost to the overdose epidemic from April of last year to April of this year. As we continue to make strides to defeat the COVID-19 pandemic, we cannot overlook this epidemic of loss, which has touched families and communities across the country."

As we grieve those we’ve lost and honor their memories, my Administration is committed to doing everything in our power to address addiction and end the overdose epidemic. Through the American Rescue Plan, we’ve delivered nearly $4 billion to strengthen and expand services for substance use disorder and mental health. We’re working to make health coverage more accessible and affordable for all Americans, so that more people who need care can get it. We are strengthening prevention, promoting harm reduction, expanding treatment, and supporting people in recovery, as well as reducing the supply of harmful substances in our communities. And we won’t let up.

To all those families who have mourned a loved one and to all those people who are facing addiction or are in recovery: you are in our hearts, and you are not alone. Together, we will turn the tide on this epidemic.”

Learn more:

Read the Proclamation

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Every quarter we send out COAST Newsletters to keep you informed about our COAST grant efforts to address the Opioid crisis in Ventura County. Through the COAST grant, Ventura County agencies are working together to reduce illicit opioid supply, decrease opioid demand, and save lives. By sharing and comparing data, we can leverage information, analyze trends, and target resources to respond to this evolving public health crisis. In this newsletter, see the Interview with Dr. Christopher Young, MD, Ventura County Medical Examiner.

COAST Newsletter - October 2021

Opioid Data Dashboard, COAST Ventura County

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SATURDAY, OCTOBER 23, 2021 - 10 AM - 2 PM

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Saving Lives

Ventura County is committed to preventing prescription drug misuse and abuse. One of the ways the county works to address the issue locally is by reducing access, especially to teens. The Ventura County Sheriff's Office in collaboration with Ventura County Behavioral Health established a countywide Rx disposal program that allows residents to safely dispose of unused, unwanted, or expired Rx medication via secure, confidential disposal bins. Over the last several years, this has expanded to other jurisdictions and retail pharmacies.

The DEA’s Take Back Day provides an opportunity to prevent drug addiction and overdose deaths. It encourages people to dispose of prescription drugs while also educating the public about the potential for abuse of medications.

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What You Can Do

• Commit to safely disposing of your prescription drugs
• Get the facts on Rx & OTC drug abuse
• Dispel the myth that Rx drugs are safe to abuse
• Know the signs and symptoms of drug use
• Monitor and secure all medications

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Learn more:

Medication Disposal Drop-off Locations

DEA Take Back Day

takebackday.dea.gov

DEA Warns that International and Domestic Criminal Drug Networks are Flooding the United States with Lethal Counterfeit Pills

WASHINGTON, DC – Today, the Drug Enforcement Administration issued a Public Safety Alert warning Americans of the alarming increase in the lethality and availability of fake prescription pills containing fentanyl and methamphetamine. DEA’s Public Safety Alert, the first in six years, seeks to raise public awareness of a significant nationwide surge in counterfeit pills that are mass-produced by criminal drug networks in labs, deceptively marketed as legitimate prescription pills, and are killing unsuspecting Americans at an unprecedented rate.

These counterfeit pills have been seized by DEA in every U.S. state in unprecedented quantities. More than 9.5 million counterfeit pills were seized so far this year, which is more than the last two years combined. DEA laboratory testing reveals a dramatic rise in the number of counterfeit pills containing at least two milligrams of fentanyl, which is considered a lethal dose. A deadly dose of fentanyl is small enough to fit on the tip of a pencil.  

Counterfeit pills are illegally manufactured by criminal drug networks and are made to look like real prescription opioid medications such as oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like amphetamines (Adderall®). Fake prescription pills are widely accessible and often sold on social media and e-commerce platforms – making them available to anyone with a smartphone, including minors.

“The United States is facing an unprecedented crisis of overdose deaths fueled by illegally manufactured fentanyl and methamphetamine,” said Anne Milgram, Administrator of the Drug Enforcement Administration. “Counterfeit pills that contain these dangerous and extremely addictive drugs are more lethal and more accessible than ever before. In fact, DEA lab analyses reveal that two out of every five fake pills with fentanyl contain a potentially lethal dose. DEA is focusing resources on taking down the violent drug traffickers causing the greatest harm and posing the greatest threat to the safety and health of Americans. Today, we are alerting the public to this danger so that people have the information they need to protect themselves and their children.”

Learn more:

https://www.dea.gov/press-releases/2021/09/27/dea-issues-public-safety-alert

THE WHITE HOUSE

AUGUST 27, 2021

The overdose epidemic has taken a toll on far too many Americans and their loved ones. Addiction is a disease that touches families in every community, including my own. The epidemic is national, but the impact is personal.  It is personal to the millions who confront substance use disorder every day, and to the families who have lost loved ones to an overdose. During Overdose Awareness Week, we recommit to taking bold actions to prevent overdoses and related deaths, and enhance our support for individuals with substance use disorders.

In recent years, we have seen synthetic opioids, such as illicitly manufactured fentanyl, drive many overdose deaths with cocaine- and methamphetamine-related deaths also increasing at alarming rates. The COVID-19 pandemic has exacerbated the overdose epidemic, as necessary pandemic restrictions made it harder for individuals with addiction to receive the treatment and support services they need. These factors contributed to the more than 93,000 drug overdose deaths in 2020. As a Nation, we need a strong response to America’s overdose epidemic and an investment in prevention, harm reduction, treatment and recovery services, as well as strategies to reduce the supply of illicit drugs.

‍Read more:

A Proclamation on Overdose Awareness Week, 2021

Recovery is For Everyone: Every Person, Every Family, Every Community

Recovery Month is a national observance held every September to educate Americans that substance use treatment and mental health services can enable those with a mental and/or substance use disorder to live a healthy and rewarding life.

Recovery Month celebrates the gains made by those in recovery, just as we celebrate health improvements made by those who are managing other health conditions such as hypertension, diabetes, asthma, and heart disease. This observance reinforces the positive message that behavioral health is essential to overall health, prevention works, treatment is effective, and people can and do recover.

There are millions of Americans whose lives have been transformed through recovery. Since these successes often go unnoticed by the broader population, Recovery Month provides a vehicle for everyone to celebrate these accomplishments.

The 2021 theme, “Recovery is For Everyone: Every Person, Every Family, Every Community,” reminds people in recovery and those who support them that no one is alone in the journey through recovery. Everyone's journey is different, but we are all in this together. Recovery Month will continue to educate others about substance use disorders and co-occurring disorders, the effectiveness of treatment and recovery services, and that recovery is possible. All of us, from celebrities and sports figures to our co-workers, neighbors, friends, and family members, throughout our lives have experienced peaks and valleys, both big and small. But with strength, support, and hope from the people we love, we are resilient.

Learn more:

Faces & Voices of Recovery’s National Recovery Month

NAADAC

California Attorney General Rob Bonta announced a historic $26 billion settlement that will help bring desperately needed relief to people in California and across the country who are struggling with opioid addiction. The settlement includes Cardinal, McKesson, and AmerisourceBergen – the nation’s three major pharmaceutical distributors – and Johnson & Johnson, a company that manufactured and marketed opioids. Read CSAC’s full response to the announcement here.

“These critical settlement funds are desperately needed to help California’s local communities heal from the severe devastation caused by opioids,” said Graham Knaus, Executive Director of the California State Association of Counties. “We are optimistic and confident that the Attorney General’s Office will negotiate and reach an agreement that provides funding and resources for counties and local communities to address this crisis.”

Upon the news of this national settlement, California’s Counties renew their ongoing commitment to working with the California Attorney General to reach an intrastate allocation agreement. Without such an agreement, counties cannot access funds from this national settlement, even though they are tasked with providing substance use disorder and prevention services on behalf of the state. California’s cities and counties have been in negotiations with the Attorney General’s office since last year, including thwarting legislative efforts to cut local governments out of the national settlement negotiations.

Learn more:

California State Association of Counties

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Every quarter we send out COAST Newsletters to keep you informed about our COAST grant efforts to address the Opioid crisis in Ventura County. Through the COAST grant, Ventura County agencies are working together to reduce illicit opioid supply, decrease opioid demand, and save lives. By sharing and comparing data, we can leverage information, analyze trends, and target resources to respond to this evolving public health crisis. See the July 2021 Newsletter and learn about recent efforts being made by our team.

COAST Newsletter - July 2021

Opioid Data Dashboard, COAST Ventura County

The Washington Post, July 14, 2021

Deaths from drug overdoses soared to more than 93,000 last year, a staggering record that reflects the coronavirus pandemic’s toll on efforts to quell the crisis and the continued spread of the synthetic opioid fentanyl in the illegal narcotic supply, the government reported Wednesday.

The death toll jumped by more than 21,000, or nearly 30 percent, from 2019, according to provisional data released by the National Center for Health Statistics, eclipsing the record set that year.

• Opioids, primarily illegal fentanyl, continued to drive the death toll, as they have for years. Overdose deaths involving opioids reached 69,710 in 2020, up from 50,963 in 2019, according to the data. Deaths from methamphetamine and cocaine also rose.
• Nora Volkow, head of the National Institute on Drug Abuse, said in an interview that fentanyl has so thoroughly infiltrated the illegal drug supply that 70 percent of cocaine overdose deaths and 50 percent of methamphetamine overdose deaths also involved fentanyl
• In many cases, she said, users are unaware that their drugs are laced with the powerful painkiller, which can halt breathing even if a minute amount is ingested. In others, users knowingly take multiple drugs. “Most of the deaths are from multiple drugs,” she said.

Learn more:

Drug overdose deaths soared to a record 93,000 last year, The Washington Post, July 14, 2021

Drug overdose deaths in 2020 hit highest number ever recorded, CDC data shows, CNN, July 14, 2021

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IT TAKES A VILLAGE

By Kirsti V. Thompson, Director, Give an Hour California

We have all heard the saying “It takes a village." Our story is “It takes a transportation center.” Our new "village" is serving the needs of the Oxnard Transit Center and the surrounding community.

In early 2020, VCBH was contacted by Gold Coast Transportation Services. They shared that a team of bus operators who work in the Oxnard area had concerns about drug use paraphernalia left behind at the Oxnard Transit Center, which is located in downtown Oxnard and is the busiest transportation center in our region. They reached out for our help.

The Overdose Prevention Program was founded in 2014 and offers outreach, training, and access to Overdose Rescue Kits to those who qualify in Ventura County. Ashley Nettles, Program Manager of the Overdose Prevention Program offered training and overdose kits to the Gold Coast team. Since then, a collaborative work group was born! Members from Ventura County Public Health, Oxnard Police Department, VCBH, City of Oxnard, and Gold Coast Transit met virtually several times to identify the issues that were contributing to the problem and brainstorm ways to solve it.

One of the initial issues identified was ensuring that the resources that are available are promoted to those who may benefit from them. Instead of ignoring the problems with drug use and paraphernalia at the Transit Center, or simply calling the police, the collaborative recommended developing an outreach tool that highlights the local social services that could help. A bilingual resource card was developed.

The resource cards are on display at the Oxnard Transit Center and on the buses that travel through that area. Gold Coast drivers and managers have been trained in Opioid Overdose Response, and Opioid Overdose Rescue Kits are now kept on hand at the Transit Center and with Gold Coast Field Managers.

This a new project, and we recognize it is a relatively small step in the big world of substance abuse and homelessness in Ventura County. We also know that it takes true collaboration (a real village!) to get meaningful work accomplished, and we are thankful to all who worked on this initial village building, and will continue to work together to take steps together to address the big issues we face.

Learn more:

www.safechoicesvc.org

www.safechoicesvc.org/es

FDA News Release, April 30, 2021

The U.S. Food and Drug Administration announced today the approval of a higher dose naloxone hydrochloride nasal spray product to treat opioid overdose. The newly approved product delivers 8 milligrams (mg) of naloxone into the nasal cavity. The FDA had previously approved 2 mg and 4 mg naloxone nasal spray products.

Naloxone is a medicine that can be administered by individuals with or without medical training to help reduce opioid overdose deaths. If naloxone is administered quickly, it can counter the opioid overdose effects, usually within minutes. A higher dose of naloxone provides an additional option in the treatment of opioid overdoses.

“Today’s action meets another critical need in combatting opioid overdose,” said Patrizia Cavazzoni, M.D., director of the FDA’s Center for Drug Evaluation and Research. “Addressing the opioid crisis is a top priority for the FDA, and we will continue our efforts to increase access to naloxone and place this important medicine in the hands of those who need it most.”
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Learn more:

FDA News Release

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Every quarter we send out COAST Newsletters to keep you informed about our COAST grant efforts to address the Opioid crisis in Ventura County. Through the COAST grant, Ventura County agencies are working together to reduce illicit opioid supply, decrease opioid demand, and save lives. By sharing and comparing data, we can leverage information, analyze trends, and target resources to respond to this evolving public health crisis. See the April 2021 Newsletter and learn about recent efforts being made by our team.

COAST Newsletter - April 2021

Opioid Data Dashboard, COAST Ventura County

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April 24, 2021, 10am - 2pm

Ventura County is committed to preventing prescription drug misuse and abuse. One of the ways the county works to address the issue locally is by reducing access, especially to teens. The Ventura County Sheriff's Office in collaboration with Ventura County Behavioral Health established a countywide Rx disposal program that allows residents to safely dispose of unused, unwanted, or expired Rx medication via secure, confidential disposal bins. Over the last several years, this has expanded to other jurisdictions and retail pharmacies.

The DEA’s Take Back Day provides an opportunity to prevent drug addiction and overdose deaths. It encourages people to dispose of prescription drugs while also educating the public about the potential for abuse of medications.

What You Can Do

• Commit to safely disposing of your prescription drugs
• Get the facts on Rx & OTC drug abuse
• Dispel the myth that Rx drugs are safe to abuse
• Know the signs and symptoms of drug use
• Monitor and secure all medications

Learn more:

Medication Disposal Drop-off Locations

www.venturacountyresponds.org/medication-safety/safe-medication-disposal

DEA Take Back Day

takebackday.dea.gov

Ventura County saw a spike in overdose deaths in 2020, driven largely by a powerful synthetic opioid, a new report shows. Fatal overdoses reached 217 in 2020, a jump of more than 45% compared to the prior year, according to an annual report from the Ventura County Medical Examiner's Office. "A few years ago, when there were reports about fentanyl in other parts of the country, we weren't seeing that many deaths from it here in Ventura County," said Dr. Christopher Young, the county's chief medical examiner. “This is a dangerous drug that's in our community and causing these deaths," Young said.

Source:  Ventura County Star

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Special Report: 2020 Fatal Overdoses

Noteworthy trends:

• Total overdose deaths between 2019 and 2020 increased by 68 (45.6% increase). Compared to the previous year, accidental overdoses for 2020 increased by 75 while suicidal overdoses decreased by 5.
• Fentanyl and benzodiazepine deaths increased significantly in 2020 compared to 2019. Fentanyl contributed to 54 more deaths than the previous year. Benzodiazepines contributed to 34 more deaths than the previous year.
• The highest number of overdose deaths in 2020 were between ages 31 to 40 years (49 deaths) and of these deaths, 24 involved fentanyl.

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Learn more:

• ‍Overdose deaths in Ventura County spiked in 2020, largely due to fentanyl, Ventura County Star, March 3, 2021
• ‍Special Report: 2020 Fatal Overdoses, County of Ventura, Medical Examiner’s Office
• Opioid Data Dashboard, COAST Ventura County

Today we are talking with Brad Friday, Implementation Coordinator for the County Opioid Abuse Suppression Taskforce (COAST) Grant, Ventura County Behavioral Health, Substance Use Services - Prevention.

Hi Brad. Please describe your work with the COAST grant.

Brad: My work with COAST includes collection, dissemination, and publishing of pertinent County Opioid-related data via Public and Internal Dashboards, as well liaising between the requirements of the grant and our key stakeholders/partners.

How did you get interested in the field of prevention?

Brad: While serving as an Active-Duty Hospital Corpsman in the Navy, I was assigned to Marine Corps ground forces as a Field Medic. The prevention bug first bit while preparing/educating Marines prior to operational deployments rather than being strictly reactionary. After that tour I became a “Preventive Medicine Technician” within Navy Medicine which specialized in overall safety, health, and wellness of deployable forces within the Navy and Marine Corps.

What is your passion for working in the community?

Brad: It’s validating to contribute toward providing our diverse population a safe place to live and grow despite the challenges we face. This only happens by being at the ground level and interacting with the community along with our multi-agency partners who are working hard to achieve this mutual goal. My passion is to keep these threads tied together, to enhance these relationships and to maintain a unified front in suppressing the opioid crisis.

What are the areas that you hope to make changes in?

Brad: My goal in working within the COAST Project is to act as a conduit toward reducing opiate abuse, overdoses and overdose deaths via immediate communication of real-time data. This communication will then guide prevention, health care, and community leaders who join us in tackling the opioid crisis toward making more informed decisions.

Tell us one thing about you that helps us get to know you better?

Brad: I am originally from the Midwest but felt deeply connected to Ventura County upon being stationed in Port Hueneme some 20 years ago. While my career took me out of the county for a while, the attachment to this area never left. I’m not only happy that I get to live in this amazing area with so much to offer; I’m also increasingly proud I’m able to serve this community in this capacity.

Thank you Brad for sharing your experience with us. Your commitment and passion is inspiring.

Learn more:

Opioid Data Dashboard

www.coastventuracounty.org

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Drop off your unused and expired Rx Medications at the Oxnard Police Department's Rx Drop-Off Day on Saturday, December 5!

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Guest Post, Sheila Murphy, COAST Grant Administrator

Led by multi-disciplinary experts from across the nation, the Cocaine, Meth & Stimulant Summit provides the most extensive educational experience for professionals on the frontlines of this rising epidemic.

The Cocaine, Meth & Stimulant Summit was held virtually from November 20-22, 2020. During a year in which conferences via Zoom have become the norm, the Summit came off seamlessly, while also informative and relevant. In its third year, the Cocaine, Meth & Stimulant Summit is the only educational event focused on addressing the Stimulant crisis. Drug overdoses in this country were increasing prior to the COVID-19 pandemic and have increased exponentially since March of this year.

Presentations included 28 live discussions, and two educational tracks, with field experts and change makers who work daily to address this emergency compounding the opioid epidemic. It provided a roster of clinical, law enforcement, and public health professionals with practical strategies and solutions. Stimulants have become increasingly prevalent in overdoses and addiction nationally and locally.

A session I attended on “Applying Best Practices to Communicate about Drug Overdose Prevention” shared that opioids were responsible for 60% of overdose deaths in 2018 across the country and sadly only 10% of those addicted to opioids ever receive treatment. Older people are less likely than the general population to perceive themselves at risk for addiction. Prevention communications about the dangers of opioid addiction to caregivers and first responders is essential.

Watch for my updates where I’ll share some more about lessons learned at the Summit.

Stats: 2.2 million people are current users of cocaine; 6 million Americans misuse prescription stimulants; 964,000 people aged 12 and older have a meth use disorder; and 0 is the number of FDA-approved medications to treat stimulant use disorder.

Learn more:

www.stimulantsummit.com

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Many medications can impair your ability to drive, making you an unsafe driver while you’re taking them. It’s against the law to drive when you’re impaired. A prescription doesn’t mean it’s OK to drive.

This campaign launched in partnership with the California Office of Traffic Safety to share the message that pain medication and driving don’t mix! This is part of our Dental Prescribing Toolkit and patient education materials.

Learn more:

Ventura County Responds

https://www.venturacountyresponds.org/safe-prescribing/dental-prescribing-toolkit

Simi Valley Acorn, September 18, 2020

Online resource made possible by federal grant aimed at addressing crisis.

The Ventura County Behavioral Health Department launched on Sept. 1 a public-facing data dashboard that provides the community with statistics about opioid-involved drug use. Dr. Loretta Denering, chief of the county’s Substance Use Services Division, said the new dashboard will be a valuable resource to county residents. “Local trends and resources, including addiction treatment locations, prescription drug drop-off locations and overdose prevention strategies, are featured,” she said. “Until now, there has never been a one-stop site.”

In 2018, the department was awarded a federal grant that, in collaboration with multiple agencies, has allowed for more innovative ways to address the opioid crisis. One of the grant efforts was to create the community dashboard in addition to tracking the nature and extent of the crisis locally, as well as providing more services to the public, especially those with an opioid-use disorder.

> Read the article, Simi Valley Acorn, September 18, 2020

> www.coastventuracounty.org/

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Fewer Overdoses and Increased Access to Care Are Priorities

Ventura County agencies are working together to reduce illicit opioid supply, decrease opioid demand, and save lives. By sharing and comparing data, we can leverage information, analyze trends, and target resources to respond to this evolving public health crisis.

On September 1st, The Ventura County Behavioral Health Department (VCBH) launched a public-facing data dashboard that provides the community with important statistics around opioid involved drug use. The public can access this user-friendly dashboard by visiting www.coastventuracounty.org.

“Local trends and resources, including addiction treatment locations, prescription drug drop-off locations, and overdose prevention strategies are featured. This is a one-stop site."

— Dr. Loretta Denering, Chief, Substance Use Services Division

As a response to the opioid crisis, VCBH has prioritized increased access to care for opioid users. In October of 2018, VCBH was awarded a federal grant, that in collaboration with multiple agencies, including Public Health, Emergency Medical Services, Ambulatory Care, Sheriff’s Office and the Medical Examiner’s Office, has allowed for more innovative ways to address the crisis. One of the grant deliverables was to create this dashboard for the community, in addition to tracking the nature and extent of the crisis locally, as well as providing more services to the public, especially those with an opioid use disorder.

VCBH provides a continuum of care for substance use and addiction problems, with six locations and access to a range of treatment services for achieving and maintaining recovery.

“Getting help for addiction starts with taking fifteen minutes to call the Access Line, or visiting our dashboard. We want people to get to the help they need."

— Dr. Sevet Johnson, Director, Ventura County Behavioral Health

If you believe you or a family member may be struggling with addiction, talk to your healthcare provider or call the confidential 24/7 Access Line: 1-844-385-9200.

View Promotion Resources

www.coastventuracounty.org/media

Coast Data Dashboard

www.CoastVenturaCounty.org

NIH Director, Dr. Francis Collins and NIDA Director Dr. Nora Volkow discuss how the COVID-19 pandemic may be escalating the opioid crisis and efforts to adapt research as a result of the convergence of two drastic health crises.

Source: National Institute on Drug Abuse, July 6, 2020

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SAMHSA’s Office of Behavioral Health Equity is pleased to announce a new issue brief: The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue. The opioid crisis has not abated and has had a significant impact on Hispanic/Latino communities in the U.S. This issue brief presents recent data on prevalence of opioid misuse and death rates in the Hispanic/Latino population; contextual factors and challenges to prevention and treatment; innovative outreach and engagement strategies to connect people to evidence-based treatment; and the importance of community voice.

> Read the report

Could someone you care about Overdose? For more information on how naloxone can save lives and how to get an Overdose Rescue Kit.

Goal is to Help Reduce Opioid Overdoses and Deaths

The U.S. Food and Drug Administration today announced it is requiring that labeling for opioid pain medicine and medicine to treat opioid use disorder (OUD) be updated to recommend that as a routine part of prescribing these medicines, health care professionals should discuss the availability of naloxone with patients and caregivers, both when beginning and renewing treatment. Naloxone is a medicine that can be administered by individuals with or without medical training to help reduce opioid overdose deaths. If naloxone is administered quickly, it can counter the overdose effects, usually within minutes.

“Even during this global pandemic, we have continued to prioritize addressing the opioid crisis,” said FDA Commissioner Stephen M. Hahn, M.D. "Today’s action can help further raise awareness about this potentially life-saving treatment for individuals that may be at greater risk of an overdose and those in the community most likely to observe an overdose. We will use all available tools to address this crisis, and we know efforts to increase access to naloxone have the potential to put an important medicine for combatting opioid overdose and death in the hands of those who need it most – those at increased risk of opioid overdose and their friends and family.”

> FDA News Release

Sharp reductions in prescription opioid supply, continued increases in PDMP use, but staggering increase in fatalities involving illicit opioids, methamphetamine, heroin and cocaine were demonstrated last year. AMA calls on policymakers and others to remove barriers to evidence-based care for patients with pain and those with a substance use disorder.

Although fatal opioid overdoses hit a record high in 2019 — and the Covid-19 pandemic threatens to make matters worse — the latest report from the American Medical Association's Opioid Task Force finds that prescriptions for these drugs decreased last year for the sixth year in a row. There was a 37% decrease in opioid prescriptions last year — from more than 244 million in 2014 to around 154 million in 2019. Other trends also point to higher scrutiny of these prescriptions: There was a 64% increase since 2018 in physicians' use of state drug monitoring programs, for instance, which are online databases meant to track prescriptions of controlled substances. And more doctors are also prescribing naloxone: More than 1 million prescriptions of the drug were dispensed last year, which is more than double the number in 2018.

> 2020 AMA Opioid Task Force Drug Overdose Report

> End the Epidemic, American Medical Association (AMA) website

The COVID-19 pandemic presents unique challenges for people with substance use disorders and in recovery. The following resources from Dr. Nora Volkow, NIDA Director, may help. See interviews with Dr. Volkow and read the FAQs on COVID-19 and Addiction/Substance Use Disorder.

> Learn more at the National Institute on Drug Abuse (NIDA)

This study from the National Institute on Drug Abuse (NIDA) reported:

• About 1 in 20 patients treated for a nonfatal opioid overdose in an emergency department died within 1 year of their visit, many within 2 days.
• Two-thirds of these deaths were directly attributed to subsequent opioid-related overdoses.
• Immediate treatment for substance use disorder in the ED that continues after discharge is needed to reduce opioid-related deaths.

> Read the article

Citation: NIDA. (2020, April 2). Many People Treated for Opioid Overdose in Emergency Departments Die Within 1 Year. Retrieved from https://www.drugabuse.gov/news-events/nida-notes/2020/04/many-people-treated-opioid-overdose-in-emergency-departments-die-within-1-year on 2020, June 10

Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) by SAMHSA’s Office of Behavioral Health Equity, March 2020

The opioid crisis has not abated and has had a significant impact on African American communities. This issue brief presents recent data on prevalence of opioid misuse and death rates in the Black/ African American population; contextual factors and challenges to prevention and treatment; innovative outreach and engagement strategies to connect people to evidence-based treatment; and the importance of community voice.

> Read the report

With families encouraged to stay at home due to the nationwide health crisis, the Drug Enforcement Administration is asking Americans to keep prescription medications safe and secure until they can properly dispose of them. The Secure Your Meds awareness campaign addresses a vital public safety and health issue. Medicines that languish in home cabinets are highly susceptible to diversion, misuse, and abuse. The campaign also prompts families to discuss the issue of controlled prescription drug abuse.

> Learn more about the DEA Take Back Day

> Read the Press Release

Volkow spoke with Kaiser Health News about the emerging science around COVID-19’s relationship to vaping and to opioid use disorder, as well as how these underlying epidemics could increase people’s risks. In 2018, opioid overdoses claimed about 47,000 American lives. Last year, federal authorities reported that 5.4 million middle and high school students vaped. And just two months ago, about 2,800 cases of vaping-associated lung injuries resulted in hospitalizations; 68 people died. Until mid-March, these numbers commanded attention. But as the coronavirus death toll climbs and the economic costs of attempting to control its spread wreak havoc, the public health focus is now dramatically different.

> Read the article

Untreated drug and alcohol use contribute to tens of thousands of deaths every year and impact the lives of many more. Healthcare already has effective tools including medications for opioid and alcohol use disorder that could prevent many of these deaths, but they are not being utilized widely enough, and many people who could benefit do not even seek them out. One important reason is the stigma that surrounds people with addiction.

> Read the article

NIDA. (2020, April 22). Addressing the Stigma that Surrounds Addiction.

NPR

Opioid addiction isn't taking a break during the coronavirus pandemic, but the U.S. response to the viral crisis is making addiction treatment easier to get. Opioid addiction isn't taking a break during the coronavirus pandemic. But the U.S. response to the viral crisis is making addiction treatment easier to get. Under the national emergency declared by the Trump administration in March, the government has suspended a federal law that required patients to have an in-person visit with a physician before they could be prescribed drugs that help quell withdrawal symptoms, such as Suboxone. Patients can now get those prescriptions via a phone call or videoconference with a doctor

> Read the article

Opioid-involved overdose deaths dropped in 2018. Learn how the Opioid Crisis is affecting your state.

> Opioid Summaries by State Report

Rx Drug Abuse & Heroin Summit 2020

Despite overall drug overdose-related deaths decreasing in 2018, other statistics indicate a rising “fourth wave” in the nation’s substance use disorder crisis means there is more work to be done, federal officials said in addresses presented during the evening plenary session of the virtual Rx Drug Abuse & Heroin Summit on Wednesday.

Admiral Brett Giroir, MD, assistant secretary of the U.S. Department of Health and Human Services, said methamphetamine-associated deaths saw a 20% to 30% year-over-year increase in 2018, with methamphetamine-associated deaths overtaking those linked to prescription opioids and heroin, with cocaine soon to be next. Polysubstance use is now the norm, Giroir said, noting that methamphetamine and illicit fentanyl or fentayl analogue use together is on the rise.

> Read the article

The U.S. Drug Enforcement Administration has released the 2020 edition of Drugs of Abuse, A DEA Resource Guide, which is designed to be a reliable resource on the most commonly abused and misused drugs in the United States. Drugs of Abuse provides important science-based information about the harms and consequences of drug use, describing a drug’s effects on the body and mind, overdose potential, origin, legal status, and other key factors.

> Resource Guide

Many clinical trials and research initiatives targeted to the opioid crisis have had to be placed on hold while our country focuses on responding to the COVID-19 pandemic. However, the potential that awaits just over the horizon is encouraging, stated two of the country’s leading researchers. Dr. Francis Collins, Director of the National Institutes of Health (NIH), and Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA) – both long-time contributors to the Rx Drug Abuse & Heroin Summit – joined Thursday, April 16, for a conversation to discuss the status of promising research.

> Read the article

RX Drug Abuse & Heroin Summit.

In Wednesday’s morning plenary session in the Rx Drug Abuse & Heroin Summit, three U.S. representatives expressed cautious optimism about the nation’s drug overdose death rate dropping by 4.6% in 2018—the first decline recorded in decades—but added that neither that development nor the COVID-19 crisis is a reason to throttle back now.

“For the first time in literally 20 years, the number of Americans who lost their lives to opioid overdose declined. Think about that. That’s bending the curve in a productive way. But obviously, the fight is not over. We’ll have to continue in the years ahead to devote additional resources to research, law enforcement and, most importantly, finding ways to help folks who have become addicted—usually through no fault of their own, usually by following a legitimate prescription given to them by a medical professional."

> Read the article

ABC news

Health officials worry extended isolation could exacerbate the problem. Health officials acknowledged there could be a myriad of potential factors behind the increase of overdoses in some communities, with a primary concern being the obstacles that social distancing orders have created for public health services like addiction clinics and syringe exchange services.

> Read the article

U.S. News

The National Institute on Drug Abuse director warns the coronavirus could increase the pressure to use, cause complicated health effects and curtail access to treatment for those struggling with addiction. As the novel coronavirus spreads and more states issue stay-at-home orders in the U.S., the head of the National Institute on Drug Abuse says social isolation and overburdened health systems could paint a dire picture for people struggling with addiction.

"Every one of us is affected by COVID – maybe we don't get infected, (but) we're all anxious because of the uncertainties" surrounding it, NIDA Director Dr. Nora Volkow says. "How we cope with that anxiety is very much dependent on multiple factors, including our circumstances, but one of the ways that people cope with it is by taking drugs."

> Read the article

The Rx Drug Abuse & Heroin Summit, a 2020 Virtual Experience, begins today through April 16. VCBH staff have been attending the Rx Summit since its inception in 2012. We brought back the inspiration and the momentum of the Rx Summit annually to inform our efforts to address the opioid crisis at home in Ventura County.

“The same power, the same drive that prompted you to be a part of the solution – to beat back the opioid epidemic, to save lives, and bring illegal drug dealers to justice – it’s that same victorious spirit that will carry this nation through the coronavirus pandemic. Together, we have witnessed a dramatic shift in the stigma behind drug abuse, and most importantly we have seen the number of overdose deaths finally decrease across the country – falling from more than 70,000 in 2017 to under 68,000 in 2018, according to the CDC. It’s a direct result of your comprehensive work. We have ambushed the opioid epidemic on every side – through improvements in law enforcement, treatment and education.” - Congressman Hal Rogers

> Rx Drug Abuse & Heroin Summit

We know very little right now about COVID-19 and even less about its intersection with substance use disorders. But we can make educated guesses based on past experience that people with compromised health due to smoking or vaping and people with opioid, methamphetamine, cannabis, and other substance use disorders could find themselves at increased risk of COVID-19 and its more serious complications—for multiple physiological and social/environmental reasons. The research community should thus be alert to associations between COVID-19 case severity/mortality and substance use, smoking or vaping history, and smoking- or vaping-related lung disease. We must also ensure that patients with substance use disorders are not discriminated against if a rise in COVID-19 cases places added burden on our healthcare system.

> Read the article

NIDA. (2020, April 6). COVID-19: Potential Implications for Individuals with Substance Use Disorders. Retrieved from https://www.drugabuse.gov/about-nida/noras-blog/2020/04/covid-19-potential-implications-individuals-substance-use-disorders on 2020, April 10

If a loved one or someone you know may be at risk of an overdose, call us about getting an Overdose Rescue Kit. If you are eligible for a kit, we will train you online on how to use naloxone. You will then be instructed on how to pick up a kit by appointment at one of our VCBH locations.

Call about a Rescue Kit at (805) 667-6663.

The precarious intersection of the COVID-19 national health emergency and the concurrent epidemic of drug overdose deaths is outlined in the Annals of Internal Medicine this week by Dr. Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. Dr. Volkow discusses how the serious health risks of COVID-19 pose unique challenges to people who smoke or vape, are already struggling with substance use disorders (SUD), or are in recovery from addiction.

People recovering from addiction now face new challenges. Physical distancing measures, while critical to COVID-19 mitigation, eliminate the important element of social support needed for addiction recovery. Additionally, people with opioid use disorder may face barriers to obtaining medications (i.e., buprenorphine or methadone) or obtaining services from syringe services programs. Social distancing will also decrease the likelihood of observed overdoses; administration of naloxone to reverse overdose may be less likely, potentially resulting in more fatalities.

> Read the announcement

NIDA. (2020, April 2). NIDA Director outlines potential risks to people who smoke and use drugs during COVID-19 pandemic. Retrieved from https://www.drugabuse.gov/news-events/news-releases/2020/04/nida-director-outlines-potential-risks-to-people-who-smoke-use-drugs-during-covid-19-pandemic on 2020, April 2

The upcoming National Prescription Drug Take Back Day scheduled for Saturday, April 25, 2020, is postponed due to the ongoing coronavirus (COVID-19) pandemic. DEA will reschedule Take Back Day for a date shortly after the health crisis recedes and national emergency guidelines are lifted.

https://takebackday.dea.gov/

As people across the U.S. and the rest of the world contend with coronavirus disease 2019 (COVID-19), the research community should be alert to the possibility that it could hit some populations with substance use disorders (SUDs) particularly hard. People with opioid use disorder (OUD) and methamphetamine use disorder may also be vulnerable due to those drugs’ effects on respiratory and pulmonary health.

> Read the article.

Source: NIDA. (2020, March 12). COVID-19: Potential Implications for Individuals with Substance Use Disorders. Retrieved from https://www.drugabuse.gov/about-nida/noras-blog/2020/03/covid-19-potential-implications-individuals-substance-use-disorders on 2020, March 20

Health Day

Having opioid withdrawal symptoms increases the odds that injection drug users will share needles or have a non-fatal overdose, new research suggests. For the study, the researchers questioned more than 800 injection drug users in San Francisco and Los Angeles. "Withdrawal is one of the main chronic health challenges for this population, and we need to be intervening on it," said lead author Ricky Bluthenthal. He's associate dean for social justice at the University of Southern California's Keck School of Medicine, in Los Angeles. An average 130 people a day die in the United States from an opioid overdose, according to the U.S. Centers for Disease Control and Prevention. Needle sharing increases a person's risk of infections such as HIV and hepatitis, as well as other serious health problems, the CDC says.

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Stay updated at the National Institute on Drug Abuse on the latest news about COVID-19.

https://www.drugabuse.gov/drug-topics/comorbidity/covid-19-resources

“Don’t be a drug dealer!” warned a flier distributed to seniors over the past month. The flier advocated safe disposal for expired and unused drugs and promoted a collection event, which collected and safely disposed more than 22 pounds of pills at three senior centers in Oxnard. To combat the problem of seniors unwittingly contributing to the opioid addiction epidemic by storing unused and expired medications in places accessible to friends, family, workers, intruders or just curious children, Eastlake obtained a grant to fund the Senior Volunteer Program, which includes the drug collection program. Using additional funds and assistance provided by the Ventura County Behavioral Health Department, Eastlake is also overseeing additional efforts by STOP, an acronym for Seniors Tackling the Opioid Problem.

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More Ventura County drug abusers are overdosing on pills that look like real medications but are often spiked with a lethally potent synthetic opioid, according to authorities. While the overall number of overdoses appears to be holding steady, authorities are seeing a lower proportion from the street forms of drugs that are injected or smoked, according to the Ventura County Pharmaceutical Crimes Unit. Instead, the trend since the last quarter of 2019 is toward look-alikes of commonly abused prescription pills.

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Ventura County Star

Public safety personnel locally and nationwide have seen a dramatic increase in drug overdose calls in recent years. In 2018, Oxnard police responded to 190 overdose calls, or nearly four per week. The Oxnard Police Department has responded to the opioid epidemic by training officers to administer an overdose-reversal drug and changing the protocol for logging overdose calls. In early 2018, the department began equipping officers with naloxone, also known as Narcan, a nasal spray that reverses the effects of an opioid overdose. Today, 150 officers are equipped with naloxone kits, Cmdr. Sharon Giles said Tuesday in a report to the City Council.

“If you have someone that you believe is suffering from drug dependency and has overdosed, this goes into the nostril, a couple pumps and it’s administered,” Giles told the council while showing the nasal spray. In 2018, 19 of the 96 opioid-related deaths in Ventura County were in Oxnard. Figures for 2019 were not yet available, but Giles said she expects the number will be lower due to naloxone. 2019 was the first full year in which officers were equipped with naloxone. Officers used the nasal spray nine times.

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> See the Video "Oxnard Police Respond to the Opioid Epidemic in Ventura County"