National Rx Take Back Day is October 28.
Learn more:
https://www.dea.gov/takebackday
Medication Disposal Drop Off Locations
https://www.venturacountyresponds.org/medication-safety/safe-medication-disposal
Interview With Assistant Sheriff Victor Fazio
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.
Tell us about your background. How long you’ve been with VCSO and what your role is?
I started my career with the Ventura County Sheriff’s Office in 1994. I worked a variety of assignments throughout the agency spending a large portion of my career investigating narcotics related offenses. During my 16 years assigned to the narcotics division, I commanded two multi-agency task forces. One task force focused on the proliferation of pharmaceutical drugs and the surge of heroin and opioid related overdose deaths. The other task force was dedicated to identifying and neutralizing drug trafficking organizations at the highest level.
I was proud to also serve the City of Moorpark – which contracts law enforcement services with the Sheriff’s Office – as Chief of Police for nearly four years from 2019-2023. In January of 2023, Sheriff Fryhoff appointed me as one of his four Assistant Sheriffs. I have the honor of leading the Special Services Division which includes Major Crimes, Narcotics, Bomb and Arson Unit, Criminal Intelligence, Crime Analysis, Crime Lab, Air Unit, Crime Scenes Investigation Unit, SWAT, Tactical Negotiations Unit, Technical Services Unit, and Sheriff’s Systems Bureau which is responsible for hardware, software, and new technology.
What can you tell us about FOCUS?
The Ventura County Fentanyl and Overdose Crimes Units (VC FOCUS) is the rebranding of the Ventura County Interagency Pharmaceutical Crimes Unit. The mission of VC FOCUS is to actively address overdoses and fentanyl related crimes in Ventura County through enforcement, prevention, education, and partnerships. Investigations by VC FOCUS will create accountability, education supports prevention, and public partnerships assist in fostering increased awareness of this epidemic. VC FOCUS is comprised of two units of law enforcement representation from the east and west side of Ventura County.
VC FOCUS will be relentless in making communities safe from fentanyl and other opioids. Through partnerships with COAST, Federal, State, and Local Law enforcement, the Justice System and the Community, VC FOCUS will strive to eliminate the root cause to addiction and deaths caused by illicit opioids.
What do you think readers should know about the opioid crisis in Ventura County currently?
Without bold action, the opioid crisis isn’t going anywhere soon. Unless we work together, we will never solve the problems related to opioid misuse and abuse. We have a seemingly endless supply of fentanyl coming from Mexico and sourced by China. Unfortunately, there is a long-standing appetite for opioids in our county which continues to poison our residents. We must be united in education and prevention efforts, understand the importance of harm reduction, and maintain a desire to hold drug dealers accountable. This isn’t solely a law enforcement problem, a behavioral health issue, or a public health responsibility, it is an all of us problem that needs all of us to solve it.
Tell us one thing about you that helps us get to know you better?
I enjoy teaching and have instructed well over 10,000 law enforcement officers, health care providers, and community members throughout the nation on various law enforcement related topics. Additionally, I am an Adjunct Criminal Justice Professor for the University of Southern California as well as Arizona State University in both graduate and undergraduate programs. I also like learning, researching, and writing. I have a bachelor’s degree from UCLA in political science, a master’s degree from ASU in criminal justice, and a doctorate in education from USC where my research was focused on reducing harms caused by opioids through physician education.
Thank you, Victor, for sharing your valuable experience with us!
National Fentanyl Awareness Day is May 9.
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National Fentanyl Awareness Day is May 9. Raising awareness about an urgent national problem: people are dying at alarming rates due to illicit fentanyl, a dangerous synthetic opioid. Get the facts and share them widely. Learn about our efforts to raise awareness and see our campaigns at www.venturacountyresponds.org and www.fentanylventuracounty.org. View more resources www.fentanylawarenessday.org.
Event – The Fentanyl Crisis: What You Need to Know Now
The Fentanyl Crisis: What You Need to Know Now
Learn About Latest Trends and Burprenorphine in Primary Care for Our Patients
May 9, 2023 • 5:30–8:00 PM
Las Posas Country Club, Camarillo
Ventura County faces a crisis of fentanyl deaths. In 2022 there were 181 accidental overdose deaths involving fentanyl. In just three short years our county has experienced a 445% increase in fentanyl fatalities. However, these deaths only represent a fraction of the total number of Ventura County individuals, families, and communities harmed by substance misuse, and suffering daily from chronic use disorders. We invite you to join us in changing this reality.
In facing our local crisis, the importance of practitioner training in substance use disorders cannot be overstated. All members of a patient’s care team play important roles, but primary care providers are pivotal in providing increased access to treatment. The recent elimination of the X-waiver requirement to prescribe buprenorphine for opioid use disorder offers the chance to expand access to treatment in primary care settings, which can turn the tide of the opioid crisis.
- Hear from local experts and discuss with peers the latest overdose trends
- Learn about recent legislative changes related to opioid use disorder treatment
- Receive provider and patient resources that can assist in expanding access
- Discuss factors at the provider, health system, and patient levels that serve as barriers to accessing buprenorphine-based treatment.
- Learn skills needed to screen, counsel, treat, and coordinate care
- Help us bend the trend!
Join the Discussion May 9th!
National Fentanyl Awareness Day
REGISTER HERE
Panelists:
- Chris Young, M.D.
Ventura County Chief Medical Examiner - Sergeant John Hajducko
Ventura County Sheriff’s Office - Joseph C. Vlaskovits, M.D.
Psychiatry, Forensic Psychiatry, and Addiction Medicine, Program Director, Community Memorial Healthcare Psychiatry Residency Program; Faculty, Ventura County Medical Center Primary Care Addiction Medicine Fellowship; Medical Director, Substance Use Treatment Services, Ventura County Behavioral Health - Tipu Khan, M.D., FAAFP, FASAM
Chief of Addiction Medicine at VCMC; Family, Emergency, and Addiction Medicine; Fellowship Director, Primary Care Addiction Medicine Fellowship; Faculty, Family Medicine Residency Program, Ventura County Medical Center; Adjunct Clinical Professor, USC Keck SOM - Mathew Lamon, D.O.
Family and Addiction Medicine; Core Faculty, Ventura County Medical Center Family Medicine Residency Program; Associate Program Director, VCMC Primary Care Addiction Medicine Fellowship
CME credits will be available for this event. Dinner and Refreshments will be served.
If you have questions regarding this series, please contact Ashley Nettles at Ashley.Nettles@ventura.org.
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.
PREVIOUS DISCUSSIONS
- September 21, 2022
Person-Centered Strategies to Reduce Opioid Overdose
- August 31, 2022
Deprescribing is Good Prescribing
- June 8, 2022
Evidence-based Safe Prescribing
- May 11, 2022
Latest Trends in Overdose: What Prescribers Need to Know About Illicit Fentanyl
LEARN MORE AND REGISTER:
Event: Fentanyl Strategies for Schools – Nov 1
DATE: November 1, 2022
TIME: 2:30pm – 4:00pm
LOCATION:
1911 Williams Dr., Oxnard, CA 93036
Training Room, Ground Floor
(Parking will be available rear of building adjacent to Probation Offices.)
This training will provide foundational knowledge and tools to draft policy that will enable access to naloxone for Ventura County school districts and sites. Subject matter experts will engage in discussion regarding district protocols and next steps to train staff in recognizing and responding to the signs of an opioid-related overdose.
This is a no-cost, in-person event. Space is limited.
To RSVP, please contact Cari Kawell at 805-981-6831 or email cari.kawell@ventura.org.
WHO SHOULD ATTEND?
- District Superintendents
- Site Administrators
- School Nurses
- Site/Local Teams of Educator
FEATURED PANELISTS
Oxnard Union High School District
Lisa is a school nurse for Oxnard Union High School District. She has 13 years of local experience working in Ventura County schools in addition to raising and graduating five children in Conejo Valley. She is the Special Education Chair of the Central Coast section of the California School Nurse Organization and was recognized by her peers for excellence in school nursing in 2022.
Program Manager, Give an Hour
Ashley Nettles specializes in Substance Use Prevention and program services with an expertise in the Opioid crisis. Providing innovative strategies to reach high risk community members and their families through quality education and training. Ashley’s passion for her work is fueled by her personal family experience. Her first-hand experience with how addiction affected her family gives her the ability to champion change for families and communities that are feeling the devastating effects of our nation's opioid crisis.
This is a no-cost, in-person event. Space is limited.
To RSVP, please contact Cari Kawell at 805-981-6831 or email cari.kawell@ventura.org.
See and download the event flyer.
NPR: Is 'rainbow fentanyl' a threat to your kids this Halloween? Experts say no
Experts believe that children are not being specifically targeted. That doesn’t mean that we should not be concerned about children and pills. All medication should be safely stored and away from children, and children should be alerted not to consume anything that looks like a pill.
International Overdose Awareness Day - August 31, 2022
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:
National Fentanyl Awareness Day May 10, 2022
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:
SENATE RESOLUTION DESIGNATES MAY 10 AS NATIONAL FENTANYL AWARENESS DAY
Prescribers Care Discussion Series
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.
LEARN MORE AND REGISTER
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
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.
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
For more information: Ashley.Nettles@ventura.org
UPCOMING DISCUSSIONS IN THE SERIES
- June 8, 2022, 5:30–7:30 PM
Evidence-based Safe Prescribing
- 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
Suicides by drug overdose increased among young people, elderly people, and Black women, despite overall downward trend.
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.
Interview with Dr. Christopher Young, MD, Ventura County Medical Examiner
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!
COAST Update
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.
Featured Campaign: Fentanyl is Forever
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.
Learn more:
Statement by President Joe Biden on Surpassing 100,000 American Overdose Deaths in the Past Year
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:
COAST Newsletter - October 2021
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.
DEA Issues Public Safety Alert on Sharp Increase in Fake Prescription Pills Containing Fentanyl and Meth
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
A Proclamation on Overdose Awareness Week, 2021
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:
Settlement Reached in Opioid Suit as Negotiations Continue in CA
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:
COAST Newsletter - July 2021
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.
In the News: Drug overdose deaths soared to a record 93,000 last year
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
Spotlight: New Partners in Opioid Overdose Prevention
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:
FDA Approves Higher Dosage of Naloxone Nasal Spray to Treat Opioid Overdose
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.”
Learn more:
COAST Newsletter - April 2021
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.
News: Overdose Deaths in Ventura County spiked in 2020, Largely Due to fentanyl
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
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.
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
Cocaine, Meth & Stimulant Summit
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:
Opioid Summaries by State
Opioid-involved overdose deaths dropped in 2018. Learn how the Opioid Crisis is affecting your state.
DEA releases 2020 Drugs of Abuse Resource Guide
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.
Opioid Withdrawal Raises Health Risks for Injection Drug Users: Study
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.
News: Lethally potent counterfeit pills taking more lives with drug overdoses in Ventura County
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.