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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

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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

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

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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

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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

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

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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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

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

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

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

> Opioid Summaries by State Report

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

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

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

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.

> Read the article

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.

> Read the Story, Ventura County Star

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"