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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.

> Read the Story, Ventura County Star

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