The silent epidemic: drug overdose deaths surge in California pre-pandemic – State of Reform

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Sydney Kurle | Jan 15, 2021

Analysis provided by California Well being Coverage Methods (CHPS) reveals that the speed of will increase of overdose deaths in California far surpasses the nationwide price of enhance as of Might 2020. Specialists say this development has elevated because the pandemic has continued.

 

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California noticed 7,121 deaths reported as drug overdoses within the Might 2020 12 month-ending interval, the nationwide quantity on the identical time was 79,251. That is a part of a skyrocketing rise, with overdose deaths in California up 26.8 p.c within the interval between June 2019 and June 2020. Nationally, in that very same timeframe, deaths had been up 21.3 p.c. 

In 2019, males died of overdoses at a price of 21.46 per 100,000 in California, comparatively ladies died at a price of 8.45. Native Individuals died at a price of 34.91 per 100,000 in 2019, with Black and African American individuals not far behind with a price of 27.05. Nonetheless white individuals accounted for nearly 60 p.c of the overdose deaths in California in 2019.

“It’s a wave and it’s not achieved cresting,” stated Konrad Franco, a researcher at CHPS and the creator of the chart featured beneath.

 

Credit score: CHPS and Konrad Leo Franco

 

“I don’t assume most of the people actually understands the scope of the epidemic,” stated Franco. “In the event you look in particular person counties’ knowledge and in all of 2020, 5 occasions extra individuals died in San Francisco [of drug overdoses] than they died of COVID.”

One of many predominant causes of the development is a rise in the usage of fentanyl in California, a drug the place a single misstep within the dosage can result in an overdose, stated Dr. Aimee Moulin, behavioral well being director on the Emergency Division at U.C. Davis and a co-principal investigator with the California Bridge Project. Fentanyl is an artificial opioid much like morphine however about 100 occasions stronger. 

“Up to now, now we have been very heavy on stimulants, methamphetamines predominantly with heroin sort of within the background, and that has shifted dramatically in direction of fentanyl over the previous 12 months, “ stated Dr. Moulin.

Fentanyl can also be killing a number of younger individuals, stated Dr. Moulin. These aged 20-34 years outdated died extra from fentanyl overdoses than from different kinds of medication.

“The scary factor is how younger these persons are, the oldsters which can be utilizing fentanyl are younger,” stated Dr. Moulin. “We’ve had some youngsters overdose not too long ago. So while you have a look at these numbers and also you see that spike up there, these are individuals and they’re younger.”

This enhance in the usage of fentanyl might not, nevertheless, be a results of overprescribing of opiates by docs. Franco says California has truly seen a few 25 p.c lower in prescriptions since 2015. 

“The tragic factor for me round opioid use dysfunction, is that opioid use dysfunction is ridiculously simple to deal with,” stated Dr. Moulin. “Within the context of psychological well being, a number of our acute psychological well being crises you want a really costly inpatient locked psychiatric mattress. For opioid use dysfunction, I simply want somebody with an outpatient comply with up appointment and a prescription to buprenorphine.”

The Trump administration launched new addiction treatment guidelines Thursday that permit docs to prescribe buprenorphine. Earlier than this transformation, docs needed to take an 8-hour course to obtain a license, referred to as an “X-waiver”, to have the ability to prescribe the drug. This was a barrier for entry to many physicians. 

The pandemic nevertheless is predicted to have triggered a rise within the rise in overdose deaths. The CDC reports a rise in psychological well being points, elevated substance abuse and suicide ideation through the pandemic.

“The pandemic has been disruptive in a number of methods. Folks have moved, individuals have misplaced their jobs, so your common supply of care will get disrupted, in order that causes a number of gaps in care,” stated Dr. Moulin. “Plus the social stressors, individuals who had been beforehand in remedy, [their] clinics had been closed, misplaced their insurance coverage, in order that disrupts their remedy. On prime of that, the entire social isolation, financial insecurity, and [then] they relapse.”

Nonetheless Dr. Moulin stated that California is healthier positioned to get better than most states with related tendencies attributable to buprenorphine being lined by Medi-Cal. California can also be altering how they supply drug remedy companies by way of Drug Medi-Cal.

“It offers, by way of this new organized supply system, an array of recent remedy companies,” stated David Panush, president of CHPS. “From residential remedy to outpatient companies and every thing in between. So it strikes our drug remedy supply system into the twenty first century.”

Dr. Moulin believes that the decriminalization of medicine would assist allow individuals to hunt remedy. Particularly as a result of the struggle on medication was racially biased and the prison justice system doesn’t assist deal with the illness, stated Dr. Moulin.

“Substance use dysfunction is a medical illness,” stated Dr. Moulin. “It’s treatable, it’s a mind illness. We now have basically criminalized a illness, which will increase stigma. It’s the one medical prognosis that may be a crime.” 

This development is not going to disappear after the pandemic has ended both, stated Dr. Moulin.

“I believe we’re going to have a number of digging out to do,” stated Dr. Moulin. “Subsequent 12 months once we’ve vaccinated everyone, we’ll nonetheless be digging out from this.”



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