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GUEST VOICES: 2020 Fails to Supply the Demand for Opioid Treatment

By Ramón Castellblanch, PhD

a stack of single-dose suboxone tabletsThe COVID-19 pandemic aggravated the opioid epidemic, both in terms of supply and demand. In terms of the supply, we took a terrible hit in the number of programs to fight it. As of September, their revenues were down by over 20%. With those losses, more than half of these programs were not sure that they’d still be operating this spring.

At the same time, demand for substance use disorder (SUD) treatment skyrocketed under the COVID-19 pandemic. For the last three quarters reported, California’s opioid dashboard shows that opioid overdose deaths rose from 882 in the final quarter of 2019 to 1,255 in the second quarter of 2020, an increase of over 40%.

On the bright side, the state of California took some serious steps toward addressing the crisis. Its most notable achievement was in the area of funding SUD treatment. The enactment of SB 855 means that private insurers must cover it. At this beginning of this year, the state Department of Managed Health Care has directed the insurers to submit forms documenting their compliance by February 1.

The state also made gains in the delivery SUD treatment with the enactment of SB 803. This bill set up a program to certify peers of people with SUD to help them access SUD treatment. The federal government has found that peer support can make behavioral healthcare more effective. The Department of Health Care Services is required to promulgate requirements for counties to use in certifying peer support specialists next year.

Before certification, some peer counselors will be able to work in emergency departments this year under a budget appropriation to fund 200 substance use navigators (SUNs). These navigators are essential to helping individuals admitted to the hospital for acute SUD-related causes access long-term treatment and support services. The funding has recently been distributed to E.D.s across the state. The contractor hired to operate the program, California Bridge Program, has sub-contracted with the Vituity physician group to advise E.D.s on the training of SUNs and related tasks.

But much remains to be done. A bill to license outpatient alcoholism or drug misuse recovery or treatment programs receiving Medi-Cal managed care funds, cutting down on sometimes scandalous conditions, was vetoed. Advocates for more effective outpatient recovery programs are having another go in 2021, in the form of AB 77. Supervised drug injection sites have been found to reduce drug overdose, but efforts to authorize them at the state level continually stall out—most recently when a bill to allow such a site in San Francisco passed the state Assembly last year but died in the Senate. Proponents of supervised drug injection sites are trying again in the form of AB 57.

While the gap between those needing SUD treatment and the availability of such treatment may, in some ways, be widening, at least the effort to close it with more and improved SUD treatment appears to have gathered momentum.


PROJECTS

ALCOPOP-FREE ZONES

Alcopops are heavily flavored, heavily sugared, often high-ABV alcoholic beverages. They are among the most popular first drink for many youth. The Alcopop-Free Zone project used youth representatives to engage the San Rafael Canal community, educate retailers, and get alcopops off of store shelves.


MAT ACCESS
]Medication-Assisted Treatment (MAT) for opioid use disorder includes bupernorphine among other medications. It offers the best opportunity for people who use opioids to live long, healthy lives, but only if they have access to it. Geographic, economic, and language barriers further complicate individuals' efforts to obtain this life-saving treatment. The MAT Access Project/Proyecto Latino TAM works to educate the Latinx community of Marin on the dangers of opioids, and promote culturally competent MAT services for those who needs it.


YOUTH ACTION FOR SAFE STORES

Within liquor, grocery, and drug stores, good retail practices can not only make it harder for youth to obtain alcohol, but make youth less interested in drinking. Youth Action for Safe Stores (YASS) develops youth leaders who can evaluate stores' retail practices, engage with business owners, and promote best retail practices throughout San Rafael.

PUBLICATIONS

Alcopops 2020

Others

SRADC BOARD

Don Carney, Director, Marin Youth Court
SRADC President

Nick Moorhatch, Producer, Comcast Cable Access
SRADC Vice President

Adolfo Aguilar, member, Youth For Justice

Marcianna Nosek
, PhD, MPH, MS, Associate Professor, University of San Francisco.
Larry Merideth, PhD, Director, Marin Health and Human Services

Michael Watenpaugh
, EdD, Superindent, San Rafael City Schools

Kevin Lynch, Director of Juvenile Services Division, County of Marin Probation Department

Elia Manzo, leader, Consejo Restaurativo

Wilibaldo Pulido, owner, La Plaza Market.

Douglas Mundo, Executive Director, Canal Welcome Center.

Mary Joe Williams, CAO, Bay Area Community Resources

Sam Alexander, Pastro, First Presbyterian Church of San Rafael

Intern
Eric Bejarano, student, Sonoma State University

FUNDERS