County unveils updated plan to prevent opioid abuse

The San Diego County Board of Supervisors received a comprehensive update on the region's plan to fight opioid and other prescription drug abuse and the devastating impact the substances are having on San Diegans.

The updated plan of the San Diego County Prescription Drug Abuse Task Force, which was established in 2008 to address the growing prescription drug epidemic in the region, incorporates a broader public health approach and addresses multiple levels of prevention.

Dr. Dean Sidelinger, interim county deputy public health officer, shared with the board the most recent trends in the opioid epidemic and data surveillance plans.

He highlighted the fact that as access to prescription opioids has decreased, heroin overdoses increased. That change is because as prescription opioids become more expensive, users turn to heroin, a cheaper alternative.

Another recent change is the rise of fentanyl overdose deaths. Fentanyl is an extremely potent and dangerous synthetic drug that has been increasing on the illicit market because it is cheaper to produce.

"The shape of the epidemic is changing, and the impact continues to be staggering on our community," Sidelinger said.

Between 2007 and 2017, there were nearly 2,200 accidental overdose deaths from prescribed opioids in San Diego County. During the same period, 890 San Diegans died from accidental heroin overdoses in San Diego County. In 2017, there were 87 deaths in the region due to fentanyl.

"Each of these deaths was preventable," Sidelinger said, adding that with enhanced data surveillance the Prescription Drug Abuse Task Force will be able to get the resources such as offering Naloxone – used to counter the effects of an opioid overdose – to specific areas of the county to reduce the risk of death due to overdose.

Other strategies to prevent misuse of opioids include community outreach and engagement, education, resource development, promotion of alternative pain management and appropriate medication disposal.

Dr. Nicole Esposito, assistant clinical director for County Behavioral Health Services, presented three additional strategies in the updated plan. Those strategies include the safe prescription of opioids, access to evidence-based treatment and reducing harms to prevent overdose deaths.

"Opioid stewardship in health care ensures that clinicians in our communities are adhering to current and informed prescribing practices for pain management," Esposito said. "This includes clinicians using non-opioid pain management strategies as a first course of action."

According to the county Health and Human Services Agency, one of eight San Diegans has a substance use disorder but about 90% of those suffering from addiction do not access treatment.

To help more people suffering from substance use disorder, in July 2018, the county implemented the Drug Medi-Cal Organized Delivery System, which is an investment in providing high quality substance use disorder treatment to more people. The enhanced system was specifically designed to serve low-income San Diegans and will address the systemic damage that substance abuse inflicts on people, families and communities.

The county is developing a plan to ensure that medication assisted treatment is available to people and is responsive to community health and safety.

"Surveillance data will be developed for real-time interventions to 'hot spot' specific resource allocation and prevention activities," Esposito said.

The county drug treatment services align with Live Well San Diego, which aims to improve the health and safety of area residents.

People experiencing a substance abuse problem can call the county's Access and Crisis Line at (888) 724-7240 or 211 San Diego.