The regions with the 21 worst opioid death rates in California – from the tribal lands of San Diego County to rural hamlets near the Oregon border – have no Medication Assisted Treatment facilities within easy reach, leaving those struggling with addiction little hope for recovery, an analysis by The Bakersfield Californian has found.
Those treatment facilities provide people suffering from substance abuse with daily physician-supervised doses of scheduled narcotic drugs like Methadone, Suboxone and Buprenorphine to help wean them off illegal drugs, including heroin and other opioids.
When combined with traditional recovery services like counseling and support groups, Medication Assisted Treatment can save lives, experts say.
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But people living in the areas of California with the worst opioid death rates – which range from 65 to 545 per 100,000 – must contend with transportation barriers after mustering the will to get sober, according to The Californian’s review of state licensing records for MAT facilities and opioid death rate data.
In some cases, people living in those places must travel more than 100 miles to the nearest MAT facility on a daily basis – a tedious and taxing task for someone who’s sober, much less someone in recovery.
To be sure, Medication Assisted Treatment is not the only option for people trying to recover from substance abuse, although it is the most comprehensive. Some counties have Office Based Treatment Programs that allow clinic doctors to dispense specific narcotic medications, but not the wide range that are federally regulated under Medication Assisted Treatment facilities.
When presented with The Californian’s findings, California Department of Public Health officials said the department is “leveraging a multi-sector strategic collaboration” to address the opioid epidemic, especially in rural areas.
Those strategies include developing a “public awareness and education campaign for youth and high-burden rural counties” and funding 16 counties with the worst opioid overdose rates to implement local opioid safety coalitions. Those coalitions would perform outreach activities with high prescribers and dispensers of opioids. It’s also rolling out a $90 million “Hub and Spoke System” first introduced in Vermont which allows physicians in rural areas to prescribe narcotics medications to those in need while working in collaboration with the nearest opioid treatment program.
It will benefit people from places like Hornbrook, along the Oregon border; Standish, a tiny farm community about 65 miles northwest of Reno; and Eureka, a waterfront community ubiquitous of small town America.
Lake Isabella, in Kern County, was not selected to be part of that hub and spoke system, meaning those in recovery from that area must continue traveling an hour into Bakersfield to the closest opioid treatment program.
A federal regulation that restricts MAT clients from taking home medication before they can prove their sobriety forces them to travel to treatment centers daily for the first six months. As they spend more time in treatment and hit certain benchmarks, they’re allowed to take some medication home.
That policy creates difficulties for those attempting to recover in far-flung places who have the will to get sober but not the time or means, leaving scores stranded.
There are 28 California counties with no Medication Assisted Treatment facilities, and among those, 17 have death rates higher than the state average and six have rates more than triple the state average, according to a Californian analysis of state data.
Inyo County, neighboring Kern to the east, for example, spans more land than the state of Vermont. It hasn’t a single MAT facility within its borders, but boasts an opioid death rate almost five times higher than the state average.
People living in those ZIP codes most impacted by opioids, many of whom are in upper Northern California, far removed from major population zones, must drive an average of 95 minutes by car daily to get to a MAT facility, the Californian analysis shows. In many cases, however, those struggling to overcome addiction are riding the bus, which in some cases takes significantly longer. In many of those areas there’s no bus service.
The longest commutes statewide are for those living in Korbel, Eureka and Scotia – three Northern California communities in Humboldt County. Getting to a MAT facility from those cities tops three hours each way by car. The county has, however, established an Office Based Treatment Program.
“I don’t think anyone in California should travel over 10 miles to receive treatment, let alone be in a car for three hours, to and from, to receive services,” said Javier Moreno, the regional manager for the southern Central Valley region for Aegis Treatment Centers, which operates more than 30 MAT facilities statewide. “I think that’s unacceptable.”