Kern County health officials say they’re not sure what to expect locally from President Donald J. Trump’s announcement Thursday that he intends to authorize a robust fight against the devastating opioid epidemic spreading throughout the country.
The U.S. Department of Health and Human Services declared a 90-day public health emergency after Trump delivered a lofty speech promising to end the epidemic, but there’s no promise of any federal money to fund resources needed throughout impacted regions.
“We’re just trying to figure out what it really means,” said Roger Perez, spokesman for Kern County Behavioral Health and Recovery Services, which heads up substance abuse issues countywide.
Trump called the epidemic, which he said claimed 64,000 American lives last year, “the worst drug crisis” in world history before declaring it a National Public Health Emergency. He directed executive agencies Thursday to use “every appropriate emergency authority” to fight the crisis, promised to roll back laws limiting the number of beds allowed in treatment clinics and banned the sale of at least one specific opioid.
“We can be the generation that ends the opioid epidemic,” Trump said to applause. “We can do it.”
Opioids, a class of drugs that includes heroin as well as legal painkillers such as codeine, hydrocodone and morphine, have exploded in popularity across the country as thousands have become addicted to the substances.
In California last year, 1,925 people died of opioid overdoses, according to the California Department of Public Health’s Office of Vital Statistics.
Hardly a community has been left untouched. Kern County ranked ninth statewide in opioid overdose deaths in 2016. Fifty-one people died last year, ranging in age from 15 to 85. Twenty-four of those who died, however, were between 55 and 74, data show.
Kern’s death rate of 5.7 per 100,000 people hovers above the state average of roughly 4.6 per 100,000.
Despite those grim statistics, Ana Olvera, a behavioral health and recovery system administrator for the Substance Abuse Disorder Division, said they pale in comparison to the stranglehold of methamphetamine on the community.
“The majority of our treatment is for methamphetamine rather than opioid use disorders,” Olvera said. “One of the things we haven’t seen here within our treatment system is the kind of explosion like those areas in the east coast.”
Still, drug trends spread west, Olvera said.
“We are trying to put in place prevention efforts,” Olvera said, aware that more opioid prescriptions have been issued in Kern than other counties.
Last year roughly 820 opioid prescriptions were written per 1,000 residents, and almost 120 opioid overdose emergency department visits and 95 hospitalizations occurred in 2015, CDPH data show.
Those prescription figures could be high, Olvera said, because pain has been added as a vital sign when patients visit doctors' offices.
“So when you go to your doctor, they ask about your weight, blood pressure and now, level of pain, no matter what you come in for. So in trying to provide good care, physicians are paying attention to this level of pain,” Olvera said.
So doctors prescribe pain meds, Olvera said. And then some patients develop a dependency, go back to the doctor and ask for more.
The department is also trying to stop overmedication before it starts by initiating trainings for physicians, pharmacists and clinicians and providing them guidelines for safely prescribing opioids.
Other prevention efforts include one initiative by the Kern Stop Meth Now Coalition to install permanent prescription drop-boxes in high-risk neighborhoods, Olvera said.
“We’re trying to make prescription drugs less available to people,” she said, adding that one of the most common ways abuse starts is when there are spare pills sitting in medicine cabinets.
Limiting the number of pills that are prescribed from the start could help, she said.