CA’s Opioid Epidemic
The opioid epidemic ranks among California’s most challenging issues with record-breaking rates of drug-related overdose fatalities, including from fentanyl last year.
The Center for Disease Control (CDC), in 2022, reported that more than 109,000 in California have lost their lives due to overdose. Locally that equates to the number of people who can fit into the Sacramento Kings Arena six times over.
Nonprofit organizations are stepping in with innovative ways to prevent substance abuse and help people recover – among them the grantees of The Center at Sierra Health Foundation. At a January 18 EMS briefing, leaders from these organizations shared insights on advancing health equity across the state, from remote rural areas of Inyo County to the unincorporated towns of Central Valley, to Oakland and its surrounding suburbs in Alameda County.
“We truly believe that every person deserves an opportunity to live a healthy life of their own design,” said Kaying Hang, president of The Center at Sierra Health Foundation, referring to her organization’s portfolio of substance use programs with its unapologetic focus on health and racial equity. “We’re achieving this vision by focusing on access to care, quality of treatment, and youth prevention.”
Policing substance abuse
Historically, in the ’80s and ’90s, the federal and state governments unleashed a war on drugs by responding to drug use with incarceration and extreme policing of black communities. By criminalizing drug use and drug possession through a series of punitive laws for over 50 years, the federal government disproportionately harmed people of color and those from low-income communities.
“We have all suffered the consequences of mass incarceration,” added Hang. “People who use drugs have been deeply stigmatized and underserved through it all. However, we know that people who use drugs are deserving. They’re not strangers, right? They are our neighbors. They’re our family members and our beloved friends.”
Care over criminalization
The tide is turning said Hang, as community advocates and families lead the way in showing that it’s possible to prioritize care over criminalization. “No judgment, no stigma, but the deep realization that every individual deserves the opportunity to help themselves to be given a second chance to be seen as a human person to be able to be offered services in the most dignified ways.”
In partnership with the State of California, the Center has allotted approximately $677 million in grants for the continuum of care around drug use. Programs in partnership with community-based nonprofits focus on normalizing harm reduction through public health and healthcare settings, access to safer drug use tools, and holistic non-judgmental care. The programs – some using substance use navigators – work to end opioid overdose debt by sharing useful and honest drug education and supporting wellness for people who use drugs.
“We truly believe that people who are closest to the harm are in the best position to determine what the solution is,” said Hang. They can bring transformative, creative approaches to addressing the issue, and ensure a culturally and linguistically appropriate lens to the work.
Combating the Central Valley’s opioid crisis
Mari Perez-Ruiz, the executive director of Central Valley Empowerment Alliance (CVEA) in Poplar, Tulare County, said her organization deals with the impact of fentanyl and other addictive substances on unincorporated farm-working communities of the Central Valley
“Our rural communities are the target for the cartels – that’s where a lot of the drugs are passed.”
CVEA serves a mix of Filipino farmworkers, Mexicans, and Yemeni immigrants, a population of roughly 5000 people living within 700 dwellings that are decaying. “You see three generations, over 20 people living in small two-bedroom dwellings.” They don’t have a park, clinic, fire station, or first aid responders. Healthcare access and equity have been impacted on so many levels in this community. There hasn’t been any investment and infrastructure in this rural community in over 50 years, said Perez-Ruiz.
With funding from the Center, CVEA is fighting the negative narrative of a community that has no future with a youth-led rural equity campaign. The goal is to bring the community together and create secure spaces, such as converting a garage into a center where youth can safely gather. They also work with adult parents, some of whom are users, to sign an agreement to ensure the space is scam and drug-free.
Programs to improve equity range from free lunches, bringing FEMA and Homeland Security resources to flooded areas, and enrichment opportunities that take youth to the Oakland Zoo and the Golden Gate Bridge.
“This is the first time for most of them that have ever been anywhere near the Bay Area or seeing the Golden Gate or seeing the ocean,” said Perez-Ruiz. “Only 3% of them are expected to pursue a higher education. “
Youth advocacy at the district level helped raise $1.4 million towards the creation of a community park – the groundbreaking ceremony is in February.
“What we’re trying to do is to build a beloved community, .. a beautiful promise of what it is possible,” added Perez-Ruiz.
Recovery programs in Inyo County
At Crossroads Recovery Center and Skoden Native Harm Reduction Services, founder Arlene Brown is pioneering harm reduction programs that serve Native Americans and other residents of Inyo and Mono Counties. Brown is a member of the Bishop Paiute Tribe in Inyo. Nationwide, Native Americans have some of the highest fatal overdose rates, she said.
Her CBO specializes in decolonizing services by indigenizing services. They add prayer tags to opioid overdose reversal kits, distribute Narcan communitywide, operate one of the first certified syringe exchange programs in California, and have created a wellness journey – an indigenous-based model of care that engages and works actively with the Native populations who are using drugs. “As Native people, you treat the whole person, you treat the individual, the family, and the community,” said Brown. “The punitive piece doesn’t work. So we make it our own, we want to right and to make sense for our own culture.”
Harm reduction in Alameda County
Quantitative and qualitative data indicate that the drug overdose crisis disproportionately impacts Black and African Americans said Braunz Courtney, Executive Director of the HIV Education Prevention Project of Alameda County (HEPPAC.). HEEPAC’s main goal is to create equitable access to its medication assistance treatment and harm reduction program in the areas around Oakland, Contra Costa, and Delano counties.
“Our goal is to talk with people openly in an ambivalent way around their relationship with their drug use. Not everybody who is in recovery is going to get to sobriety. Our goal is to meet each individual where they are at geographically, as well as within their addiction, about where their goals are, and where they’re trying to get to.”
Unlike traditional clinical facilities like Kaiser, HEEPAC’s non-clinical, integrated services setting offers open dialog on drug use, as well as doctor syringe access, shoes, hygiene kits, coffee, and snacks with the help of substance use navigators – peers in the community who assist patients with opioid issues.
Integrated services keep people healthier, alive, and able to thrive said Courtney, because they have access to the syringe service program, drop-in center, and drug users’ health programs.
A person who wants to access substance use treatment also needs other things that keep them healthy, like housing, food security, hygiene, equity, social interaction, and getting people out of their isolation. “So having an integrated service model helps with that. We like to call it a one-stop shop.”
Photo by Giulia May on Unsplash
