Redwood Community Health Coalition wins $60,000 grant to fight opioid abuse

The Redwood Community Health Coalition, a regional consortium of community health centers, has received a $60,000 grant to implement a multi-pronged campaign to reduce the overuse of prescription opioid painkillers.

The grant from the California HealthCare Foundation would help Sonoma County develop guidelines for hospitals and the doctors who write prescriptions, expand access to medication for opioid withdrawal and make a certain type of drug for preventing overdose deaths more readily available.

“There are people who are on very high doses where it can be dangerous to your health,” said Mary Maddux-Gonzalez, chief medical director for the coalition.

“These doses need to be tapered down to lower levels. Some of those individuals, if they have become dependent, may need to switch to something else other than these opioids,” she said.

Karen Milman, the county’s public health officer, said the grant would help the fight against the misuse of opioid painkillers.

“This is a public health problem and to address it, we need a systematic approach that starts with safe management of pain and prevention of opioid misuse and goes all the way through recovery,” she said in a statement.

Maddux-Gonzalez said officials will use the grant to create uniform prescription guidelines for local health care providers, including Kaiser Permanente, Sutter Health, St. Joseph Health and the area’s multiple community health centers.

“What the group is doing is developing consistent guidelines across all the primary care providers and doing the same with all the emergency departments,” she said.

According to a new report by the county Department of Health Services, one in four Sonoma County residents had an opioid prescription in 2014. That statistic echoes a larger national epidemic of prescription drug abuse.

According to the report, hydrocodone - the most widely prescribed opioid in Sonoma County - accounted for 57 percent of the 459,000 opioid prescriptions filled at local pharmacies, while oxycodone made up 18 percent of local prescriptions.

In 2014, there were ?191 hospitalizations in Sonoma County due to unintentional drug poisoning, of which 57 were for mostly pharmaceutical opioids, the report said.

About 44 county residents die each year of unintentional drug overdoses, according to the report.

Maddux-Gonzalez traced part of the current epidemic to a trend in the medical profession more than a decade ago to address what appeared to be an underdiagnosing of pain.

At that time, the Joint Commission health care accrediting organization created a assessment tool for gauging patients’ pain. Eventually, physicians were required to receive numerous hours of education on assessing and treating pain.

“At that time, they were saying we need to be using more medication,” Maddux-Gonzalez said. “There may likely have been an underdiagnosis of pain, but the pendulum swung too far and that resulted in overprescribing of pain medications, specifically the opioid pain medications.”

Maddux-Gonzalez said she didn’t want to see the “pendulum swing too far” in the other direction, however.

“We want to make sure that those individuals for whom those medications are appropriate for their condition have access to these medications, using the safe-prescribing guidelines we’re developing,” she said.

Opioid abuse and overuse can lead to a number of health problems and side effects, including dependency, sleep apnea, decreased testosterone, a possible increase in the risk of Alzheimer’s disease and an increase in the risk of respiratory depression, she said.

A drug called naloxone could help prevent overdose deaths for those on very high doses of opioid painkillers.

The health coalition grant would help develop policies and funding options for greater access to the drug, officials said.

“Naloxone is something that’s been used successfully with individuals addicted to heroin who stop breathing and would otherwise die,” Maddux-Gonzalez said.

“It’s still an emergency, because the naloxone may last a certain period of time. But it’s those seconds to minutes that can make a difference in saving somebody’s life,” she said.

The grant also would expand access to a drug called buprenorphine for community health center patients in Sonoma, Napa, Yolo and Marin counties.

Buprenorphine, a potent long-acting type of opioid, reduces the risk of respiratory depression, “so people don’t stop breathing ... the risk of death decreases significantly,” Maddux-Gonzalez said.

“Buprenorphine is very effective and provides relief from pain, but also is an alternative to other opioids. They can take this and not have the same depression of breathing and ultimately death,” she said.

You can reach Staff Writer Martin Espinoza at (707) 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.