PD Editorial: California must prioritize treating opioid addiction

The national opioid epidemic struck close to home last weekend when a dozen people overdosed on fentanyl in Chico. One of them died. California is a national leader on measures to tackle this catastrophic disease, but we can and must do more.

Americans now are more likely to die from an overdose than they are in a car crash. According to the National Safety Council, U.S. residents have a 1 in 103 chance of dying in a motor vehicle crash over their lifetime, but a 1 in 96 chance of dying from an opioid overdose. Although illegal fentanyl is the most deadly of the drugs now on the streets, heroin, prescription pain relievers and others can kill.

California has taken steps to make it harder to acquire illicit drugs. A law that took effect last year requires doctors to check with the state's Prescription Drug Monitoring Program to make sure that people aren't culling prescriptions for painkillers from multiple physicians. Keeping that database current also will help public health officials track prescribing patterns that could inform allocation of treatment resources or highlight trouble spots.

The state also now requires doctors to use special, secure prescription pads. That, however, caused some headaches as news of the policy and the new pads didn't reach all doctors before the start of the program on Jan. 1. Pharmacists have denied some patients appropriate prescriptions because they were written on the wrong paper. That breakdown due to insufficient prep by state officials should be explored, but the system will sort itself out soon.

While these efforts will slow the flow of some drugs and prevent addiction, people who suffer from substance use disorders will find their fix on the streets. There, the drugs are more likely to be tainted or dosed incorrectly, increasing the chance of overdoses.

That's why the state needs to treat people individually for their substance use disorder. New California emergency room programs that help patients enter treatment are a good start.

Providers and policymakers also must think outside of traditional therapy models.

Medication-assisted treatment has a growing body of research behind its efficacy. Buprenorphine, for example, has saved many lives. Some advocates argue against it because they view such interventions as treating drug addiction with more drugs. That argument only works if one ignores that the new treatment drug is safer and not debilitating like the illegal one.

Another innovation of recent years is the hub-and-spoke model of treatment that Vermont has pioneered. It connects patients from a central treatment center - the hub - through counselors - the spokes - to service providers who can help patients address needs such as pain management, family services, mental health services and more. California has deployed some hub-and-spoke systems, and lawmakers should support more of them.

California and the nation will have the most success at treating the opioid epidemic and its many deleterious symptoms when public health resources and public opinion recognize that substance use disorders are a medical condition, not a moral failing.

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