San Luis Obispo County
Data Report on Opioids

SLO Opioid Safety Coalition

Since 1999, the U.S. has seen a dramatic increase in the number of pain medications, sedatives, and stimulants prescribed. Every community has been affected by this trend. Prescription drugs are easily accessible, perceived to be safer than street drugs, and are highly addictive. When misused, they are usually obtained freely or stolen from friends or family. As abuse increases, so do accidental deaths. Today, drug overdoses kill more than cars, guns, and falling. Prescription drug abuse crosses all boundaries — gender, ethnicity, economic status, and age. Because all sectors of society are impacted, solutions will require integrated community-wide approaches.

Deaths from drug overdoses have jumped in nearly every county across the US since 2007

The trend, experts say, is driven largely by an explosion in addiction to prescription painkillers. These prescription painkillers can be used to treat moderate-to-severe pain and are often prescribed following a surgery, injury, or for health conditions such as cancer. 

Source: "Drug overdose deaths in the United States hit record numbers in 2014". Centers for Disease Control and Prevention (text); "How the Epidemic of Drug Overdose Deaths Ripples Across America." NY Times. Jan 19 2016. (photo)

What is an Opioid? Opioids are derived from the opium poppy (or synthetic versions of it) and used for pain relief. The most common opioid drugs involved in prescription overdose deaths include Hydrocodone (e.g., Vicodin), Oxycodone (e.g., OxyContin) and Methadone.

The Coalition

The SLO County Opioid Safety Coalition was established in January 2016 to reduce prescription drug misuse and abuse.  A kick off event was held on January 21, 2016 as a call-to-action. The Initiative is driven by a diverse coalition of community members, including law enforcement, physicians, pharmacists, treatment professionals, Public Health Department, Behavioral Health Department, educators and others who are working to collaboratively address the problem in San Luis Obispo County.

Full Coalition Summits are held 3 times a year to provide an opportunity for all the Action Teams to collaborate, share their successes and upcoming plans, and to highlight current events.  The next SLO County Opioid Safety Coalition Summit will be held on Thursday, February 28, 2019 from 8:30am - 10:00am at the Auditorium at Sierra Vista Regional Medical Center, SLO.

ACTION TEAMS

Interested in getting involved?  Click on the link next to each action team for upcoming meeting dates and information related to the topic area.

Data Collection and Monitoring. In order to fully address the problem in San Luis Obispo County, the Coalition first needs an understanding of the issue based on accurate, relevant data. The Data Collection and Monitoring Team addresses this need by determining what data best describes prescription drug misuse in the County, as well as the community behaviors and prescribing practices that can impact them. Click here to learn more.

Community Prevention and First Responders. Prescription drug misuse is often tied to the belief that Rx drugs are safer and less addictive than street drugs. They can also be easier to get and have less stigma attached to their use. The Community Prevention and First Responders Action Team is committed to changing these beliefs by educating the community about prescription drugs and raising awareness about the dangers associated with misuse.  The team will also focus on safe in-home storage and appropriate disposal methods in the County. Click here to learn more.

Safe Prescribing and Health Care. Studies show that prescribing guidelines based on best practices can help improve patient outcomes and limit the risk of unintended harm. The Safe Prescribing and Health Care Team is focused on developing mechanisms that promote the prescribing of healthy and safe amounts of opiates, offering the benefits of the medication while managing the harm of over-prescribing. Click here to learn more.

Medication Assisted Treatment. For those County residents already impacted by the epidemic, the Coalition recognizes the need for effective intervention, treatment and recovery options. The Medication Assisted Treatment Action Team is dedicated to increasing age appropriate treatment services with access to healthcare, medically assisted treatment options, employment, and ongoing psychological and social support for those in recovery. Click here to learn more.

Naloxone: Overdose Antidote.  Naloxone (Narcan™) is a powerful medication that works to reverse an opioid-related overdose.  Because of its effectiveness and life-saving potential, the Naloxone Action Team is focused on expanding distribution locations and educational opportunities within the County, working with law enforcement, health agency officials, school districts, physicians, and community members to expand its use. Click here to learn more.

The Data

Opioid Overdoses Plague California. Taking too many prescription painkillers can stop a person’s breathing—leading to hospitalization and even death. CDPH figures showed an overdose rate of 3.7 per 10,000 residents between 2006-2013 for SLO County (compared to a low of 1.2 per 10,000 residents in Santa Clara County and a high of 9.1 per 10,000 in Plumas County).

Source: "See where California's heroin, opioid problems are worst". The Sacramento Bee. Aug 17 2015.

Opioid-Related Overdose Deaths increased from 15 in 2006 to 36 in 2017, affecting community members of all ages. Deaths related to opioids have been on the rise in the county in recent years, similar to trends seen nationwide.

Source: California Office of Statewide Health Planning and Development (OSHPD); County of San Luis Obispo Public Health Department

Note: These figures include both overdose deaths identified by the state, as well as additional deaths determined by the Public Health Department to be related to opioids. This results in a higher, but more precise, number.

Drug Abuse Often Starts Young

The epidemic of prescription drug misuse and abuse effects people of all ages and often starts in youth. In SLO County, 15% of 11th graders reported having used Rx opioids, tranquilizers, or sedatives recreationally at least once in their lifetime. 3% reported having used Rx drugs to get high in the last 30 days.  Research shows that among people who abuse drugs, 1/3 start with prescription drugs.  The statewide CHKS survey monitors self-reported drug use with the question: "During your lifetime, have you ever used…?"

Source: California Healthy Kids Survey, 2017-18: Main Report. San Francisco: WestEd Health & Human Development Program for the California Department of Education.

Opioid-Positive Urine Tests for Arrests, by Type, 2014-2015

Of the arrest-related urine samples that tested positive for opioids by the SLO County Sheriff's Department, the majority were related to Morphine (43%), followed by Codeine (24%) and Heroin (21%).The high number of Morphine positive responses may be due to the fact that the majority of opiate drugs are morphine derivatives. 

Source: San Luis Obispo County Sheriff's Department.  Arrest Data. 2014-2015.

SLO County Treatment Admission Data, 
by type of Drug Use

CalOMS Treatment (CalOMS Tx) is California's data collection and reporting system for substance use treatment services. With data aggregated from a variety of treatment providers around the County, this data helps provide a snapshot of client behavior with regard to alcohol and drug use over time.  In San Luis Obispo County, treatment admissions noting heroin as the primary drug of choice rose sharply in 2012, while admission for opiates rose in 2009, then leveled out in the years following. 

Source: CalOMS Treatment Admission Data, 2005-2015

* Count does not include residents of SLO County who seek treatment outside the County. 

** Counts may be affected by clinic openings in 2012 and 2013.

Number of Opioid Prescriptions per 1,000 residents, 
SLO vs. CA

For every 1,000 residents in SLO County in 2017, there were 585 prescriptions for an opioid medication.  San Luis Obispo County had a higher prescription rate for all years studied compared to the state.

Source:  CURES 2.0 (Controlled Substance Utilization Review and Evaluation System)

Residents per 1,000 using 6+ prescribers or Pharmacies over 6 Months, by Zip Code

Opioid use varies geographically within the county as well, providing insight into potential areas where abuse may be most prevalent (and where community education and prescribing best practices are most needed).

Source: CURES 2.0 (Controlled Substance Utilization Review and Evaluation System)

Positive Response to EMS Naloxone Administrations in SLO County

Naloxone (Narcan™) is given to patients who have an altered level of consciousness, respiratory depression, or cardiac arrest when local EMS arrive on the scene of an emergency call.  However, only those who are opioid-intoxicated will show symptom improvement with Narcan.  Because of this, a positive response to Narcan is often used as a marker of opioid-induced overdoses within a community. 

Source: County of San Luis Obispo Emergency Medical Services Agency (EMSA)

Resources

Complementary Treatments

Complementary medicine, also referred to as alternative treatments, includes diagnostic, treatment, or preventative disciplines that are used together with conventional medicine. Utilizing complementary medicine to treat chronic pain can reduce the risk of adverse side effects caused by prescription medication. Click HERE for a list of providers in the community.

Hepatitis C and the Opioid Epidemic

The California Department of Public Health has noted that rates of hepatitis C and heroin overdoses among young adults (ages 25-29) are increasing together, at a similar rate. This is not surprising given that sharing injection equipment is the #1 way hepatitis C is spread, but it is concerning given the severity of the infection.  For information on curbing this troubling trend, see CDPH's infographic on the issue, their main Hepatitis web page, and a local report on SLO County rates.

Media

KCBX Central Coast Voices. 'SLO Opioid Safety Coalition'. May 2017.

American General Media's Public Service Announcements, mp3 (15 sec)mp3 (30 sec). Mar 2017.

KCBX Central Coast Voices. 'Kayla's Story'. Jan 2017.

New Times SLO. 'A Quiet Epidemic: SLO County's Opioid Problem'. Jan 2017.

KSBY News. 'National Drug Take Back Day encourages community to clean out medicine cabinets'. Oct 2016.

San Luis Obispo County press release. 'Upcoming Summit & Drug Take Back Event to Address Prescription Painkiller, Opiate Abuse Epidemic'. Oct 2016.

KSBY News. 'Opioid-related deaths on the rise in SLO County'. Aug 2016.

San Luis Obispo County e-newsletter. 'Coalition Aims to Address Local Opioid Epidemic'. Mar 2016.

Partners

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