Faced with surge in overdose deaths, regulators develop opioid settlement funding plan

San Diego County officials are developing plans to address opioid addiction and overdose, and the county expects to receive $100 million from settlements with drug manufacturers.

On Tuesday, October 25, the Supervisory Board unanimously approved an opioid resolution framework that will fund counseling for overdose survivors, expand opioid addiction treatment, and provide housing and other services for people with substance use disorders , and create a safe disposal system for unused prescription drugs.

The county is battling several lawsuits against opioid manufacturers seeking compensation for the public health costs of opioid addiction and death. County officials did not provide further details about the status of the lawsuits or what they specifically expected from each lawsuit, but Board Chairman Nathan Fletcher said the county expects to receive its first payment of about $4 million in November. .

Although this was a small fraction of their expected total, board members decided to develop a plan now to be in place when the county receives the remaining funds in subsequent years.

“What we propose in the framework is to initiate substantial investment in opioid treatment and prevention,” Fletcher said.

In addition to the problems caused by prescription opioids, the county has seen a sharp rise in overdose deaths from the illicit form of the powerful synthetic opioid, fentanyl. Those deaths surged from 151 in 2019 to more than 800 in 2021, according to county authorities. In June, the county declared illegal fentanyl a public health crisis.

The first phase of the plan will expand the drug-assisted treatment program for opioid addiction and add services such as mental health treatment and housing for people with substance use disorders.

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Through a 24-hour peer support program called Relay Mode, the county will send peer advocates to hospitals to counsel overdose patients and persuade them to receive treatment before resuming drug use.

“With Narcan, we had a lot of near misses, but not after the near misses,” said San Diego County District Attorney Summer Stephan, referring to naloxone, a drug used to reverse opioid overdoses. “We’ve actually heard from our paramedics that they’re responding to the same people over and over again.”

The county plan will expand treatment for people using drugs in prisons and will provide prenatal and postnatal care for opioid-addicted women.

It will prevent fatal overdose by distributing naloxone or other similar drugs, develop educational programs to stop opioid use, and distribute prescription drug disposal bags to all households to reduce the amount of opioids found in homes.

Fletcher said many people who become addicted to heroin or other street drugs begin by taking opioids prescribed to other family members. By destroying unused drugs, families can prevent such abuse, he said. He said drug disposal bags have been used successfully in other states, including Ohio, West Virginia and New York, and have reduced unused medications stored in home medicine cabinets.

Michaela Blackmon, who said her sister died of a fentanyl overdose last year, expressed support for the program, but added that it must provide resources not only for patients dealing with addiction, but also for families who support them.

“Substances cause a real hijacking of the brain, but you see that substance use is always more than just substances; it’s trauma, it’s mental health, it’s homelessness,” Blackmon said. “Families need help. We need education. We need training and programs that are readily available and accessible.”

Others urged the county to stop addiction before it begins prevention programs for children and teens.

Several speakers said the county, which is expanding its marijuana licensing program, must limit marijuana advertising and invest in enforcing age restrictions, arguing that underage marijuana use increases the risk of other substance use disorders.

A spokesperson for Lardy Children’s noted that the county’s framework is aimed at chronically addicted adults and that there is no “playbook” for pediatricians to treat children affected by opioids.

She called for programmes to address the impact of drugs on children, including babies born to drug-using mothers and children at risk of drug use due to childhood trauma or peer problems.

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