by Wesley Ford, MPH
Deputy Director, Bureau of Health Promotion
Los Angeles County Department of Public Health
According to the Los Angeles County Coroner’s Office, there have been approximately 400 reported opioid-related deaths per year in Los Angeles County, and prescription opioids are involved in about 60 percent of all drug-related deaths. However, this number is likely an underestimate of actual deaths and does not include overdoses and near deaths. Despite attention grabbing headlines about well-organized drug rings and errant physicians, the majority of individuals who misuse or abuse prescription opioids obtained them from friends, relatives, or their own doctors.
Physicians and other health care professionals play a critical role in combating the current opioid epidemic. Years of unimpeded opioid prescribing by physicians have contributed to a national epidemic of addiction, worsened health outcomes and overdose deaths. As the National Institute on Drug Abuse reported, there is a broad “environmental availability” of prescription medication and opioids, created by “drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes, and aggressive marketing by pharmaceutical companies.”
Physicians and other healthcare professionals shape our community’s perspective on how best to respond to pain, and what to do when our reliance on painkillers becomes problematic. For years now, we have elevated our focus on pain and conveyed to communities that pain should not to be tolerated. We now know that this message has contributed to the overuse and misuse of painkillers, and realize the need to reframe the goal of chronic pain management to one of “functional tolerance” as opposed to “zero pain.”
For this reason, the Substance Abuse Prevention and Control, a division of the Los Angeles County Department of Public Health, helped to establish Safe Med LA (SafeMedLA.org). Safe Med LA is a countywide coalition of health professionals dedicated to taking a multifaceted approach to reduce prescription drug abuse and overdose deaths. The work of the coalition is organized into 9 Action Teams, focused on 6 priority areas with 10 key objectives, including:
- Promoting safe prescribing guidelines,
- Expanding access to naloxone,
- Expanding access to medication-assisted addiction treatments such as buprenorphine and long-acting injectable naltrexone.
- Safe drug disposal,
- Utilization of the CURES database to track and access data about opioid prescribing activity,
- Pharmacy practice,
- Community education,
- Law enforcement, and
- Data collection.
Leveraging the collective impact of this continuum of interventions to target key pressure points of opioid misuse, Safe Med LA is using a “blanket” strategy to avoid the scenario that often arises when addressing complex problems – the ballooning and worsening of certain aspects of a problem while resolving others.
By joining Safe Med LA, healthcare professionals and other stakeholders can play an active part in mitigating the ongoing opioid epidemic.
LA’s health centers can help reverse the tide of opioid deaths and overdoses by supporting the development and promulgation of safe prescribing practices, pain management guidelines, and proactive substance use disorder screenings. LA County, CCALAC and the California Primary Care Association joined together sponsoring legislation to bring clinics into the LA County Drug Medi-Cal network. While the bill did not advance to Governor’s desk this year, the group continues to work with the State of California on how clinics can play a greater role in addressing the substance abuse challenge.
In addition, please join the Los Angeles Health Alert Network (LAHAN) to receive public health notifications such as the recent Fentanyl-Contaminated Street Norco®. In this Drug Overdose Health Alert, LA physicians were alerted to recent deaths in Northern California and provided information about reporting suspected and confirmed fentanyl overdoses in LA County. To view this alert and to join LAHAN visit publichealth.lacounty.gov/lahan.