By Anna Zepeda
AmeriCorps VISTA Associate
What is AmeriCorps VISTA?
As opioid overdose death rates increase, collaborative efforts are needed to provide a community-wide response. One example of these new partnerships is AmeriCorps VISTA with the Public Health Institute’s Center for Leadership and Practice and the California Health Care Foundation. Together, these organizations are placing VISTA associates across California Opioid Safety Network (COSN) opioid safety coalitions statewide to help increase their capacity. These full-time VISTA members support coalitions in a range of capacities, including project management, preparing materials, community outreach, and other duties as defined by coalition leadership.
Other VISTAs and I have been placed across 32 local opioid coalitions that cover 38 counties participating in the California Opioid Safety Network’s (COSN) Accelerator Program
. Launched in February 2018, the Accelerator Program offers expert coaching, technical assistance and networking opportunities to 32 local opioid safety coalitions. Their goal is to strengthen each coalition’s local impact. The program model supports coalition performance improvement and strategy implementation. In addition, the program develops capacity in measurement, strategic communications and sustainability planning. Butte-Glenn Medical Society Drug Prevention Task Force is one of the COSN coalitions.
This past year I have been assigned to the Butte County Public Health Department in collaboration with the Butte-Glenn Medical Society Drug Prevention Task Force. My role in this coalition is to assist with program management and development of community engagement materials. Event planning is one task that I assist with regularly. Past events have focused on harm reduction, opioid use among pregnant women, neonatal abstinence syndrome, and opioid use disorder treatment in primary care and emergency room settings.
Other projects that I have been involved with are tracking opioid overdoses and naloxone utilization in the county, creating a database of current X-waivered physicians who treat opioid use disorder, developing a website featuring education and community resources which will be published soon, and participating in community health fairs and other events to promote safe disposal of medications/sharps and treatment options.
How the Medical Community is Addressing the Opioid Epidemic
The medical community plays a central leadership role in addressing the opioid epidemic, which is why the Butte-Glenn Medical Society Drug Abuse Prevention Task Force is hosting a dinner program to discuss what’s been happening in our community. Physicians, providers and practice staff are welcome to join this educational program on June 12 at Butte Creek Country Club. The program has been approved for 1.5 CME units and is being offered free of charge thanks to a grant from Aegis. The following is a synopsis of the June 12 program.
At its peak in 2010, morphine milligram equivalents, MMEs, prescribed per Butte County resident were more than 3.5 times as high as MMEs prescribed per California resident, (2434.8 and 693.4 MMEs per resident, respectively). With the adoption of community prescribing guidelines and the national spotlight on the opioid epidemic, the rate has decreased in recent years. These voluntary guidelines promote practices such as using the smallest doses for the shortest amount of time; co-prescribing naloxone if a patient is on a chronic daily 50 MME dose or higher, checking CURES for each new controlled substance prescription, and not co-prescribing an opioid and a benzodiazepine. There are specific guidelines for primary care providers
and emergency care
. These guidelines were created by Butte County providers for providers practicing in our area. The guidelines have been endorsed by Butte County Public Health, Butte County Sheriff, Rotary International, Butte County Office of Education, Butte County First 5, Butte-Glenn Medical Society, Northern Valley Indian Health, and Chico Police Department.
In 2017, using the most recent publicly available data from CURES displayed through the California Opioid Overdose Surveillance Dashboard, the MME rate in the county was 1,133.12 and the statewide rate was 421.78. This, along with other key indicators such as opioid prescriptions per resident, neonatal abstinence syndrome rates, and opioid related overdose deaths will be presented by Sandy Henley, Public Health Epidemiologist, at the June 12 event: How the Medical Community is Addressing the Opioid Epidemic.
Dr. James Moore will also highlight Enloe Medical Center’s Emergency Room Bridge-like program and will lead a discussion about new policies and procedures in place in the ER department for patients suspected to be experiencing an opioid use disorder. Following a model developed by the California Bridge Program
, Enloe Medical Center’s Emergency Room aims to become a primary access point for the treatment of acute signs and symptoms of opioid use disorders. In addition, Dr. R. Kelly Otani from Adventist Health will be presenting on chronic pain management and alternatives to opioids.
Lastly, there will be an opportunity to meet representatives from the informal group, Northern Valley Harm Reduction Coalition
. They are a local grassroots organization providing community overdose response trainings with a free naloxone kit; syringe litter clean up; outreach and education; and rapid HIV and Hepatitis C testing. One of the principles of Harm Reduction is that it “accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them”.
During the June 12th event, the Butte-Glenn Medical Society will also be showcasing a special advertising supplement recently published in the Chico News and Review. The insert provides details about several programs currently in the community, as well as future directions to better address opioid misuse and opioid use disorder in the region. Highlights include: medication assisted treatment (MAT)programs; chronic pain management and safe alternatives to opioids; harm reduction examples; fentanyl information; law enforcement’s commitment to carrying and using naloxone, Enloe’s Emergency Room response to overdoses; behavioral health programs that target youth, families, and athletes; safe disposal; and the role of the Hub and Spoke model in Butte County.
This CME event will serve to promote the use of an X-waiver to treat patients with opioid use disorder, as well as giving an update on programs that are addressing the opioid epidemic in the region.
I've enjoyed working on these programs and see how a community can make a difference. I look forward to seeing the great work this coalition will do in the future, as well as the Accelerator program's efforts with COSN.
To RSVP for the event, visit: www.tinyurl.com/opioidepidemicdinner
To learn more about opioid focused AmeriCorps program, visit: http://www.dialogue4health.org/web-forums/detail/what-americorps-members-bring-to-public-health
If you have further questions, feel free to contact me at firstname.lastname@example.org before July 12, 2019. A new VISTA associate will join us in July and report to the Department of Behavioral Health.