COVID-19: Addressing the Opioid/Fentanyl Crisis within a Public Health Crisis | 2020-07-01

Hello, good morning.

I'm Mego Lien, ProgramManager with the Santa Clara County Behavioral Health Services Department, and we apologize in advance for the noise⁠—background noise you can hear withthe construction today.

We have taken off our face coverings to better allow ourAmerican Sign Language translators to understand the conversation but thepublic is encouraged to continue keeping your face coverings on whenever you'reconducting essential activities outside the home.

To date, there have been 4, 370cases of COVID-19 in Santa Clara County, 156 deaths, and happyto report there have been 0 new deaths from COVID-19.

And today, we'regoing to be addressing the opioid fentanyl crisis that's happening withinthe crisis of COVID-19 in the country and in our county as well.

And I havehere two panelists from the Behavioral Health Services Department's substanceuse treatment services, Mira Parwiz, Division Director for MedicationAssisted Treatment Programs and Stephanie Kitchen, Substance UsePrevention Program Manager.

So welcome to you both.

Thank you.

And Mira, can you get us started by shedding some light on the opioid epidemic? Sure, thank you forbringing light to this important topic.

It's important that we note that we havea national epidemic going on inside this pandemic.

As most of you might haveexperienced it personally or know friends or family members, but this epidemic isalive and it was alive before this pandemic came along upon us.

We've beenin crisis, opioid crisis, going back to 2013 and 14 andas many of you may know there's been a declared national crisis in our country.

And recently, in the last⁠—this year alone, we have seen a surge in opiate overdosesin our country.

As of today, Washington Post reported that we had 18%jump in overdoses in month of March and then in April, it jumped 29% and Mayjumped to 42%.

So as you can see it is jumping every month and it's takinglives every day.

In 2018-19, the average loss on a daily basis was120 people per day.

So this is going up every day and it's important thatnote and we all have this crisis in Santa Clara County as well.

We, in 2018, welost 66 persons and overdoses and in 2019, we lost 89.

And less than half ayear⁠—now we are only six months of this year⁠—when we have lost 45.

So it's continuing to rise and it's important to know that what is happeningnationally and also locally because it's affecting everyone in our society.

So Mira, thank you for sharing those numbers.

Could you share a little bit more about what we are experiencing in County of Santa Clara and do you think that this rise in deaths is related to COVID-19 and Shelter-in-Place? Yes, definitely the rise has been due to Shelter-in-Place for mainly three reasons: One, Anxiety and depression.

So people using⁠—people using alone, so there's nobody next to them to call9-1-1 and to⁠—and also to provide narcan to them.

Narcan is a drug that reverses overdose.

And also the economic crisis have playeda role here.

Depression and anxiety and loss of connection to drug dealers hasbeen another cause for it, because the borders are closed so people arereaching out to other unknown sources, maybe their known sources havedried up, so they're not⁠—they don't know what they're using when they're buyingoff the street.

In Santa Clara County in particular, we're seeing a crisisrelated to fentanyl.

We have had 19 deaths as of May 8 specifically related tofentanyl.

Fentanyl is a synthetic opioids and it's very potent it's like 50 to 100% more potent than morphine, so a very small amount of it can take yourlife away.

And Santa Clara County in particular, we're seeing it on thestreets, using⁠—people using fake pills asOxycontin and the fake pills kind of look in the streets they come in a bluecolor, white color, a different color, it looks like this.

It has an M shape and it has like 30 milligram you're taking it looks real butit's not.

Often it's not and it's laced with fentanyl.

So it can take your life away very very quickly.

And just to comparison thefentanyl crisis, last year comparing the data from January of 2019 to May of 2019we have only had 7 losses due to fentanyl.

This year that has tripled, sowe're almost at 20.

So that's the crisis that we're currentlyseeing Santa Clara County.

Well I'm really glad we have the opportunitytoday to talk to the public about this crisis.

Stephanie, what are some otherways that our department is getting the word out about this issue? Well first thank you, Mego.

So there's substance use preventionservices.

We have several strategies that we use to kind of get messaging out tothe public through education and outreach.

And so first of all, most peoplewant to know how do we reach the youth and we have service providersthat we make sure we get information to them and feed them the latest researchand for that research, we just distribute it to the schools whether it isafter-school programs, summer camps, arts and sports groups, and community groups.

And for our young adults, we have a relationship, we have actualcollaborative with the colleges, and so we serve 7 community colleges, 2universities that we get information out to their student centers and theirwellness centers.

And for adults, we make sure that we hit our parent groups thatwe already work with and for other different family events that we have inthe community.

We even have a program for older adults and that'sspecifically for adults 55 and older in which we do a lot of focus on medication, prescription drugs, being able to recognize what's real and what's notreal, and how they're mixing their prescription drugs.

And also for adults, for professionals, we have a specific program training that we do.

So we make sure that professionals, whether they're nurses in clinics orfolks in the community doing work, we make sure they have up-to-dateinformation to pass down to whoever their clients and their patients are.

Wealso do community media awareness campaigns.

Those awareness campaigns, we've had one just before COVID-19 that we did that wasspecifically for opioids, and we do a lot of print materials that we get out andjust distribute that.

But we also do digital advertising; we're hitting a lotof the other social media platforms as well.

So those are some of the ways thatwe get information out.

⁠[mic cut]—public education efforts.

Has COVID-19 affected your community outreach? Absolutely.

One of the things that we've had to all do is we've had to switch over to using technology and understanding the different platforms that are out there.

That's been a little trial and error, but I will tellyou a lot of our service providers have done really creative things with that.

They're using the different platforms beyond Zoom and BlueJeans but they'rehitting TikTok and⁠—and Instagram and of course, Facebook as well with a lot ofthe advertising and a lot of the messages.

I would also say that they'vebeen creative and creating a lot of online, for instance we have an onlinecreative art workshop that's going on.

We fund a culinary arts program and withthat culinary arts program they're now doing it online, in which they're sentall of the recipes and all of the things that they need, and then so the chef isactually walking them through live through Zoom and preparing things.

So alot of these programs have been really creative, and⁠—and for all these programs, even the one the culinary arts, there's information that's infused into theseprograms to make sure these young people get this message and understand what arethe latest trends and what's going on.

Now, there have been some challenges andsome of those challenges have been particularly in a lot of theunincorporated areas where there's weak or no Internet access.

We've had issues with getting kids and other adults as well devices.

We knowmost people have phones, but then we also have to make sure whether the connectionis good.

And so these are challenges we'll continue to work with, but thoseare ways in which we've had to really kind of change the way weprovide services.

I will say that we've been able to meet and reach more youngpeople, more parents by using technology.

Let's say, in the past, we've done groupswhere we've only hit 15 kids.

Now, we're hitting 25 and 30 each time that we'reactually doing different events.

So it has increased our ability to get thesemessages out.

That's great that your prevention efforts have been able to continue in spite of the pandemic and even reach more people than before.

So Mira, if somebody in the community is struggling with opioid addiction, what kind of treatment and resources are available for them? Yes, in Santa Clara County we're lucky to have access to Medication Assisted Treatment programs.

In a County, we have particularly three Substance Use Medication Assisted Treatment programs.

They're located throughout the County.

One is on VMCcampus, one is on the East side of the County, and one is on the South side ofthe County.

Aside from that, Medication Assisted Treatment programs are alsoavailable through our VMC emergency room and through inpatient hospital.

Ourinpatient units can also start someone on Medication Assisted Treatment programand primary care sites.

Medication Assisted Treatment program for addictionconsists of primarily three drugs, which are methadone, buprenorphine or Suboxone, and naltrexone or Vivitrol.

Those are the three FDA-approved drugs that'savailable for treatment of addiction and they're very effective.

So I encourageanybody that's struggling with addiction to please seek help.

We're here to help.

You can go as easy as stepping into VMC emergency room and you can getstarted on Suboxone treatment.

You can contact your primary care and discussthe options or you can call directly the substance use call-in center, theSUPs Gateway number which is 1-(800)488-9919 and get connected to any of the treatment programs.

In addition to that, we also offer Narcan.

Narcan is a drug that reverses overdose and Narcan isreally important to have if you're using any substance use, just to stay safebasically from overdosing, and that is available in form of injection or interms of we can use as a nasal spray.

In Santa Clara County treatment programs, wealso offer the nasal Narcan and you can stop at any of the county sites, theMedication Assisted Treatment program sites, to get a free Narcan training anda free kit.

Those are the resources available in Santa Clara Countyfor residents.


And Stephanie, if a family member or parent just wants to get more information, where can they go? Well aside from our Behavior HealthServices also has⁠—on our website is substance use prevention services.

You'llfind information on all drugs, but if you want specific information on opioids youcan go to the website www.


org Thank you both for your time today.

We just want to make sure to leave you with some of these important resources.

Again, as Mira mentioned, to access substance use treatment services, including the Medication Assisted Treatment, you can call 1-(800)488-9919.

There's also a youth direct intake line which is (408)272-6518.

For a list of sites with free Narcan, you can go to www.


org/SCCOOPP And finally, for more information about COVID-19 in the County, go to www.


org/coronavirus So all of this information will be added to this Facebook post afterwards for you to access and we want to thank you forwatching today and encourage you to please continue to shelter in placewhile practicing social distancing.

Right after this, there is going to be aFacebook Live in Spanish right after this broadcast.

This will be taking placehere and on the Spanish Public Health website.

So we hope you join us for thatas well.

Thank you so much.


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