Panel discusses fentanyl issue at local level
Agencies offer their views on impact and strategies
A fentanyl awareness and education program held in Bishop Tuesday included a panel of experts who gave their perspective on the impact the drug is having locally in the area.
Arlene Brown, the recovery support navigator for Northern Inyo Healthcare District’s addiction treatment program, said when it comes to “fixing” what’s going on behind the scenes, “it’s not just law enforcement, it’s not just medication-assisted treatment, it’s not just one thing.”
“There’s a lot of reasons that people become addicted,” Brown said, adding that the panel discussion was aimed at addressing some of those issues.
The panel included Bishop Police Lt. Josh Ellsworth, Inyo County Probation Chief Jeff Thomson, Stephen Dondero, NIHD’s harm reduction specialist, Dr. Anne Goshgarian, an emergency and addiction medicine physician at NIHD, and Eric Sanders, the executive director for Bakersfield Recovery Services.
The impact of fentanyl
Sanders said with fentanyl he and his staff have to think outside the box in terms of not only treatment but educating the community.
“Obviously we’re in an epidemic,” Sanders said. “And fentanyl is unique.”
He said his facility has treated opioid dependence in the past but with fentanyl there are two issues. There are those individuals who are opiate dependent specifically. Then there is what is being seen with the epidemic – people, including youth, are dying from fatal overdoses because they think they are taking a different drug, a drug that they might be used to, but now it’s been processed with fentanyl.
“So we’ve had to really think outside the box in terms of outreach and
educating the community in dealing with fentanyl,” Sanders said.
Goshgarian said the situation is similar at NIHD.
“We are working hard both to treat patients who are actively seeking support and help in recovering from opioid addiction and also working hard to outreach to community members who are in active addiction.”
The hospital provides fentanyl testing strips to allow those who are in active addiction to be educated about what they’re using.
“It has created a change but I think education is power,” Goshgarian said. “The more we know, the more opportunity we have to bring more patients into treatment.”
Dondero said with an increased the risk of overdose due to fentanyl, he has been focusing on education people about Naloxone, a medicine that rapidly reverses an opioid overdose, and “trying to get it into everybody’s hands.”
Dondero said Naloxone education is critical because many overdoses are accidental. Because of this reason, he also distributes fentanyl test strips because “we want to keep them safe where they are at.”
Thomson said with the Probation Department, it’s understood that about
85% of probation cases involve some kind of a drug or substance abuse issue and so he and his staff must make sure that they provide the resources and help those probationers might need for that.
He said another issue his staff must consider is officer safety due to the danger even small amounts of fentanyl can pose. Officers sometimes have to go into homes to search them as part of a person’s terms or conditions of probation and can come across fentanyl. Officers must be educated and trained to recognize what fentanyl is and to be able to protect themselves from accidental overdose.
Ellsworth said the Bishop Police Department faces similar challenges that the Probation Department does as far as taking more precautions in how officers make contact with people and with how searches are conducted.
Ellsworth said a significant number of law enforcement officers throughout the country have come into contact with the drug, which has led to accidental overdoses, by simply doing their jobs.
Ellsworth said officers are issued Narcan, a spray that’s similar to Naloxone, not only for members of the public but for use on themselves if necessary.
Rendering assistance
Sanders said his facility might not be for those looking for assistance depending on where that individual is at. He said he and his staff are familiar with the referral system in order to meet those individuals “where they are at” as far as their addiction and potential treatment.
Goshgarian said her role is similar to Sanders’ as far as helping a patient find the best treatment plan that’s going to work for them. Treatment usually includes a combination of medications, counseling and support services to make sure their needs are being met from all angles, which would include adequate health care.
Goshgarian noted that the NIHD Emergency Room is the area’s only 24/7 access to care “and one of the ways in which we try to meet people where they are.”
“When somebody has a moment where they are motivated and reaching out for help, we want to be there to wrap around that patient and really utilize whatever resources are available,” Goshgarian said. “The Emergency Department is a great option for initiating treatment.”
She said all of NIHD’s ER physicians are trained in the use of medications that have been FDAapproved for the treatment of opioid use disorder to help patients get started. The hospital also has a recovery support navigator in Brown and a harm reduction specialist in Dondero, both of whom reach out to patients who are looking for help.
“The ER is really a great option for patients who might have the desire to quit at two o’clock in the morning or whenever else,” she said.
Thomson said the most important thing he and his staff can do for someone who is on probation and is looking for help is to “act” by providing them with referrals to NIHD or Toiyaba Indian Health Project or other local resources.
Ellsworth said law enforcement officers act as “kind of a conduit.” He said if somebody is at a point where he or she wants help, “we have the resources to put them in a car and give them a ride to the hospital where they can get that.”
He said officers also carry information to distribute to people if they’re not ready for treatment at that moment.
“They have that information on them so when they do have that moment when they want help, the resources are available,” Ellsworth said.
Dondero said in his role he accompanies patients to treatment appointments to help them with any necessary paperwork and give them whatever support they might need.
The stigma of addiction
Sanders said the stigma with addiction is still very prevalent, although it has gotten better in the last few years. He said the stigma extends beyond just the addiction but to treatment and the life-saving medications needed to deal with addiction.
He said as with many issues dealing with addiction, the key is education.*
Goshgarian said the stigma is a “huge barrier” to accessing care for a lot of patients.
“One of our goals throughout the hospital has been to really de-stigmatize substance-use treatment because when patients feel like they’re treated poorly, it’s not fair and it also really just dissuades people from trying,” Goshgarian said. “So we work really hard to dispel stigma because everybody deserves to be treated.”
Thomson noted that the stigma often extends beyond the user to the family whose members might be afraid of what their neighbors or their community might say or think if that family reaches out for help.
“I think we could really reduce the number of overdoses if we get our family and friends to step up and help out,” Thomson said.
The program also included training on recognizing signs and symptoms of an opioid overdose and training on opioid overdose reversal kits.
For more information, call:
NIHD Recovery Support Navigator, (760) 920-0362
NIHD Syringe Service Planner, (760) 920-0322
NIHD Rural Health Clinic-MAT Program, (760) 873-2849
NIHD Emergency Department, (760) 873-581