Thursday, May 17, 2018

On the drug scourge in rural northern California--and state and local government responses (or lack thereof)

The New York Times reported recently about a drug scourge (heroin, opioids, fentanyl)  in Humboldt County, part of the state's Emerald Triangle, an area legendary for pot growing more than anything else in recent decades.  Jose A. Del Real reports:
The problem is exacerbated here in Eureka, the county seat, by a sizable homeless population that is growing amid an extreme lack of affordable housing and a changing, weakened economy that relies heavily on tourism. The combined ills have devastated a particularly vulnerable community that is often overlooked in the state. [Read more here and here].  Now those problems are spilling into public view, sparking grievances and anger among the town’s residents.
The opioid death rate here is five times higher than the state's average, and it rivals that of Vermont and Maine, where the issue has garnered far more attention.   

Del Real writes also of a controversial needle exchange program--a controversy driven in part because of appearances problems and the heavy reliance on tourism in the region.  He writes, too, of the struggle to provide services such as drug treatment in this remote and often forgotten part of the state.  Del Real quotes chief deputy coroner Ernie Stewart :
The state is failing miserably, and you can quote me on that.  The state is failing miserably across the board. They are not putting enough funding and resources toward rehabilitation.
Mike McGuire, the region's state senator estimates that between "500 and 700 residents of Humboldt and nearby Trinity and Del Norte counties are on a waiting list for opioid treatment services."  According to Marlies Perez, the chief of the California Department of Health Care Services’ Substance Use Disorder Compliance Division, however, local government officials often oppose treatment options in rural areas because of the stigma. Nevertheless
[t]he treatment provider Aegis is scheduled to assist in opening a center just outside Eureka by early 2019. The hub is meant to treat up to 200 patients and to serve as a center for smaller “spoke” centers in the region, including Del Norte and Trinity counties.
Stewart also observes that the rate of opioid abuse is dramatically underreported in the region--and that meth remains "king" there.   

Del Real paraphrases state senator Mike McGuire, who urges government leaders to expand rural resources, observing that "rural Californians are 'desperate' for more assistance." McGuire states:
Humboldt County is just a few hours up Highway 101, but as an individual travels further north on the highway, it’s like you take a step back in time. We need to step up to the plate and provide rural counties with the tools they need to combat this crisis.
Finally, Del Real's story takes up housing issues, initially quoting Stacy Cobine, who has been homeless in Eureka for decades.   
I don’t know why treatment and rehab and these services always have to come into play first.  If there was just affordable housing, people wouldn’t be using as much.
Again, however, local government and local residents appear to be part of the problem.  According to Sally Hewitt of the Humboldt County Department of Health and Human Services, the "inability to expand public housing options will make that far more difficult, particularly because of local resistance."  Because of state restrictions on the development of public housing, county officials "must largely deal with private landlords when seeking to house the homeless. Many of the landlords require potential tenants to have references, good credit and an income at least three times the cost of rent."

A somewhat related story was filed a few days ago by Elizabeth Zach with USC Annenberg's Center for Health Journalism.  Its dateline is Plumas County, California, and the gist is that some California counties are cooperating to deliver services in response to the opioid crisis--and it's working.  Plumas County has now brought its death rate--previously extremely  high in relation to the rest of the state--down to zero.  Here are some key excerpt from Zach's reporting on how the relatively new program works: 
The California Health Care Foundation started funding Opioid Safety Coalitions four years ago, so counties could combine opioid treatment resources. The nonprofit Center for Health Leadership and Practice, in cooperation with the foundation, has advised public health officials in 32 counties representing 24 coalitions and formed the umbrella group the California Opioid Safety Network.
* * * 
In 2015, health professionals in California’s northern Sierras formed the regional Northern Sierra Opioid Safety Coalition. The group aimed to curb the growing number of opioid-related deaths in four counties — Plumas, Lassen, Sierra and Modoc — and to expand access to treatment for those struggling with addiction. Its objective was three-fold: promote safer prescribing, increase access to naloxone, which can counteract the effects of an opioid overdose, and widen treatment options for addiction. 


Orchid64 said...

Drug use is the weeds of the issue and it can't be solved by mowing them over with cheaper housing and rehab clinics. The basic problems are the lack of jobs in areas that lost them when environmental initiatives robbed these communities of their greatest sources of employment and the problem with transient populations who come to rest in these areas.

I'm a liberal, but I'm a liberal who both grew up as a rural poor child and lived near poor people in an urban area as an adult and I've noted that other liberals who have not had either of these experiences love to tell people in other areas what to do while not putting up low-income housing next door to them. The problem is that living next to poor people is not a good life experience. Low income housing complexes are so hard to deal with that it's hard to get property managers to take the jobs of looking after them. Poor people who live in them are often loud, rude, destructive, irresponsible, and indifferent to the needs of their neighbors. In my current area, they vandalize their own complex, leave trash everywhere, use drugs, steal from others and one another, and the police are constantly showing up to deal with domestic violence reports. Nobody wants to live next to that.

It's not a failure to be compassionate, but an understanding that the answer isn't warehousing people in more low-income housing solves nothing and creates new problems for everyone nearby. The answer is to put unskilled work back into the communities so that people aren't impoverished, unhappy, and hopeless. These areas only rely on tourism because nothing else is left for them. All of the jobs are centered in overcrowded urban centers while rural areas are left to decay. Fix the employment situation and the rest will follow. Putting more bandaids on it won't do anything except assuage the conscience of NIMBY limousine liberals.

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