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cvm_mag_vol6_no3

We are a weekly newspaper serving the communities of Exeter, Lindsay, and Woodlake California.

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MINERAL KING PUBLISHING INC | FSGNEWS.COM | 13 or patients currently taking anxiety medications, such as Xanax or Valium. Patients with a history of high-dose opioid use are also much more common than patients with multiple prescriptions. Since 2008, the number of people being prescribed more than 90mg of opioids per day in Tulare County has been cut in half and is at a 10-year low. The same trend can be seen in surrounding counties and across the state. People prescribed over 50mg per day are twice as likely to overdose and those who die from overdose have an average dosage of 98mg per day, according the CDC. The number of people using more than five doctors and pharma- cies to get opioids is less in Tulare County than the state and Kern County and only slightly higher than Fresno and Kings Counties. According to the California Department of Public Health, using multiple prescribers or pharmacies is a sign of addiction because it is unlikely the prescribers are aware of each other, and likely that the patient is taking much more than their doctors know about, pos- sibly even to sell. Tulare County doctors have also become more adept at saving overdose patients from death. Hospitalizations for opioids overdose increased between 2007 and 2014 at a much higher rate than the state, but overdose deaths have remained below the state average. Hospitalizations for heroin were far below the state average. A simi- lar trend can be seen in surrounding counties. Dr. Haught said Naloxone, an antidote for opioid overdose, will soon be distributed to first responders, such as officers and firefight- ers, who often arrive on scene before paramedics. Naloxone can also be prescribed by a physician or purchased over the counter at a pharmacy. Dr. Love said Tulare County's health clinics and para- medics have had the antidote for sometime and staff members have been trained to use it. "It can reverse the immediate effects of the drug if administered in time," Dr. Haught said. PartnershiPs Patricia Hamilton, supervisor for Tulare County's Alcohol and Drug Prevention Programs, said community outreach and partner- ships have played a huge role in curbing opioid abuse. The Tulare County Prevention Coalition brings together the offices of Tulare County Alcohol and Drug programs, Public Health, Education, drug enforcement agencies, job training programs and Family Health- Care Network "to address the issue of substance abuse in the community." For example, the Tulare County Office of Education asked students to produce a 2 minute public service announcement regarding prescription drug misuse among youth. Hamilton's pro- gram now has alcohol and drug counselors educating employees with Child Welfare Services and TulareWORKS on recognizing the signs and symptoms of substance abuse. First-year residency doc- tors in Tulare County now have a one-month rotation for addiction treatment. "There's no poster child for opioid addiction," Hamilton said. "In the case of many seniors, they don't know that they are addicted." In 2016, most opioid overdose deaths occurred in people ages 55 to 64, not the teens stealing from the medicine cabinet portrayed in film. At least three deaths were recorded in people ages 30 to 34 and 40 to 44 and there were just as many deaths in people age 25 to 29 as there were in people ages 65 to 69. In Tulare County, opioid users are more likely to be women over the age of 85 living in mountain communities. Those most likely to abuse opioids are woman ages 55 to 64 years old living in the Dinuba, Porterville and Tulare areas while those at the highest risk of overdose are Na- tive American men ages 55 to 64 living in mountain communities. Most overdose deaths occur in white men ages 55 to 64 living in Farmersville. "There is still a high percentage of addiction for alcohol and meth, much higher than opioids," Hamilton said. "Opioids are often a drug of consequence and not of choice. In terms of illegal drugs, meth is the drug of choice." While opioid deaths have remained relatively consistent since 2007, alcohol-induced deaths in Tulare County have increased by 37 percent since 2002. In 2014, there were 9.6 deaths per 100,000 people from alcohol, including alcohol poisoning, cirrhosis and traf- fic accidents in Tulare County. That's compared with just 3.9 deaths per 100,000 from opioid poisoning in Tulare County for the same year. Alcohol related driving deaths alone killed 131 people in Tu- lare County in 2014, compared with just 17 deaths due to opioid overdose. Admissions to drug treatment programs for meth were over 60% higher than that of heroin between 2000 and 2008, according to a study conducted by the Center for Applied Research Solutions (CARS), Inc. in collaboration with the Calfornia Department of Al- cohol and Drug Programs. In 2008, 41% of admissions were due to meth while just 14% were due to heroin and 4.5% for all other drugs, including opioids and other legal prescriptions. Despite easy access to opioids, meth was also the drug of choice for people under the age of 18. Meth represented 5.3% of admissions to drug treatment programs in 2008 compared with none for opioids. Between 2000 and 2008, nearly 850 juveniles were admitted into drug treatment programs for meth in Tulare County, compared with just five for heroin and 54 for all other drugs. "When anyone is struggling with substance abuse comes in there is an underlying issue that addiction is just a symptom of," Hamil- ton said. "We are only able to correct that when we try to heal the whole person." Like alcohol and meth, opioid misuse and abuse creates other health conditions that can be fatal. Sharing needles can lead to the spread of Hepatitis C, HIV, botchelism and in rare cases endocar- diosis, which infects the lining of the heart. Snorting and smoking heroin can lead to lung cancer. "Opioids can be responsible for a significant amount of health conditions far beyond conditions directly associated with their use," Patricia said. About 27% of people who abuse prescription opioids get them from their doctor and about 15% from a drug dealer, according to the CDC. But the majority either purchase them (23%) or get them for free (26%) from a family or friend. So while medical profession- als work to identify high risk patients and law enforcement officers work to crack down on dealers, most of the credit for low opioid abuse and blame for high opioid use falls on the Tulare County resi- dents. Those most likely to abuse opioids are woman ages 55 to 64 years old living in the Dinuba, Porterville and Tulare areas. Cover Story

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