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GUEST VOICES: Small Steps in Opioid Epidemic
2018 opioid legislation on right track, but CA still miles short of real care.
Ramon Castellblanch, Ph.D., President, Quality Healthcare Concepts, Inc.
This year, the California legislature and governor took small steps toward alleviating the opioid epidemic that is plaguing our state. Action on the epidemic is desperately needed. In the past three years, more Californians have died of opioid overdoses than were killed in the Viet Nam war and the 
death rate could still be rising. In 2016, roughly 350,000 Californians abused and/or were dependent on opioids, putting them at high risk of a fatal overdose. These latter Californians are said to suffer from opioid use disorder (OUD).
GUEST VOICES: Gov's Hesitation Hastens Death Toll
by Ramon Castellblanch, PhD
Quality Healthcare Concepts, Inc.
UPDATE 9/26: The Governnor has vetoed SB 2384, which would require that private insurers pay for opioid addiction treatment services. AJ supported SB 2384.
In his last turn at signing bills, Governor Jerry Brown could take some big steps in saving California lives from the opioid epidemic; but, so far, he hasn’t done so. As he hesitates, the death toll gets higher. His deadline is September 30.
The number of opioid overdose deaths in the United States is still rising. In fact, the rate at which those deaths is going up has actually increased in the past few years. Deaths due to the synthetic opioid fentanyl, 80-100 times stronger than morphine, are driving this soaring death toll. Deaths due to fentanyl are rising in California, too. At this point, the top priority in fighting the opioid epidemic is funding recovery and treatment for opioid use disorder.
The Legislature has put a dozen or so bills on Brown’s desk that are aimed at fighting California’s opioid epidemic. Some could substantially increase funding for recovery and treatment for opioid use disorder while otherrs would not. Guess which bills Brown’s signed so far.
Still sitting on his desk are all the bills that would increase funding for recovery and treatment for opioid use disorder. SB 275, supported by the California Society of Addiction Medicine, would require that substance use disorder (SUD) treatment services for adolescents be provided by competent and adequate staff. SB 823, supported by American Society of Addiction Medicine (ASAM), would require SUD treatment for adults meet ASAM’s outcome-oriented and results-based standards. SB 992 would provide more state oversight of recovery and treatment facilities. Finally, SB 212 would require the pharmaceutical industry to run a statewide drug and sharps take-back program. This would help get dangerous opioids out of medicine chests and into safe disposal. All of these bills could save many Californians’ lives.
It’s good that the Governor has signed all the opioid legislation that doesn’t increase funding for recovery and treatment for opioid use disorder; but he’s got to back up these bills with serious funding. It’s time for him to show he’s really serious about reducing California’s opioid death rate and saving lives. Next week is his last chance.
GUEST VOICES: Here Come “Low Energy Drinks”
Building a Wall Between Cannabis and Alcohol
by Bruce Lee Livingston, MPP
Executive Director/CEO, Alcohol Justice
Alcohol and marijuana just don’t mix. Alcohol has some stimulating properties at low dosages, but ultimately it is a sedative. Marijuana and most cannabis products are sedating. When a teen tries both together, the result is much drowsier, much tipsier teen.
Take driving for example. Most countries already limit blood alcohol content (BAC) to .03% or .05%. Utah is the first state to lower the BAC limit to .05%, and Canadian provinces are moving that direction. In California and every other state the BAC limit is .08%. Some studies have shown driving while high on marijuana might actually be slightly safer than driving while drug-free, but most studies indicate increased risk from cannabis. Importantly, there is overwhelming evidence that combining the two leads to more impairment and reckless driving than either alone. Even at BACs below .08%, driving occurs when the influence of cannabis is added.
Veto Needed to Stop 4 A.M. Bar Bill
The cloak-and-dagger vibe surrounding the SB 905, the 4 A.M. Bar Bill, does not just stem from the rise in assaults and violent crimes that come with late last calls. It also arises from the combination of opacity and deliberate distortion of science that has gotten it through the California Assembly.
On Wednesday, August 29, the California Assembly approved the bill, authored by State Sen. Scott Wiener (D-San Francisco). On its way to the floor, it was amended innumerable times, its hearings repeatedly delayed, and its scope expanded arbitrarily. In short, it showed every sign of bad-faith governance, favoring Big Alcohol and the handful of large nightlife promoters who support its coauthors over the lives and safety of California citizens. Having already cleared the Senate, the bill now goes to Gov. Jerry Brown. Alcohol Justice and the California Alcohol Policy Alliance (CAPA) urge all concerned Californians to tell the governor to VETO it.
The bill was initially proposed as a “pilot," but it is not clear that Sen. Wiener knows what that term means. Unlike legitimate pilot studies, which seek to test a theory in a small population before any large-scale rollouts, SB 905 targets 5 of the 10 largest cities in California. Counting the "Splash Effect" from drivers within an hour of those cities, the “pilot" threatens over three-quarters of California. Never mind the fact that Sen. Wiener did not bother to put together a coherent plan to assess the impact of late last calls, nor designate funding for professional data analysis.
It is hard to tell whether SB 905’s backers are simply scientifically illiterate, or are literate enough to understand the weight of the science opposing them. Sen. Wiener’s initial arguments for the safety bill were based on a flimsy unsourced spreadsheet that had not been analyzed at all. The U.S. Community Preventive Services Task Force performed a systematic review of 40 years of data on last call times, finding that any change of 2 hours or more lead to increases in alcohol-related traffic deaths. A one-hour change was enough to create a spike in violence, assault, accidental injury, and ER admissions.
“Alternative facts are very popular right now," said Carson Benowitz-Fredericks, Research Manager for Alcohol Justice. “California needs leadership that understands the significance of basic research in protecting lives."
Nothing about California suggests it would magically be immune to the harm experienced elsewhere in the U.S., Canada, Europe, and Australia. Despite the rise of Lyft and Uber, fatal traffic accidents involving alcohol have been rising steadily year after year. Major holes in transit service combined with the spike in rents make driving the only option for younger, lower-income Californians—the same to whom late last calls would be most appealing.
“We know who this hurts," said Michael Scippa, Public Affairs Director of Alcohol Justice. “We know how badly it hurts them. We know the catastrophic costs to hospitals, first responders, and government. We just need to make sure Gov. Brown knows as well."
Concerned Californians can TAKE ACTION to reach out to Governor Brown here. Let the Governor know that 2 extra hours of drinking are not worth our neighbor’s lives.
TAKE ACTION to tell Governor Brown to VETO SB 905.
READ MORE about the threats and effects of later last calls.
READ MORE about how SB 905’s backers failed their basic statistics classes.
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