Opioid Crisis: Doctor explains risk factors in Shasta County
REDDING, Calif. - The Northstate is a concentrated area of opioid use, but there have been improvements in Shasta County.
"What disturbs me the most, especially in our community is that you see young people who needlessly die tragically," said Shasta County Chief Deputy Coroner Gene Randall.
The drug epidemic doesn't just mean illegal drugs.
"In 2013, we had about 1,300 to 1,400 opioid prescriptions every 1,000 people here in a year, which means more than one opioid prescription for every man, woman and child in Shasta County. Whereas the state rate was in the 500 to 600 range so we double that," Dr. Andrew Deckert, Shasta County Public Health Officer.
Dr. Deckert said that since the peak in 2013 to the end of 2016 it has gone down 15 percent, but it still remains double the state rate.
But the question remains as to how people are getting their hands on these drugs.
"Most people who abuse or misuse opioids don't actually get them as a prescription from their doctor and use them as a doctor prescribes them, most people get them from social connections," said Dr. Deckert.
People are also getting several different prescriptions from different doctors, taking what they want and selling the rest.
"One sign that there could be diversion happening is when a person and individuals getting multiple prescriptions from multiple doctors and pharmacists that don't know it," added Dr. Deckert.
Dr. Deckert also mentioned that opioids combined with other medication can be lethal, "Another concerning situation is when prescriptions opioids are prescribed for chronic conditions and Benzodiazepine, which are anti-anxiety medications like Valium. When these are prescribed together, sometimes by different doctors who don't know they are prescribing, those two medicines together are potentially much more lethal. Nationally 30 percent of people overdose on opioids also had Benzodiazepine. For veterans its 50 percent."
However, it has declined in Shasta County 20 percent from 2013 to the end of 2016. There is no direct cause for why Northern California is seeing higher numbers compared to the rest of the state, but there are correlations.
Dr. Deckert says a big piece of the puzzle are Adverse Childhood Experiences (ACEs). Which are a stressful or traumatic event including; mental, emotional or physical abuse and neglect.
"More categories a population have as a childhood the more likely they are to have a long list of physical health, mental health and social issues later in life," explains Dr. Deckert.
He added that people with ACEs score of four or more are three times as likely to abuse opioids.
"In our community, we have double the state average in how many people have four or more ACE versus the state average. And we have about half the people with zero ACE compared to the state average," said Dr. Deckert.
Dr. Deckert credits spreading awareness, "That rate has also declined remarkably since 2009 in our peak to the end of 2016. The five or more pharmacies and doctors in 12 months for prescription opioids has declined 91 percent. That's a huge accomplishment."
State lawmakers are taking action, doctors are required enters all controlled substances including all opioids that are filled by retail pharmacies into a database.