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Harm Reduction in California Part II: The California Harm Reduction Initiative (CHRI)

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Pinnacle Team
8 months ago
Pinnacle Icon
Pinnacle Team •
8 months ago

In Part II of our Harm Reduction in California series, we’ll discuss the California Harm Reduction Initiative (CHRI), a program designed to mitigate the damaging effects of substance use and substance use disorder (SUD) on individual, families, and communities in California.

The Opioid and Overdose Crisis in the U.S. and California

In the United States, the opioid and overdose crisis has claimed over a million lives in the past 25 years, with over 75 percent of those deaths involving opioids. California is not immune to this crisis. The latest data from the California Department of Public Health (CDPH) and the Centers for Disease Control (CDC):

Overdose Fatalities in California: 2019-2022

  • 2019: 3,244 opioid-related overdose deaths
    • 5,885 total drug overdose deaths
  • 2020: 5,502 opioid-related overdose deaths
    • 6,198 total drug overdose deaths
  • 2021: 7,175 opioid-related overdose deaths
    • 9,462 total drug overdose deaths
  • 2022: 7,385 opioid-related overdose deaths
    • 11,761 total drug overdose deaths

Figures from the CDPH and CDC aren’t identical, due to differences in vetting procedures, reporting deadlines, and other technical issues. However, the data above offer the best possible record/report of all drug and opioid overdose deaths in California. For a detailed dive into the data, please click the links and explore both the state and national overdose surveillance dashboards.

That’s the current situation in California, where Pinnacle Treatment Centers offers a core element of harm reduction – medication assisted treatment (MAT) – at over 40 locations across California, including these three facilities:

  1. Aegis Treatment Centers Modesto in Modesto, CA

  2. Aegis Treatment Centers Ontario in Ontaria, CA

  3. Aegis Treatment Centers Roseville in Roseville, CA

Those treatment centers serve a clear and demonstrated need for MAT treatment, as illustrated in the data above: a 100.1 percent increase in total drug overdose deaths between 2019, and a 127.6 percent increase in opioid-related overdose deaths.

Pinnacle Treatment Centers and Aegis Treatment Centers support the harm reduction efforts prioritized by the California Harm Reduction Initiative (CHRI), established by the state of California in 2019.

About the California Harm Reduction Initiative

Officials in California allocated 15.2 million dollars to form a partnership with the National Harm Reduction Coalition to create harm reduction programs that address needs unique to the citizens of California under the umbrella of the California Harm Reduction Initiative.

The diversity of California makes implementing any statewide program a challenge, but that challenge also creates an opportunity for the rest of us: programs that succeed in a state as diverse as California can serve as templates for other areas of the country that are just as diverse, and face similar problems with implementation, scale, and access.

If a program succeeds in California, a state which include urban, suburban, exurban, semi-rural, and rural areas, then it’s likely it can succeed anywhere. Since 2019, the CHRI has implemented programs that improve the lives of Californians across the state.

CHRI Programs: Help for California

  • Increase programs that prioritize reducing harm
  • Expand access to treatment for SUD, especially OUD
  • Mitigate the damaging effects of drug use for individuals, families, and communities.

One of the most successful programs launched by the California Harm Reduction Initiative is the California Bridge Program, called CA Bridge. The goal of the bridge program is to allow any person in California to initiate substance use disorder (SUD) treatment in hospitals in California, wherever the hospital is and whenever anyone needs treatment.

That’s a goal we can relate to.

Our goal at Pinnacle Treatment Centers is to bring SUD treatment to anyone who needs it, as quickly as we possibly can.

The CA Bridge program is important because it leverages a specific time – when a person with SUD or OUD visits a hospital for a drug-related reason, including overdose – that evidence shows people who use drugs are most willing to accept and initiate treatment. When a person ends up in the hospital emergency room for drug-related reasons, they often spend the hours re-evaluating their circumstances – and many decide it’s time to make a change.

California Bridge: The Impact

As we mention above, if you can’t measure it, you can’t improve it.

With that in mind, let’s look at the measurable impact of the California Bridge Program on the people of California, as reported on their comprehensive website.

  • As of 2023, 83% of California hospitals participate in CA Bridge
    • 25% in 2020
    • 49% in 2021
    • 73% in 2022
  • 109,000 patients screened for substance use disorder
  • 31,000 patients administered or prescribed buprenorphine, on of the medications for opioid use disorder (MOUD) used in medication-assisted treatment (MAT) programs.
  • 37,300 patients made a follow-up appointment for SUD counseling/treatment
  • 36,078 patients initiated MAT as the result of CA Bridge
    • 8,544 were in a criminal justice setting
    • 33% were people of color
    • 33% reported housing insecurity
    • 77% were uninsured
    • 70% had co-occurring mental health disorders
  • 85% of patients offered MAT accepted MAT
  • 40% of patients who initiated treatment in the hospital participate in ongoing care

The heroes of the CA Bridge program are Substance Use Navigators. Substance Use Navigators help connect people in the hospital with MAT services while in the hospital, then connect them to ongoing support after discharge from the hospital. Substance Use Navigators introduce the concept of harm reduction, treat patients with dignity, focus on empathy and understanding, and show patients without support how they can access support and treatment that can change their lives for the better.

Up Next: Harm Reduction in Prisons and Jails in California

The success of these programs in mitigating the harm caused by the opioid crisis is significant. In just over five years, CA Bridge has had a positive impact on the lives of people in California. In that way, California is indeed leading the way in comprehensive harm reduction programs in the U.S. Another area where California is ahead of the rest of the country is in the implementation of SUD treatment with MAT in prisons and jails.

The California Department of Corrections and Rehabilitation (CDCR) and the California Correctional Health Care Services (CCHCS) created a program called Integrated Substance Use Disorder Treatment (ISUDT)  to offer substance use disorder treatment – including MAT – to incarcerated individuals in California. The goals of ISUDT are in the CDCR are to “reduce SUD-related morbidity and mortality, and recidivism.”

We’ll report on the outcomes of the ISUDT in Part III of our Harm Reduction in California series. We’ll also shine a light on the ongoing work of our Director of Government Relations (California), Javier Moreno. Javier coordinates our effort to bring MAT to prisons and jails in Califiornia. He works closely with the California Department of Corrections and Rehabilitation (CDCR) and the California Correctional Health Care Services (CCHCS). Together, they manage programs that support incarcerated individuals with opioid use disorder (OUD). Also, whenever possible, Javier works to offer continuing MAT services, counseling, and therapy upon release from incarceration.

We’re committed to the harm reduction effort in California: look for Part III in this series to learn more.

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