Harm Reduction in California Part I: The SOS Workgroup

Photo of man speaking to a therapist.

The drug overdose crisis in the United States has claimed the lives of more than one million people over the past 25 years, and there may be one way to help reduce the impact: harm reduction, with the state of California as a model.

Over 3/4th of the overdose fatalities we describe above involved opioids. From prescription opioids such as oxycontin to illicit opioids such as heroin, opioid addiction can have a devastating effect on individuals, their families, and the communities in which they live.

Here’s the most recent information on the situation, as published by the Centers for Disease Control (CDC):

Overdose Fatalities: 2019-2022

  • 2019:
    • 50,178 opioid-related overdose deaths
    • 67,697 overdose deaths
  • 2020:
    • 70,029 opioid-related overdose deaths
    • 93,655 overdose deaths
  • 2021:
    • 80,816 opioid-related overdose deaths
    • 107,622 overdose deaths
  • 2022:
    • 82,807 opioid-related overdose deaths
    • 109,360 overdose deaths

The steady increase in overdose deaths reflected in these numbers convinced lawmakers to allocate millions of dollars in funding to harm reduction programs. California was one of the first states in the country to commit to harm reduction almost ten years ago.

The Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. indicates that harm reduction services can:

  • Help people access addiction treatment
  • Increase access to naloxone
  • Supply naloxone to first responder
  • Decrease transmission of disease
  • Decrease overdose fatalities
  • Increase access to addiction assessment/treatment in primary care settings
  • Increase access to addiction assessment/treatment in emergency room settings
  • Decrease stigma around addiction and addiction treatment
  • Improve treatment outcomes by including people in recovery to help create and initiate harm reduction programs
  • Increase access to social services to improve the lives of people with SUD and/or OUD

This position statement from SAMHSA reinforces the fact that this is an effective, data-driven approach to helping people with substance use disorder (SUD). In fact, harm reduction programs present the best possible way to reverse steady upward trend in drug overdose deaths in the U.S. To learn more about harm reduction, please navigate to the blog section of our website and read the following articles:

Harm Reduction in Addiction Treatment: What You Need to Know, Part One

Harm Reduction in Addiction Treatment: What You Need to Know, Part Two

Now let’s answer a question you may have. We talk about the benefits of harm reduction above, but what is harm reduction?

Harm Reduction: A Basic Definition

For a full review of the principles and practices of harm reduction in the U.S., please read the articles we link to above. We’ll quickly review the essentials here, in order to set the stage for discussing harm reduction initiatives in California.

Here’s how The National Harm Reduction Coalition (NHRC) and the World Health Organization (WHO) define harm reduction:

“Harm reduction is a set of practical strategies and ideas aimed at reducing negative physical and social consequences associated with drug use.”

In addition, the principles of harm reduction include a basic acknowledgment of the direct relationship between harm reduction and foundational human rights:

“Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”

In the United States, one component of this approach is an attempt to correct the mistakes and unintended negative consequences of our previous national strategy to reduce drug use and related problems in the 1980s and 1990s, which we called the war on drugs. This is not news to many of us, but it’s plain to see: the war on drugs didn’t work.

The war-like posture toward drug use included focusing on the criminal component of drug use. Policies focused on increasing arrests for use, possession, and distribution of drugs and establishing policies like mandatory minimum sentences and three-strikes laws. In retrospect, we can see that this approach – while it may have put some violent criminals behind bars – ended up stigmatizing drug use, and by extension. stigmatized treatment for drug use.

Data over the past thirty years show that the best approach to reducing drug use and addiction is harm reduction. In California, Pinnacle Treatment Centers offers a core element of harm reduction – medication assisted treatment (MAT) – at over 40 locations across California, including these five:

1. Aegis Treatment Centers Oxnard in Oxnard, CA

2. Aegis Treatment Centers Stockton 5th Street in Stockton, CA

3. Aegis Treatment Centers Stockton California Street in Stockton, CA

4. Aegis Treatment Centers Stockton Lower Sacramento Rd. in Stockton, CA

5. Aegis Treatment Redlands in Redlands, CA

We’re committed to offering harm reduction services like medication-assisted treatment (MAT) with medications for opioid use disorder (MOUD) to as many people as possible. These locations, along with our additional treatment centers across the state, can help improve the lives of individuals and families living in the communities of Oxnard, Stockton, and Redlands.

Now let’s take a look at the harm reduction initiatives currently in place in the state of California.

California Adopts Harm Reduction Programs

There’s a common adage that appears across a wide range of endeavors we undertake:

If you can’t measure it, you can’t improve it.

To that end – improving the lives of people in California by taking proactive steps to address the opioid crisis, the California Department of Public Health created a public overdose surveillance dashboard to report the latest information on the drug overdose crisis in California. Up-to-date, reliable data is essential for policymakers, treatment providers, and community advocates. It helps them to target underserved communities and allocate resources to where they’re needed most.

Anyone can check the dashboard for the latest information on:

  • Overdose deaths
  • Hospital visits for opioid overdose
  • Opioid prescription rates
  • Links to all pubic addiction support programs in California
  • Links to harm reduction programs

This public overdose surveillance system exemplifies the potential benefits of getting citizens and leaders on the same page: real change that impacts real people in real ways. California led the way in their response to the opioid crisis in the U.S. In 2014, government officials formed the  Statewide Opioid Safety Workgroup (SOS) that elicited the participation of all stakeholders – public, private, individual – to brainstorm a way to mitigate the significant harm caused by the opioid crisis.

Among other things, the SOS workgroup identified areas where the state could implement harm-reduction programs.

Harm Reduction in California: Current and Future Focus Areas

  1. Expanding access to medication-assisted-treatment (MAT)
  2. Expanding access to naloxone, an overdose reversal medication
  3. Expanding clean and safe syringe service programs (SSPs)
  4. Increase support for underserved populations in high-risk settings
  5. Expand access to all SUD treatment, including warm handoff programs in emergency rooms
  6. Increase treatment support in prisons and jails with the Integrated Substance Use Disorder Treatment (ISUDT) program

We’ll elaborate on the ISUDT effort in a forthcoming article on the use of MAT in prisons and jails in California. We currently support incarcerated patients with medication-assisted treatment (MAT) with methadone in several locations in California. Whenever possible, we also support patients upon release from incarceration with ongoing MAT services, counseling, and therapy.

Our Director of California Government Relations, Javier Moreno, leads the way on our work offering MAT prisons and jails, forging important, long-lasting relationships with key members of the California Department of Corrections and Rehabilitation (CDCR) and the California Correctional Health Care Services (CCHCS).

We’ll talk more about Javier’s important, lifesaving work with ISUDT in Part III of this Harm Reduction in California series of articles.

In Part II, we’ll review another positive outcome of the SOS workgroup: the California Harm Reduction Initiative (CHRI), a program established by the state in 2019.

The materials provided on the Pinnacle Blog are for information and educational purposes only. No behavioral health or any other professional services are provided through the Blog and the information obtained through the Blog is not a substitute for consultation with a qualified health professional. If you are in need of medical or behavioral health treatment, please contact a qualified health professional directly, and if you are in need of emergency help, please go to your nearest emergency room or dial 911.