While local service providers acknowledge a lack of resources available on the Coastside for people struggling with opioid abuse, some progress is being made to address a gap in services.
In 2015, San Mateo County’s Integrated Medication Assisted Treatment team formed as a partnership between multiple organizations to treat people with substance abuse issues. The team, which is embedded in San Mateo Medical Center’s Emergency Department, links people with opioid or alcohol dependencies with services and continues to follow up through their recovery. Officials say the team has dropped inpatient hospital, emergency room and psychiatric emergency services visits over the period.
About 10 percent of the people the team serves live on the Coastside, according to Mary Fullerton, supervisor of the assistance team.
When the team first started, the majority of cases were for alcohol use disorders, with an average of 50 to 60 monthly visits compared to five to 10 opioid use visits. Now, “we’re seeing a lot more for opioid use disorders,” Fullerton said.
In June, the IMAT team saw 122 visits for opioid use disorder. In July there were 150 visits.
While the IMAT team is one of the leading efforts to assist people struggling with opioid use disorder across the county, the services are largely based in one geographical area. Fullerton, who’s lived on the Coastside for 16 years, says there is a need for more providers to assist people struggling with drug or alcohol addiction disorder on this side of the hill.
The San Mateo County Sheriff’s Office also recognizes the problem.
“I think it is a challenge and it would be nice to have a formalized program out here we could refer people to,” said San Mateo County Sheriff’s Capt. Saul Lopez, who leads the Sheriff’s efforts on the coast.
There is one outreach program at the San Mateo County Coastside Clinic in Half Moon Bay that Fullerton is aware of, but for people living in Pescadero or Montara, that “is quite a hike,” she said.
“People may not have the money or resources to go, so access is a huge issue,” she said.
When treating someone with opioid use disorder, medication assisted treatment is considered the “gold standard,” according to Fullerton.
“Using opioids creates these receptors in the brain, so, to take that away, the person goes into withdrawal. That is how people end up in hospitals,” she said.
Currently, Fullerton is working to provide a doctor who can prescribe opioid use disorder medication at the Coastside Clinic at Shoreline Station in Half Moon Bay. The goal is to have that doctor present once a week at the clinic.
Fullerton said her team also has partnered with ambulance provider American Medical Response to notify the county’s team whenever Narcan is used. Narcan, also known by the generic name Naloxone, is a medication used to block the effects of opioids and can work within minutes.
“This year, we’ve been alerted on three instances for people on the Coastside,” she said. “It’s just another avenue we are trying to reach people.”
Lopez said every deputy on the Coastside is trained and equipped with Narcan. The Sheriff’s Office was the first agency in the county to get approval for training and equipping personnel with Narcan.
“I was the person to lead this effort as the commander of the San Mateo County Narcotics Task Force,” Lopez said. “When I departed that assignment, the new commander of the Task Force, Lt. Vince Bedolla, executed the training and distribution to our staff.”
The U.S. Centers for Disease Control and Prevention estimates that the total "economic burden" alone of prescription opioid misuse in the United States is $78.5 billion per year, including the costs of health care, lost productivity, addiction treatment and criminal justice involvement.
To understand the scope of the problem, from 2006 to 2012 there were about 110 million prescription pain pills, enough for 22 pills per person per year, supplied to San Mateo County, according to a database from the Washington Post. Misuse of prescription pills can lead to use of other opioids, including heroin or synthetic opioids such as fentanyl.
Earlier this year, San Mateo County joined a lawsuit with more than 1,300 cities, counties and groups suing opioid drug makers for allegedly fueling the nation’s opioid epidemic.
Meanwhile, those on the ground are doing what they can to make services readily available for people on the Coastside struggling with opioid addiction.
“For some people they have to make the decision between going to work that day or taking care of themselves, and that is how they end up in the hospital,” Fullerton said.