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MCAVHN Recognizes International Opioid Overdose Awareness Day

MCAVHN Recognizes International Opioid Overdose Awareness Day

Joe Ditto of MCAVHN stands near the community memorial installation honoring those who have died from drug overdose. MCAVHN is partnering with groups around the world to celebrate International Overdose Awareness Day, Aug. 31. (photo by Carole Brodsky)

On Aug. 31, the world’s largest annual campaign to end opioid overdose is taking place. For Mendocino County, MCAVHN Care and Prevention Network (aka Mendocino County AIDS/Viral Hepatitis Network) is commemorating this event with the installation of a community memorial board located on Clara Street in front of the MCAVHN office.

“We want to memorialize the people who have passed,” says Executive Director Joanna Olson. “As has been noted in several news articles, Mendocino County is number one in opioid use per capita in the State. In support of reducing opioid overdose in Mendocino, we need to continue to create awareness,” she continues.

The purpose of International Overdose Awareness Day (IOAD) is to “remember without stigma those who have died from overdose and acknowledge the grief of the family and friends left behind,” according to the IOAD website. According to the CDC, 107,735 Americans died between August 2021 and August 2022 from drug poisonings, with 66 percent of those deaths involving synthetic opioids like fentanyl. The memorial board at MCAVHN is filling up with photos of friends, loved ones and messages, and the community is encouraged to add their own photos and messages to the board. The 2023 theme is “recognizing those people who are unseen,” and that theme is a huge driver of the activities that take place daily at MCAVHN.

Judy Popowski, MCAVHN’s CFO and Board Treasurer explains the staff met to discuss how to recognize the event. “It’s not a holiday, so what could we do? The staff came up with the heart cork boards on the fence- putting up pictures of people we’ve lost.”

“Even for a Harm Reduction agency, we are unique,” Olson continues. MCAVHN offers a syringe service program, as the only Harm Reduction agency in the county, and one of their most effective recent efforts has been the bringing of opioid use, substance use and Narcan training into schools as part of the organization’s community campaign approach to prevention.

“We are seeing a measurable number of intergenerational addicts,” says Olson. “We are working to intervene intergenerational use cycles by bringing information and support directly to youth. We recently were awarded a grant to support working directly with schools and local tribes as a part of our community education piece. We ran a pilot program with Anderson Valley School District and select schools in Willits last spring. It was wildly successful with MCAVHN staff receiving input from teachers and students, so we will be back, working with students from the 5th to 12th grades. We had students at the Willits Alternative School skipping class to attend our presentation for a second time and telling staff he wanted to do what they do.

MCAVHN brings a 360-degree approach to their Harm Reduction services, which is defined as “prevention plus intervention.” Dr. Ace Barash is the medical services director for the agency, serving in the Medicated Assisted Treatment Clinic on site at MCAVHN and is deeply respected by both staff and clients who all agree “He is nothing short of angelic,” says Olson.

The goal of MCAVHN is to provide an array of services with the hope that through the building of trust and support, people will take independent steps to move toward improved health- whether that means finding housing, entering into employment training, reducing or stopping the use of street drugs or becoming willing to receive regular medical or mental health care. Part of the Harm Reduction ethos is to meet the person where they are- an ethos that is still widely misunderstood by the average person, but also by a measurable number of the medical community and in some cases, local and countywide community leaders. Olson has made it a point to invite community leaders to MCAVHN and feels that those interactions have helped to open and change minds about the significance and importance of MCAVHN’s work- everything from saving lives to helping people take steps to recovery- at their own pace.

“We offer injection alternative kits such as clean snorting supplies, for those IV drug users who are ready to shift to a safer method of administration,” says Olson. In addition, MCAVHN remains to be the leading agency in the county to offer syringe exchange and has continued to do so for at least 20 years and strives to partner with other agencies and clinics to provide Harm Reduction services throughout the county.

Joe Ditto is MCAVHN’s Program Manager for Harm Reduction and Substance Use Prevention Education. He notes the agency’s syringe exchange service is probably the most misunderstood aspect of their work.

“There are opinions out there that say that providing syringes increases use,” says Ditto. “The reality is that provision of clean syringes helps people take care of their health. We’re preventing Hepatitis C, HIV and other blood-borne pathogens. But what we’re also doing is building a relationship with these people so that they have increased opportunities to decrease use.”

MCAVHN also stages regular syringe clean-ups throughout the community and has done so for years. “What we’re doing is building a link so that when people are ready, they meet Ace and can begin the process of accessing many other services,” says Olson. She stresses that services at MCAVHN have developed far beyond the provision of syringes.

“We provide housing case management, transport to recovery programs, assist folks with enrollment to re-entry training programs, link to specialty mental health services, and medical and dental services.” MCAVHN was originally formed to raise awareness and assist those with HIV/AIDS. As time went on, the agency was able to change with the community needs, which morphed into the need to serve a growing population with Hepatitis C. Those services continue, along with numerous partnerships with housing programs, the provision of services to those needing enhanced care management, case management for unhoused individuals and medication-assisted treatment for those wishing to cease use of opioids- whether prescribed medications or street drugs. They serve as a site for Cal Poly interns who work at MCAVHN and help strengthen the team, Substance Use Disorder Treatment interns, as well as a site for those who must perform court-ordered community service hours.

“We also provide free Narcan and training to agencies and anyone requesting this service in the community. We deliver it and we train at no cost,” says Olson. Narcan has been distributed to fire departments, churches, school-based staff and other organizations serving the community such as Our Daily Bread in Willits.

There is still a huge misunderstanding about the people who access MCAVHN’s services.

“The people we serve are cross-sector. They are not all unhoused or transients. We serve people from every background, all ethnicities and all ages. This is an important piece of our efforts to educate the community: to dispel myths and reduce stigma,” says Olson. Homelessness increases, and with it a dehumanizing factor. We need to be more educated about this. People profile homeless people. We don’t know their story. We don’t know their trauma, or their medical issues. We also serve many Veterans. Additionally, child abuse rates in Mendocino County are off the charts. This also greatly affects our community and can lead to substance use and abuse. There are many factors in families and within the community that lead to substance use disorder and the increased opioid overdose rates that we are experiencing.

Olson and her team feel the community continues to misunderstand the fentanyl crisis, now enhanced by the infusion of xylazine, or “Tranq” into basically all street drugs.

The DEA has a sober warning to communities. “Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said DEA Administrator Milgram. “The DEA has seized xylazine and fentanyl mixtures in 48 of 50 States. The DEA Laboratory System is reporting that in 2022 approximately 23 percent of fentanyl powder and 7 percent of fentanyl pills seized by the DEA contained xylazine.”

The DEA notes that Xylazine is FDA-approved for use in animals as a sedative and pain reliever. But Tranq is not safe for use in humans and may result in serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use, making it difficult to distinguish opioid overdoses from xylazine exposure.

According to the DEA, Xylazine and fentanyl drug mixtures place users at a higher risk of suffering a fatal drug poisoning. Because xylazine is not an opioid, Narcan does not reverse its effects.

“Overdose incidences are up everywhere because Narcan didn’t work,” says Ditto. “We had an incident here in Mendocino County- a person had used fentanyl with xylazine. He was hit with Narcan, but the Tranq was so heavy in his system that it shut the person down.”

“Increased numbers equal more clients experiencing adverse reactions to fentanyl and Tranq, which results in increased overdoses,” says Olson.

When asked why the overdose rate is so high in Mendocino County, Olsen Olson feels that more funding is needed to help avert the crisis.

“There is a tremendous need for increased local funds, especially given how funding is dispersed or withheld. We went to the state to advocate for continued funding for harm reduction. Studies show that 75% people in this area know someone who is an addict or who has overdosed, yet the funding we receive from local sources barely funds 1.5 full-time positions annually. That’s without administrative support and very little operational support,” says Olson.

What Olson doesn’t say is that the County of Mendocino has elected to divert Opioid Settlement Funds- funding that is supposed to support programs like MCAVHN- to reduce the county deficit. According to a broadcast on National Public Radio (NPR), “the board of supervisors decided to use more than $63,000 of opioid settlement funds — about 6.5% of all the settlement cash the county has received in the first two years of distribution— to help fill a general budget shortfall of about $6 million. Specifically, the money has been allotted to cover employee health insurance premiums, wage increases, and cost-of-living adjustments. County officials plan to use that amount as a recurring source of payment, since opioid settlements are scheduled to arrive annually till 2038.”

Because of the increased need for service, outreach numbers are going up countywide. MOUs are being developed to increase partnerships everywhere in the county. Street outreach workers continue to visit Building Bridges shelter, the rail lines and homeless encampments, so that those needing services are not forced to brave the elements to receive services. “We’re visiting people face-to-face to hand out information about Tranq. A lot of people didn’t know anything about it,” says Ditto.

Ditto came from the biker world and continues to be one of the MCAVHN staff who sits on the curb talking to community members. “I get participants who come to us- first by getting clean supplies from the needle exchange and from there deciding to get help.” The Willits native is going back to college to get into the Substance Use Disorder Treatment counseling field and credits MCAVHN for his success and his commitment to sobriety.

“Along with memorializing those who have passed, I want to stress the uniqueness of our approach. It’s built from a peer-to-peer model. A lot of us have lived experience. Without this place, I probably wouldn’t have returned back to college. My goal is to continue to re-educate the community about what Harm Reduction is,” he concludes.

The community is invited to post a photo of a loved one who passed from Opioid-related issues on MCAVHN’s memorial board. MCAVHN is located at 148 Clara Street in Ukiah.

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MCAVHN is proud to offer Harm Reduction Services for the prevention of Hepatitis C & HIV. We've been providing services and comfort for over 28 years to persons affected by substance use disorders and behavioral health conditions.

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