Los Angeles County (LAC) is currently experiencing the highest rate of overdose deaths in our history driven by fentanyl and methamphetamine. We propose a data-driven response focused on improving linkage to and retention in care, expanding of harm reduction services to the priority populations described below, and improving clinician and health systems practices that align with CDC guidelines on prescribing controlled substances and ASAM, SAMHSA, and other applicable practice guidelines on low-threshold initiation of clinically effective treatment for OUD (such as MOUD) and initiation of treatment clinically effective for stimulant use disorder (StUD) including contingency management and off-label medications for StUD. The proposed harm reduction services and linkage to clinical interventions for OUD and StUD prioritizes: (1) people who use opioids and/or simulants and who are currently not receiving specialty SUD treatment, (2) people recently released from incarceration, (3) people experiencing homelessness, and (4) anyone who has experienced a non-fatal overdose. These are the priority populations referenced elsewhere within this proposal. Proposed activities will deploy interventions in community, public safety, and healthcare settings.
For the priority populations described above, LA County proposes to reduce the number of overdose deaths in LA county in community, public safety, and healthcare settings through: (1) expanding programming that increases the initiation of low threshold medications for opioid use disorder (MOUD) and the forthcoming American Society of Addiction Medicine and improves engagement and linkage of priority populations within LA County to continuity SUD treatment and medical, mental health, and social services; (2) expanding the availability of harm reduction services to priority populations in each setting; (3) improving clinician and health systems adherence to CDC guidelines on safer prescribing of controlled substances and adoption of best practices that include the low-threshold initiation of MOUD in accordance with established national guidelines, and management of StUD in accordance with the (forthcoming) American Society of Addiction Medicine National Practice Guideline interventions for Stimulant Use Disorder (ASAM StUD NPG), specifically including naloxone prescription and distribution and referral to community harm reduction services; (4) Launching a harm reduction focused anti-stigma media campaign involving the community, health care systems, first responders, and PWUD that lifts the voices of PWUD, increases the acceptability of harm reduction policies, services, and practices, and that reduces the stigma facing PWUD; (5) Enhanced LAC DPH-SAPC’s Overdose Surveillance Infrastructure to perform data abstraction to inform timely and actionable overdose responsive initiatives; (6) Conducting toxicology testing of drug product and/or paraphernalia at LA County contracted and certified harm reduction syringe services programs as described in Component B.
Applying for Surveillance Component B funding. Not applying for Component C funding