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California's Approach to the Opioid Epidemic

"For more than a decade, Californians have struggled with prescription — and increasingly non-prescription — opioid misuse and addiction.  The opioid crisis in California, and throughout the country, has shown remarkable staying power and adaptability.  Year-over-year data shows a roller coaster journey, as policy and other interventions are effectively able to bring down overdoses and deaths for several years, only to see the epidemic morph, overdoses and deaths rise, and the crisis again worsen.  


Dr Karen SmithThe opioid epidemic is closely tied to other trends in the state and the country. The recent sharp rise in opioid addiction was largely a function of unchecked and poorly understood prescription pain management. However, in recent years, despite effective interventions that have decreased prescription opioid-associated overdoses and deaths, the epidemic has become increasingly tied to heroin use, with a dramatic increase in overdoses and deaths due to the influx into the state of synthetic opioids, especially fentanyl, a highly potent synthetic opioid.   As California, and the nation, has seen rising rates of social inequity, homelessness, mental illness, and despair, so too do we see increases in opioid abuse, addiction, overdose and deaths, especially among those most marginalized in our society.   


The State of California, working in partnership with health care, academia, philanthropy, and at the community level, has taken a collective action approach and built a structure, anchored by the Statewide Opioid Safety Workgroup, to track the epidemic and pivot policy and programmatic interventions to address the changing realities of addiction in the state.  


Because of our collective efforts, California has consistently had rates below the national average. Yet, the magnitude of the impact of the epidemic is great, and the work of the state and our partners is ongoing."


Dr. Karen Smith, State Public Health Officer and CDPH Director


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