Speaker 1: Motion case.
Speaker 0: Thank you. Next up is 20.
Speaker 1: Communication from Councilwoman Price, Councilwoman Gonzalez. Councilman Andrew's recommendation to request the city manager and the Department of Health and Human Services to report back in 30 days on the feasibility strategy and potential benefits to conducting a public health detailing campaign on promoting judicious opioid prescribing among Long Beach doctors.
Speaker 0: Councilman Price.
Speaker 5: Thank you. If I can get the presentation up.
Speaker 3: It'll be a very quick staff report, I.
Speaker 5: Promise. I just want to talk a little bit about this item and see if we can get this. Item up. No, no. T.
Speaker 6: T. R z. RNC.
Speaker 5: While it's loading. I just want our being displayed. I want to just give a little bit of background on this issue. This is obviously an issue that's a national discussion and certainly a discussion that we should be having here in the city of Long Beach, especially in light of the county data, which shows that, ah, the the city of Long Beach's rates of emergency room visits, hospitalizations and deaths related to opioid use is higher than that experienced in L.A. County. So.
Speaker 3: There we go.
Speaker 5: All right.
Speaker 3: So drug overdose.
Speaker 5: Has now become the leading cause of accidental death in the United States. These numbers surpass car accidents, gun violence and HIV. The research that we have seen throughout the nation is that opioids are prescribed when they are described more judiciously if there is an and those effective opioid addiction treatment programs. The numbers will continue to will will decrease, but they'll continue to increase unless we come up with those two alternatives, preventative measures. So since 2010, Long Beach has seen higher rates than any other than L.A. County as a whole. This means more first responder calls, more emergency room visits, and more individuals addicted to this dangerous drug. Prescription practices are changing as a result of this national conversation, and there's data to suggest that we know from the research that Vicodin and hydrocodone are the most common semi-synthetic opioids that are prescribed by physicians. These opioids were intended for severe medical issues or post-op procedures when given in small quantities. Prescription rates, however, began to soar when these drugs started to be prescribed for more common ailments like back pain. This is a chart that shows you the level of increase in prescriptions from 2000 from 1999 until 2009. Heroin is the biggest problem as it relates to opioids in the city of Long Beach and in many urban communities. It's a semi-synthetic opioid and it produces the exact same effect on the brain as the Vicodin and hydrocodone. Until 2011. Most opioid deaths were as a result of prescription drug overdose. That is no longer the case. Heroin now is the major killer. And you can see here that the heroin addiction rates that are depicted in blue and the overdose as a result of heroin is on a dramatic increase. Heroin is less expensive and of course, more accessible, but it can be.
Speaker 3: Deadly due to their.
Speaker 5: Addiction potentials, overdose potentials and the addition of synthetic opioids like fentanyl. So for those who are not familiar with fentanyl fans, that fentanyl is a very deadly, highly toxic synthetic opioid that can be mixed in to drugs and it's to the naked eye and to even to most police officers eyes. It's hard to determine what the substance is in terms of whether fentanyl has been introduced into it. We're seeing a lot more a lot more people who are transients and addicted to heroin, being exposed to fentanyl, and that having a very dramatic result in terms of overdose rates. So what is the solution for a city like ours? I believe that there is a three part solution. Obviously, step one is to how we are uniquely positioned in L.A. County, because we do have a public our own public health department. And this item that we're bringing forth today is really not a unique item. Public health departments throughout the country have started these detailing or education campaigns. In fact, in New York, they ran a campaign like this and it reduced overdose rates by 29% after the preventative educational campaign in North Carolina. They ran a campaign. It resulted in a 62% decrease in overdose deaths. And in Utah, they had a 14% decrease in overdose deaths. My sister is a physician. She's an addiction specialist in New York and Staten Island. And based on just the personal experiences that she's had, these preventative measures in terms of having public health agencies work directly with the doctors, has raised awareness and created what I'm going to talk about in a moment. A swing in the pendulum in terms of how these drugs are prescribed. Tremendous research has shown that judicious prescribing campaigns, these are called public health detailing campaigns, have been successful in raising awareness and changing prescription practices. So here's some data from Staten Island and you can see how much the pre-campaign and the post-campaign prescription numbers changed in a short period of time. Step two would be for us to evaluate which we'll be doing. We'll start that discussion at public safety meeting ways to reverse an overdose through the use of drugs like Narcan, which are used nationwide by first responders and public serving employees. Narcan is a drug that's administered to folks that are experiencing an overdose. It is now available in a nasal spray. Almost every agency in Orange County where I work carries Narcan. And in L.A., I think the sheriff's department and fire department. And so this is kind of the step to is we were talking about what we can do preventatively. Then we're talking about what we can do in the field to reverse episodes of overdose. And finally, step three is for us to be vigilant in efforts to seek funding. And I did a little bit of research today. Grant funding is available for the city of Long Beach because we do have our own public health department, although the county takes the lead in rehabilitation and substance abuse. There is nothing that would preclude the city of Long Beach from participating in rehabilitation grant funding that's available on a state or national level, especially since this conversation has elevated to such a place that is a major topic of national policy. Research has shown that medication assisted treatment, such as treatment with methadone and other drugs, is the most effective for heroin and opioid addiction patients. Most of these treatments are not provided who those for those who rely on Medicaid or other similar insurance options. So in conclusion, I think that the industry pendulum is swinging towards a more judicious prescription policy. Public health departments like ours should support that movement and do everything in our power to prevent and treat our residents whose lives have been destroyed by this addiction. Now, some of the questions that I've gotten leading up to tonight is, is should the city better be getting involved in telling doctors what they should prescribe? The answer to that question is no. This is a public education campaign. Doctors would still have full discretion to prescribe whatever they want in terms of dosage and quantity, but it's to raise awareness. There was a period of time when we started to see a rise in opioid deaths.
Speaker 3: Where there.
Speaker 5: Was a different philosophy in regards to when and what circumstances opioids should be prescribed. That philosophy is changing as a result of the epidemic that we now have as a public health epidemic. So this is just an education campaign, and it's an opportunity for us to educate doctors to the extent that our resources would allow. On how to be mindful of some of the dangers. Now, the Center for Disease Control and many other cities have started public detailing campaigns. In fact, the CDC, if you go on to their website, they actually have a toolkit for local governments and local agencies on how to run an education campaign. So I think with very minimal resources, we could start the process of educating our public health officials. In addition, there are opportunities for us to work in partnership with local hospitals, local insurance companies to find the resources to be able to engage in a public education campaign. And that's certainly something that we should be doing. I've heard some objections that, you know, I don't want to do this because it's going to cost us money while it may, but there may be an opportunity for grant funding available, since this is a conversation that's being had on a national level. And frankly, I don't think we should refrain from getting involved in the discussion when most of our residents that are homeless, who have addiction problems, have an addiction to heroin. And we have to be thinking long term about these individuals. And we need to be thinking about how we can assist them, not just at the back end are reacting to the addiction, but on the front end in terms of preventative measures like this. So I asked my colleagues to join me in this conversation, allow our health department to explore what is out there currently, and maybe come back in their report to say, if we were to do a detailing campaign. These are the resources that we would need. And here's the funding possibilities in terms of where we can get grant funding. So that's my item, and I ask my colleagues to support it.
Speaker 0: Thank you. Councilwoman Gonzalez.
Speaker 1: As thank you, Councilman Price, for bringing this forward. I brought the issue forward as well during our budget cycle and talked to Police Chief Luna about, you know, this very issue. And then personally, I had a friend actually who overdosed from methadone a few years back and a very, very big case in Orange County and unfortunately overprescribed this medication and passed away under the age of 30. So it's it's personal to me, but it's also I know that our residents here in the city of Long Beach are dealing with this to some extent. And, you know, of course, it's coming from the East Coast, coming here to the West Coast. So I really appreciate, Councilman Price, your research and all of your information on the back end about this, because it's very important and it's not just individuals who are experiencing homelessness. It could be anyone, you know, people who are have income, who are extremely well-off will also be. Unfortunate victims to this unfortunate drug. So I have a few friendly amendments I want to provide that, you know, may provide some more insight to this issue. First, I know that CVS actually brought forward CVS Health, brought forward a campaign where they are addressing the opioid crisis head on. And so a few of those things were obtaining medical disposal units for our PD and health department. They have that as under their increasing disposal options. They actually donated more than 800 medication disposal units to community police departments across the country. So that could be included in this discussion, especially as CVS Caremark is one of our city preferred providers. And then secondly, they also have a pharmacy teach program where they educate high school students on the effects of opioid addiction. I think it's important to to look at our use in this discussion. And also, I can see where we can work with Cal State, Long Beach and Long Beach City College's pharmacy programs to provide additional support that way. And then lastly, in this discussion, I think it's important that we look at diversion programs. We're really great at diversion programs through the city prosecutor's office, through for our youth and for other issues. But so many cities, especially Buffalo, New York and Seattle, actually has a law enforcement assisted diversion program, the lead program that will divert individuals to services rather than jail time. And I think it's something to consider, especially if they're low level offenders, nonviolent criminals. So that is it. A few other things as well are drug takeback programs and, you know, needle exchange programs. Those are also kind of circulating around there in this discussion. But I will leave that there. If you would accept my friendly amendments, that would be really great if you would like to do that.
Speaker 5: Absolutely. I think the.
Speaker 3: More.
Speaker 5: Comprehensive the report is in terms of I mean, a lot of as data is is out there. It's it's not like we have to go out there and find the data. A lot of it. I mean, you could spend a day researching this issue and a lot of that data and options is out there. So I think all of those are very reasonable. And I thank you for bringing them forth.
Speaker 1: Thank you.
Speaker 0: Thank you. Councilmember Pierce.
Speaker 1: Yes. I want to give a wholehearted thank you to the makers of this item. I know sometimes I share a lot back here and sometimes you guys are kind of done with me sharing how all these items relate to me. But we talked earlier today about suicide and this was how my mother committed suicide. I did not expect to cry right now. Sorry. It's really important that we really consider these as not just education programs for those that are using, but also for family members and for community members to understand when somebody has a problem. I learned to drive by driving my mom to the E.R. because she was so high on opioids. I hope that we can take maybe more than 30 days to explore the exchange program and making sure that we have an opportunity for family members and those that might have over a medicine at their home to get rid of those. Because as a junior high student, my neighbors and I found my mom's medicine cabinet. And so it is something that impacts not only those that might have gone through surgery and stayed addicted to those pills, but those that are surrounded by them. I think engaging in a high school teach program is extremely important. I would also say that I know that, you know, I lived in Texas at the time, but often my mom would get her drugs from Mexico. And so I'm curious to find out, you know, while we're not stay an island, we're closer to a place where there's drugs being produced. And what are we what do we know about that market and how those drugs are coming in? So outside of just prescription drugs as well, high school market disposal options and I you know, the needle exchange comment, I think that we at least need to understand what cities have done in California around that and if there is some assistance for that. So I'll leave it at that. And I just want to, again, thank my colleagues for bringing this item forward. Thank you.
Speaker 0: Thank you, Councilman Andrews.
Speaker 7: Yes, thank you, Mayor. I would also like to thank Councilwoman Price, bring this item forward and and also you council woman, Nina, for the information both of you guys brought forward. Thank you for that. You know, plainly, you know, any program to focus on prevention, especially on health driven issues, is very important to me and I think to everyone else. You know, we see that the result of the addiction epidemic is in the streets everyday and everywhere. You know, we can come back in 30 days with a plan to work our local doctors and health care providers to reduce prescriptions, but also care for the need of those who rely on medication for the illness . And thank you again for bringing this item forward.
Speaker 0: Thank you, Vice Mayor Richardson.
Speaker 6: Thank you, Mr. Mayor. And thank you to the makers of the motion and Councilwoman Price and Gonzalez and everyone who's been involved and, you know, issues like this. How do you how do you you know, families don't know don't completely know how to address it. When you have somebody in your family who's, you know, involved or addicted to drugs. And it's a difficult conversation. And we had when we were kids, you know, there was there to keep kids off drugs and all that. But it seems like it just seems like there's not as much information out there that we need. And it's a really important issue. What I want to say is, so you've got a health department here and, you know, we've got a number of issues in the city from drug addiction to homelessness. City of Long Beach is has very high STD rates. And you can we continue to bring up items and ideas and we support them and we want to do the right thing. We all represent a number of you know, represent a lot of people and we want to do the right thing. So I think we should just, you know, have an honest conversation next time budget season comes around because it's not our favorite department to fund. It seems like it's always the last thing or certain council members have to step up and advocate for it. But health and drug addiction and homelessness and resources for for at risk individuals, I mean, it's something that cuts across no matter where you represent, no matter what socioeconomic status you come from. It's great that we put a public health lens on things. So so, you know, while I support this because it is just as important as the elevated city SD rates as youth development, just as it's that important, I consider this a call to action to to, you know, folks who, you know, during budget time consider this a call to action. We should be giving more than 1%. I mean, we should be supporting the health department at a higher level than 1% or 2%. Whatever it is, we should be supporting it. It's important. They shouldn't be entirely grant funded. We should be supporting the health department. It's important. So that's the point I wanted to make. I'm happy to support this item and there will be other health related items, but we have to start being honest and dedicating funding. We talked about cannabis funds as the new revenue source. Majority of them went to PD. We couldn't have an honest conversation about dedicating some funding to the health department. If it's a new source of revenue, we have to stop thinking so much about, you know, just suppression of issues we have to think about from a standpoint of prevention. The. People in the health department literally are they're educated in a certain way. They've got they're not planners. Their MPH is in masses in public. This is what they do. They speak that language. We should invest in them. So so I'm sorry that this message came out on this specific item and I support it. But I just want to say, we need we need to continue to invest. We're not doing a good job investing in our health department. And we asked them for a lot and we need to invest more. And I feel very strongly about that. Thank you.
Speaker 0: Thank you, Councilman Mongo.
Speaker 3: I want to thank everyone that put in on this item. I also want to take a small step back. I appreciate your passion. Councilmember Richardson, vice mayor. And we have had what? Off the top of my head is likely the largest percentage of increase in a budget in a single department in health. I think we have stepped up and supported them and I think that we do need to put our money where our mouth is. And we have several needs in the city that the Budget Oversight Committee takes great detailed action on. And there are lots of other things that are just as important as health not more important, not less important. But we we are doing the best we can with the resources we have available. And I think it's important to note the extreme change that has come in just the last two years in the way that this council has prioritized these things over any council in the past. And I think that we can continue to do that and we need to have that conversation. I agree at a budget time of year, and I think that's why the Budget Oversight Committee took the time to look at those policies this year, because what we're also not doing for our residents is ensuring that the things that have gone. Unattended for at least the last decade, get some attention as well. And so it is important and it really does need to happen at budget time and that's why those policies were brought forward and looked at again. And I appreciate my colleagues for taking the time to do that.
Speaker 0: Councilman Price.
Speaker 5: And and I want to echo some of that. I appreciate what the Vice Mayor is saying. And I think one of the biggest differences in terms of the health department versus a lot of the other departments in the city, and they're not unique to this. I mean, again, if you spent any time researching this issue, which you wouldn't do unless you were sponsoring an item like this for council, I, I realize that, but a lot of public health agencies rely heavily on grant funding because they're in a unique position to qualify for grant funding in areas where other departments can't qualify. So if you look at some of these public detailing campaigns, most of them were funded through grant funds or partnerships with industry, partnerships with pharmaceutical companies, partnerships with hospitals. I mean, there.
Speaker 1: Are creative ways to do.
Speaker 5: It. And my fear is that we can't even talk about what needs to happen without first saying we don't have the money. And I know you share that frustration, Vice Mayor, because you and I have talked about that. So I do think it's a hugely important department to the city. Hugely department, huge. Hugely important department. And I don't think there is ever a situation where we should be saying they shouldn't get more money. We should always be looking at ways to give them more money. They do amazing work. So I agree with you 100%. But I also think there are opportunities out there for us to be creative beyond just general fund dollars when it comes to this department. So I appreciate that. And I think you're absolutely right. And and I know that our health department is extremely resourceful with the amount of grant funds they bring in, as are health departments. I mean, ours probably does a better job of it than many others, but there are a lot of amazing health departments in California and throughout the nation who really go aggressively after grant dollars. And it's really the bread and butter of a lot of health departments. So I appreciate that. Thank you.
Speaker 0: Thank you. Mr. West, your kin, mayor, council.
Speaker 2: Members. I just want to just talk about the 30 day time period to come back. Will will give it our college try and all that. But we certainly will come back with a status report in three days. But I'm looking at Kelly stuff. I'm not sure that we'll be able to come back with anything comprehensive in 30 days.
Speaker 5: You know what? That I don't know if my colleagues feel any differently. I just want to get the conversation started, that 30 day timeline. It's just it's really an arbitrary timeline. So if it takes 60, if it takes 90 hopeful, it doesn't take 120. But I understand it's it's to get the conversation started and to I'd.
Speaker 3: Rather have a thorough report.
Speaker 5: Than a report that's just trying to meet a deadline. So I appreciate that.
Speaker 2: And we'll have a status report.
Speaker 0: Great. Thank you. Is there any public comment? Please come forward.
Speaker 10: That's good. I don't know. I had these big.
Speaker 6: I think you should make this brief.
Speaker 2: This is talking about prescribing from doctors. I want to talk a little bit about people that are.
Speaker 6: Already addicted to opiates. A big part of it is the shaming that our society does to the people that are already having this problem. You know, it's it's under wraps there already probably have a lot of emotional and other problems in their life and then they can't really talk about it. I think on the side of people who already have those problems, it's it's the fact.
Speaker 2: That it's still illegal to to to be addicted.
Speaker 6: And the shaming that our society does is saying that it's not okay and you can't really talk about it. I think it should.
Speaker 2: Be a medical problem, but we're still.
Speaker 6: Addressing it as a criminal problem and it doesn't really address the people that are going to be susceptible to it already. So I just want to add that there are there is information out there. There's other countries that are way ahead of us.
Speaker 2: Portugal, other.
Speaker 6: European countries. So I know it's a little controversial to make more drugs legal, but that definitely there is a lot of success there and some research to support that. Thank you.
Speaker 0: Thank you. With that members, please go ahead and cast your vote.
Speaker 3: Andrews.
Recommendation to request City Manager and Department of Health and Human Services to report back in 30 days on the feasibility, strategy, and potential benefits to conducting a public health detailing campaign on promoting judicious opioid prescribing among Long Beach doctors, and other applicable healthcare staff.