Written by: Center for Care Innovations

Substance use disorder is a multi-faceted conundrum in rural, urban, and suburban America. Relationships within a community are critical to meeting this complex challenge head on. As Rx Safe Del Norte’s coalition facilitator Jermaine Brubaker sees it, helping a community plagued by opioid use disorder takes a county-wide coalition of the willing and trusted partnerships with key organizations trying to tackle the problem. It also requires both human and medical resources in the field to support those in crisis. On the road to recovery, Rx Safe Del Norte places the people with lived experience at the center of their work.

These are fundamental tenets for Rx Safe Del Norte, a relatively new coalition formed to help its community work together on the prevention of opioid use disorders, the reduction of stigma around drug use, and the promotion of treatment, recovery, and wellness in this small, rural community just shy of the Oregon border. The population of Del Norte County was 27,470 in 2017. The same year, there were 33,932 opioid prescriptions — that’s right: More prescriptions for opioids than people living in the county. The death rate attributed to opioids here is more than double the state rate.

Del Norte is home to a significant Native American population, which is both disproportionately impacted by the opioid epidemic and chronically undeserved by health care, notes Brubaker. Native Americans are 50 percent more likely to die of an opioid overdose than non-native people, according to a Washington Post analysis in June 2020.  The county’s Native American communities include Elk Valley Rancheria, Resighini Rancheria, Tolowa Dee-Ni’ Nation, and Yurok Reservation, home to the largest federally recognized tribe in the state.  Yurok Tribe Health and Human Services, Yurok Tribe Wellness Coalition, United Indian Health Services, and Tolowa Dee-Ni’ Nation Community and Family Services are active in Rx Safe Del Norte, whose fiscal sponsor is Open Door Community Health Centers. RxSafe Del Norte holds meetings at Open Door’s Crescent City clinic location.

As part of a 16-month Center for Care Innovations learning collaborative, Addiction Treatment Starts Here: Community Partnerships, Rx Safe Del Norte engaged in systems mapping workshops, human-centered design training, and community outreach events to get a better handle on the needs of its residents, and to help figure out what strategies and solutions the group should prioritize to address drug addiction. “Sometimes amazing solutions come from random sources,” Brubaker told a local reporter covering the project in July 2019. “We’re hoping to hit the substance abuse disorder groups, the first responders’ group. We want to go to the places already working on this a little bit.”

The CCI initiative, funded in partnership with the California Department of Health Care Services, was designed to help facilitate collaborations between opioid reduction coalitions and community stakeholders, such as health care providers, local citizens, government agencies, first responders, and residents in recovery. Launched in late May 2019 and concluded at the end of September 2020, the four-member program cohort from across the state included Rx Safe Del Norte, San Benito County Opioid Task Force, SafeRx Santa Cruz County, and San Diego Prescription Drug Abuse Task Force.