Santa Clara County to expand substance use treatment, distribute naloxone with opioid settlement money

With opioid overdoses rising, Santa Clara County is expanding substance abuse support at schools, distributing more naloxone and fentanyl testing strips and boosting youth inpatient treatment using money from a settlement with opioid distributors.

In 2014, Santa Clara County became the first jurisdiction to file a lawsuit against major opioid manufacturers for their roles in creating a nationwide opioid epidemic. In July 2021, opioid manufacturer Janssen Pharmaceuticals, and three major distributors offered up $26 billion to settle more than 3,000 opioid lawsuits across the country.

Santa Clara County could be paid up to $48 million over an 18-year period, and so far has received $5.8 million. On Tuesday, the county’s Board of Supervisors unanimously approved how to spend some of those dollars to fight the local opioid crisis, with a good chunk of the money going toward youth-based programming.

Approximately $1.5 million will go to help expand the School Linked Services Initiatives — which provides mental health services to students in high-risk areas — by adding peer support specialists and clinicians who can aid in substance abuse treatment and answer questions.

Supervisor Cindy Chavez, who has been a leading voice on the board for fighting the opioid and fentanyl epidemics, pushed backed some on county officials, saying that adding more behavioral health services might not be the solution.

“The research to date demonstrates that when treated with medication — because we can treat opioid addiction with medication — that medication is the primary tool used to address addiction not counseling oddly enough,” she said. “Which means that whatever system is set up needs to address the literature as it relates to what we know works now.”

Zelia Faria Costa, the county’s children’s director for behavioral health services, said the addition of peer-to-peer support in schools would help students by giving them “someone that would be along side them to talk about risks” and other opportunities.

“It has to be broader than substance use because young people are coming in to the counselor, to their teachers for a variety of different reasons,” Costa said. “It really is to have that presence there with young people that they can really start talking about what’s happening in their lives and identifying the resources that are needed, one being substance use treatment services.”

Chavez asked county officials to examine in the future whether the county has properly invested in local pediatricians so they have enough training to talk to kids and parents about addiction and other opioid risks.

The program will be rolled out in up to 27 local high schools in high risk areas, but Supervisor Joe Simitian worried that restricting it to those schools could leave out some youth who may need help, as well.

“I had to sit on a stage and listen to the parents of a dead youngster in Los Gatos and sit on a stage and listen to the parents of a dead youngster in Los Altos,” he said. “I’m doubting that they’re on that high risk area map, but both of those schools would tell you they got a problem.”

An additional $1 million will go to helping the county’s partners expand youth residential treatment programs — which are short-term intensive services — by four beds.

Following a 300% increase in fentanyl overdoses in Santa Clara County in the last three years, according to county officials, supervisors also want to stock more vending machines with naloxone — a medication that reverses opioid overdoses — at bars, restaurants, libraries, community centers and colleges.

The county’s behavioral health services department also wants to expands its education on how to use the medication, providing training at Valley Health Centers and to drivers of trains and buses, among others. The county is expected to use nearly $800,000 to purchase 6,000 naloxone kits and 12,000 fentanyl testing strips.

When future funding comes down the line, Supervisor Otto Lee asked that county officials look at allocating some of the money to prevent the over prescription of opioids and to address the needs of pregnant women and babies who may be suffering from neonatal abstinence syndrome, a condition where a newborn is going into withdrawal.

“I myself was in a situation when I came back from the war in Iraq when I saw the doctor he was very quick to give me a bottle of opioids,” Lee, a U.S. Navy veteran, said. “I looked it up and I said ‘I’m not so sure I want to take this stuff.’ Turns out I did not but I also found out later on the effects of opioids.”