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Failing the Opioid Crisis Again
Jeffrey R. Lewis

Turlock and Stanislaus County haven’t been spared from the opioid epidemic. In fact, throughout the Central Valley, rural communities are grappling with the opioid and fentanyl crisis with an intensity that cannot be overstated. In this landscape, Governor Gavin Newsom's efforts to reduce overdoses come into sharp focus, mainly through the Naloxone Distribution Project (NDP) and the recent procurement of CalRx “branded” naloxone.

While the State must take actionable steps to tackle this growing crisis, it's essential to acknowledge the disconnect between its efforts and the harsh reality of rural communities like Turlock and its surrounding areas.

Despite successful seizures reported by the Governor’s office and local media, illegally produced fentanyl continues to bulldoze its way into our communities. Ensuring access to naloxone is undeniably crucial to counteract fentanyl-related overdoses, which account for nearly 90% of all overdoses in the state; yet, naloxone’s limitations (shortages, reduced effect against fentanyl-related overdoses, etc.) underscore the pressing need for alternative solutions.

Unfortunately, it seems that California is doubling down on naloxone. By going directly to the manufacturer – circumventing PBMs and middlemen – the State got a great deal from Amneal Pharmaceuticals for their newly approved generic naloxone. However, one critical aspect falls by the wayside when the State is more focused on cost than anything else: the human toll of the crisis. In rural communities, where resources are already limited and emergency response times can be lengthy, tackling the fentanyl crisis must extend beyond budgetary considerations. Our first responders and communities need access to a broader class of FDA-approved opioid-reversal medications. It's about saving more lives and ensuring that every individual at risk of overdose has the best chance of survival.

Other states, like Michigan, New York

, Arkansas, and New Hampshire, have already expanded access to all FDA-approved opioid reversal medications with promising results. Why? Because new nasal sprays, which are approved and supported by the FDA, are specifically formulated to reverse fentanyl- and synthetic-related overdoses. California can better protect residents and save more lives by embracing innovative solutions and getting outside the “one-size-fits-all” mindset.

The expansion of naloxone access is still needed, but our approach to overdose prevention mustn’t be focused on one tool. The illicit drug landscape continues to change, and so must statewide policies.

The health and well-being of all Californians, particularly those in rural communities, are at stake. We must confront this crisis from all angles and extend beyond cost-cutting measures—we need an inclusive approach that equips communities with every available tool to save lives. In Turlock and rural towns across the state, the cost of inaction is measured not in dollars but in lives lost—a price too steep to bear. And we must recognize and embrace the fact that no single medication like naloxone, regardless of free or cheap, will solve the opioid crisis. We will have failed if we do not offer other medications like Opvee.

— Jeffrey Lewis is the President and CEO of Legacy Health Endowment. The words expressed are his own.