In Rural California, This New Addiction Treatment Is Being Ignored -- by the Doctors
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Satterfield is the only medical provider in the county treating heroin users with the medication buprenorphine. 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\u003ca href=\"http://californiahealthline.org/news/author/pauline-bartolone/\" target=\"_blank\">Pauline Bartolone\u003c/a>\u003c/strong>\u003c/br>California Healthline","isLoading":false}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon 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addiction.\u003c/p>\n\u003cfigure id=\"attachment_353727\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-353727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Quincy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Downtown Quincy, California.\u003c/figcaption>\u003c/figure>\n\u003cp>Before Satterfield started prescribing buprenorphine late last year, anyone seeking treatment had to travel a long way to a clinic in a more urban setting. The one in Chico is a 1½- hour drive down a windy canyon road, which can be closed off during bad weather.\u003c/p>\n\u003cp>So Satterfield, 65, embarked on a pilot program to provide medication-assisted treatment for heroin users and those with other addictions. Satterfield, Plumas County’s public health officer, squeezed the program in between his other duties, including shifts as an emergency physician at a local hospital.\u003c/p>\n\u003cp>“The need is great, and we had a sense it was not going to be easy to get other providers to do it,” said Satterfield, a tall man with delicate rimmed glasses, who has lived in the region for 28 years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Unlike methadone, which is only dispensed at substance abuse treatment facilities and requires daily visits from patients, buprenorphine can be prescribed by any local doctor who has a special license. The patient can take the medication at home.\u003c/p>\n\u003cp>The California Department of Health Care Services hopes buprenorphine will become much more widely available under a new \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=W1eCmud6DtHf6F2ciFehwsOa-Lf2xOaEtColIuEDqGwzJ7i09MjUCA..&URL=http%3a%2f%2fwww.dhcs.ca.gov%2fformsandpubs%2fpublications%2fopa%2fDocuments%2f17-01%2520SAMHSA%2520MAT%2520Grant%2520FINAL.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">$90 million dollar federal\u003c/a> grant to combat opioid misuse and expand access to addiction.\u003c/p>\n\u003cp>But many health care providers in Plumas and other rural areas of California have thus far not taken the steps required to offer the addiction treatment. Because buprenorphine is itself an opioid, doctors who want to prescribe it for addiction must get eight hours of training and register with the federal Drug Enforcement Agency.\u003c/p>\n\u003cp>James Wilson, health education coordinator with Plumas County, is working as the lead coordinator for the Northern Sierra Opioid Safety Coalition. He said he has reached out to about 30 doctors in Plumas and surrounding counties ,to ask them to get authorized to offer buprenorphine. He got a lot of “nos.”\u003c/p>\n\u003cp>“For the most part, they kind of recognize the need for medication-assisted addiction treatment -- but they don’t necessarily want to be the doctors themselves that are doing it,” Wilson said.\u003c/p>\n\u003cp>Wilson said doctors or their office staffers have told him they don’t want people withdrawing from heroin or other drugs sitting in their waiting rooms, or that they are uncomfortable with the drug-seeking behaviors of that clientele.\u003c/p>\n\u003cp>That doesn’t surprise Dr. David Kan, president-elect of the California Society of Addiction Medicine.\u003c/p>\n\u003cp>“Most physicians don’t see [treating addiction] as part of their regular and routine practice,” said Kan, adding that many health care providers can’t identify the signs of addiction in a patient.\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-13e-tcr.mp3\" Image=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Satterfield_patientsmall-768x512.jpg\" Title=\"In Rural California, This New Addiction Treatment Is Being Ignored -- by the Doctors\" program=\"The California Report\"]\u003c/p>\n\u003cp>A spokesperson for the California Medical Association said some physicians fear being overwhelmed by patients if they start treating addiction. Treatment also involves a good bit of coordination, such as linking patients to other services such as mental health treatment and case management.\u003c/p>\n\u003cp>That’s one of the reasons a local hospital system in Plumas County hasn’t incorporated buprenorphine into its in-house services.\u003c/p>\n\u003cp>Lindsey Morrison, care coordinator at Plumas District Hospital, said that for a few hours a month, an out-of-town physician is available via telemedicine to treat chronic pain patients addicted to prescription opioids. But the rural health system doesn’t have the time or resources to start prescribing buprenorphine to heroin users.\u003c/p>\n\u003cp>“That’s a really difficult population to work with,” said Morrison, adding that they don’t have the necessary mental health care providers and staffers to work with those patients.\u003c/p>\n\u003cp>Even if a handful of the hospital’s doctors got the training to provide buprenorphine, Morrison said “it would be like… 'Oh my god, we have a ton of work ahead of us, we got to hire more people to help with these services!'”\u003c/p>\n\u003cp>A \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=EwnaTcFvGhNZbHF-Ixw-DRgQV32IWTS-7CiyVZaVJ_ozJ7i09MjUCA..&URL=http%3a%2f%2fkhn.org%2fnews%2famount-of-opioids-prescribed-in-u-s-has-been-falling-since-2010%2f\" target=\"_blank\" rel=\"noopener noreferrer\">recent study \u003c/a>by the Centers for Disease Control and Prevention suggests Northern California doctors’ were prescribing painkillers at higher-than-average rates. In rural counties like Plumas, the rates far exceed those seen in the rest of California. More prescriptions were written in Plumas in 2015 than there were people in the county, according to California Department of Public Health \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=ZEm8Va8AOA3fXLWs-VHDmFu28svb9LiHZ2u4vAR_rrIzJ7i09MjUCA..&URL=https%3a%2f%2fpdop.shinyapps.io%2fODdash_v1%2f\">data.\u003c/a>\u003c/p>\n\u003cp>Although Plumas county is sparsely populated, it also has one of \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=ZEm8Va8AOA3fXLWs-VHDmFu28svb9LiHZ2u4vAR_rrIzJ7i09MjUCA..&URL=https%3a%2f%2fpdop.shinyapps.io%2fODdash_v1%2f\">the highest rates of opioid-related\u003c/a> deaths in the state.\u003c/p>\n\u003cp>State health officials say they hope the federal grant to combat opioid abuse will help expand treatment options and bump up the state’s overall use of buprenorphine as a treatment, \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=bmd9kdJyhZkWZei-TJRIKaaN05es5NlFSeYVV39Ae34zJ7i09MjUCA..&URL=http%3a%2f%2fcaliforniamethadone.org%2fwp-content%2fuploads%2f2017%2f02%2fCOMP-PDF.pdf\">which is low compared\u003c/a> to the rest of the U.S.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Satterfield said he would be glad if just one more doctor in his area got trained to treat addiction in this way – he said it’s a tough, but rewarding, job.\u003c/p>\n\n","blocks":[],"excerpt":"Buprenorphine is effective and can be prescribed by general practitioners, but they're reluctant to work with addicted patients.","status":"publish","parent":0,"modified":1499987354,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":954},"headData":{"title":"In Rural California, This New Addiction Treatment Is Being Ignored -- by the Doctors | KQED","description":"Buprenorphine is effective and can be prescribed by general practitioners, but they're reluctant to work with addicted patients.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In Rural California, This New Addiction Treatment Is Being Ignored -- by the Doctors","datePublished":"2017-07-12T12:00:39.000Z","dateModified":"2017-07-13T23:09:14.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"353704 https://ww2.kqed.org/stateofhealth/?p=353704","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/07/12/in-rural-california-this-new-addiction-treatment-is-being-ignored-by-the-doctors/","disqusTitle":"In Rural California, This New Addiction Treatment Is Being Ignored -- by the Doctors","nprByline":"\u003cstrong> \u003ca href=\"http://californiahealthline.org/news/author/pauline-bartolone/\" target=\"_blank\">Pauline Bartolone\u003c/a>\u003c/strong>\u003c/br>California Healthline","path":"/stateofhealth/353704/in-rural-california-this-new-addiction-treatment-is-being-ignored-by-the-doctors","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you want to quit heroin and you live in Quincy, California, a small pioneer town up in the Northern Sierra Nevada mountains, you’ll probably go see Dr. Mark Satterfield.\u003c/p>\n\u003cp>As far as he knows, Dr. Satterfield is the only health care provider in Plumas County who is able and willing to treat heroin users with buprenorphine, a medication that has become the new standard of care in fighting opioid addiction.\u003c/p>\n\u003cfigure id=\"attachment_353727\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-353727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Quincy-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/07/Quincy-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Downtown Quincy, California.\u003c/figcaption>\u003c/figure>\n\u003cp>Before Satterfield started prescribing buprenorphine late last year, anyone seeking treatment had to travel a long way to a clinic in a more urban setting. The one in Chico is a 1½- hour drive down a windy canyon road, which can be closed off during bad weather.\u003c/p>\n\u003cp>So Satterfield, 65, embarked on a pilot program to provide medication-assisted treatment for heroin users and those with other addictions. Satterfield, Plumas County’s public health officer, squeezed the program in between his other duties, including shifts as an emergency physician at a local hospital.\u003c/p>\n\u003cp>“The need is great, and we had a sense it was not going to be easy to get other providers to do it,” said Satterfield, a tall man with delicate rimmed glasses, who has lived in the region for 28 years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Unlike methadone, which is only dispensed at substance abuse treatment facilities and requires daily visits from patients, buprenorphine can be prescribed by any local doctor who has a special license. The patient can take the medication at home.\u003c/p>\n\u003cp>The California Department of Health Care Services hopes buprenorphine will become much more widely available under a new \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=W1eCmud6DtHf6F2ciFehwsOa-Lf2xOaEtColIuEDqGwzJ7i09MjUCA..&URL=http%3a%2f%2fwww.dhcs.ca.gov%2fformsandpubs%2fpublications%2fopa%2fDocuments%2f17-01%2520SAMHSA%2520MAT%2520Grant%2520FINAL.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">$90 million dollar federal\u003c/a> grant to combat opioid misuse and expand access to addiction.\u003c/p>\n\u003cp>But many health care providers in Plumas and other rural areas of California have thus far not taken the steps required to offer the addiction treatment. Because buprenorphine is itself an opioid, doctors who want to prescribe it for addiction must get eight hours of training and register with the federal Drug Enforcement Agency.\u003c/p>\n\u003cp>James Wilson, health education coordinator with Plumas County, is working as the lead coordinator for the Northern Sierra Opioid Safety Coalition. He said he has reached out to about 30 doctors in Plumas and surrounding counties ,to ask them to get authorized to offer buprenorphine. He got a lot of “nos.”\u003c/p>\n\u003cp>“For the most part, they kind of recognize the need for medication-assisted addiction treatment -- but they don’t necessarily want to be the doctors themselves that are doing it,” Wilson said.\u003c/p>\n\u003cp>Wilson said doctors or their office staffers have told him they don’t want people withdrawing from heroin or other drugs sitting in their waiting rooms, or that they are uncomfortable with the drug-seeking behaviors of that clientele.\u003c/p>\n\u003cp>That doesn’t surprise Dr. David Kan, president-elect of the California Society of Addiction Medicine.\u003c/p>\n\u003cp>“Most physicians don’t see [treating addiction] as part of their regular and routine practice,” said Kan, adding that many health care providers can’t identify the signs of addiction in a patient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audio","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-13e-tcr.mp3","image":"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/07/Satterfield_patientsmall-768x512.jpg","title":"In Rural California, This New Addiction Treatment Is Being Ignored -- by the Doctors","program":"The California Report","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A spokesperson for the California Medical Association said some physicians fear being overwhelmed by patients if they start treating addiction. Treatment also involves a good bit of coordination, such as linking patients to other services such as mental health treatment and case management.\u003c/p>\n\u003cp>That’s one of the reasons a local hospital system in Plumas County hasn’t incorporated buprenorphine into its in-house services.\u003c/p>\n\u003cp>Lindsey Morrison, care coordinator at Plumas District Hospital, said that for a few hours a month, an out-of-town physician is available via telemedicine to treat chronic pain patients addicted to prescription opioids. But the rural health system doesn’t have the time or resources to start prescribing buprenorphine to heroin users.\u003c/p>\n\u003cp>“That’s a really difficult population to work with,” said Morrison, adding that they don’t have the necessary mental health care providers and staffers to work with those patients.\u003c/p>\n\u003cp>Even if a handful of the hospital’s doctors got the training to provide buprenorphine, Morrison said “it would be like… 'Oh my god, we have a ton of work ahead of us, we got to hire more people to help with these services!'”\u003c/p>\n\u003cp>A \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=EwnaTcFvGhNZbHF-Ixw-DRgQV32IWTS-7CiyVZaVJ_ozJ7i09MjUCA..&URL=http%3a%2f%2fkhn.org%2fnews%2famount-of-opioids-prescribed-in-u-s-has-been-falling-since-2010%2f\" target=\"_blank\" rel=\"noopener noreferrer\">recent study \u003c/a>by the Centers for Disease Control and Prevention suggests Northern California doctors’ were prescribing painkillers at higher-than-average rates. In rural counties like Plumas, the rates far exceed those seen in the rest of California. More prescriptions were written in Plumas in 2015 than there were people in the county, according to California Department of Public Health \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=ZEm8Va8AOA3fXLWs-VHDmFu28svb9LiHZ2u4vAR_rrIzJ7i09MjUCA..&URL=https%3a%2f%2fpdop.shinyapps.io%2fODdash_v1%2f\">data.\u003c/a>\u003c/p>\n\u003cp>Although Plumas county is sparsely populated, it also has one of \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=ZEm8Va8AOA3fXLWs-VHDmFu28svb9LiHZ2u4vAR_rrIzJ7i09MjUCA..&URL=https%3a%2f%2fpdop.shinyapps.io%2fODdash_v1%2f\">the highest rates of opioid-related\u003c/a> deaths in the state.\u003c/p>\n\u003cp>State health officials say they hope the federal grant to combat opioid abuse will help expand treatment options and bump up the state’s overall use of buprenorphine as a treatment, \u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=bmd9kdJyhZkWZei-TJRIKaaN05es5NlFSeYVV39Ae34zJ7i09MjUCA..&URL=http%3a%2f%2fcaliforniamethadone.org%2fwp-content%2fuploads%2f2017%2f02%2fCOMP-PDF.pdf\">which is low compared\u003c/a> to the rest of the U.S.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Satterfield said he would be glad if just one more doctor in his area got trained to treat addiction in this way – he said it’s a tough, but rewarding, job.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/353704/in-rural-california-this-new-addiction-treatment-is-being-ignored-by-the-doctors","authors":["byline_stateofhealth_353704"],"categories":["stateofhealth_3012","stateofhealth_2746","stateofhealth_1"],"tags":["stateofhealth_643","stateofhealth_2808","stateofhealth_3126","stateofhealth_2519","stateofhealth_3127","stateofhealth_3128"],"affiliates":["stateofhealth_3036"],"featImg":"stateofhealth_353725","label":"stateofhealth_3036"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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