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Addressing California’s Opioid Epidemic: A Spotlight on Innovative Solutions and Health Equity Initiatives by Sierra Health Foundation


With record-breaking rates of drug-related overdose fatalities, including from fentanyl, in California last year, the opioid epidemic ranks among the state’s most vexing issues.

On the occasion of its 10th anniversary, The Center at Sierra Health Foundation highlights the work of three nonprofit organizations working on innovative ways to prevent and recover from substance abuse and advance health equity across the state throughout Northern California — from remote rural areas of Inyo County to the Central Valley, to Alameda County.

Sierra Health Foundation is a private philanthropy that forges new paths to promote health, racial equity and racial justice in partnership with communities, organizations, and leaders.

Nearly 7,000 Californians died from opioid-related overdoses in 2022. Over 83,000 opioid-related overdose deaths occur per year across the country – more than 90% of which involve fentanyl.

Recently, California Governor Newsom announced a new legislative effort to increase penalties for the illicit trafficking of the drug xylazine, also known as “tranq” – to get ahead of a new wave in the opioid crisis. Xylazine – an animal tranquilizer with no approved human use – is increasingly being found in the illicit drug supply, and has been linked to rising overdose deaths across the country. The legislation would make xylazine a controlled substance, but exempt legitimate veterinary use, making illicit trafficking of xylazine subject to increased criminal penalties while maintaining veterinarians’ access to the drug for approved use in animals.

But the exposure to these drugs targets those vulnerable and people of color.

Kaying Hang, President, of The Center at Sierra Health Foundation said that overdose is the leading cost of death for nonelderly people in California and sadly, these numbers are only expected to increase.

Hang said historically, the federal and state governments have responded to drug use with incarceration and extreme policing of black communities.

“Under the banner of a war on drugs in the eighties and nineties. The federal government criminalized drug use and drug possession through a series of punitive losses. For over 50 years, we have all suffered the consequences of incarceration. People of color and those from low-income communities were disproportionately harmed. And people who use drugs. I’ve been deeply stigmatized and underserved through it all,” she said. 

She said that the center’s focus is on normalizing harm reduction approaches through public health and healthcare settings, including access to safer and holistic nonjudgmental care regardless of a person’s drug use status. They do this by partnering with community-based organizations that are disproportionately underserved and harmed

“We firmly believe that those closest to the harm are in the best position to identify solutions and bring transformative, creative approaches to address the issue. Our intentional approach guides our practice in collaborating with partners to open doors to care, allowing individuals to choose the path that aligns best with their vision for themselves. If you or someone in your family is struggling with drug use and wishes to make a different choice, help is available,” Hang said. 

Mari Perez-Ruiz, Executive Director, Central Valley Empowerment Alliance spoke about the UFW farmworker movement that began in this community, with fields negotiated by Dolores Huerta, Larry Itliong, and Cesar Chavez during the 1965 great strike boycott. This is where the first agricultural labor contract was established, and currently, Larry County lacks a union contract. The fight in 1965 led to redlining policies affecting us today. Poplar, one of 13 out of 15 communities with no future per the housing element, lacks investment in infrastructure. 

“Despite challenges, the community fights the negative narrative. With 40% Filipino and 50% Mexican farmworkers, Poplar’s rich history is neglected, lacking parks or clinics. The campaign for health equity, led by youth, addresses floods and provides enriching activities. Despite limited expectations, the goal is to build a beloved community with unconditional love,”  Perez-Ruiz said. 

Substance addiction, particularly fentanyl, is a serious concern in underserved rural communities, targeted by cartels. Lupus Promise Center works to create safe spaces, engaging youth and parents in candid conversations, home visits, and harm reduction. 

The community, despite challenges, is actively working on developing a much-needed park, addressing both the supplier and user aspects of substance issues. The naming of the park reflects the goal of bringing positive change to a park-poor region.

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