A sharp rise in heroin use across rural Northern California is raising alarms among community members and health advocates, who say opioid addiction and homelessness are driving a crisis unlike any seen before in the area, a recent feature from The New York Times reports.

Though California as a whole has one of the lowest opioid-related death rates in the country, Humboldt County has a death rate five times higher than the state average — similar to rates in Maine and Vermont, which have been at the center of news coverage of the crisis. The problem is made worse in the city of Eureka, where a sizable homeless population continues to expand as a result of a lack of affordable housing. Both communities lament that as problems with addiction are spilling into public discourse, they are often overlooked.

The town’s middle-class residents are now complaining about a major increase in syringe litter across their community. Meanwhile, Eureka’s homeless population has received most of the blame, while the Humboldt Area Center for Harm Reduction (which distributes clean needles via a syringe exchange) reports that its clients actually return 94 percent of used syringes.

Local health officials report that they are dealing with major increases in opioid addiction, overdoses and hepatitis C virus (HCV) cases. They also say they are ill equipped to handle the rising epidemic. Access to medication-assisted treatment (MAT) for substance use is limited in the area and funding to combat the crisis is low. 

The California Department of Health Care Services’ Substance Use Disorder Compliance Division said the state is working on increasing MAT programs in rural areas. But once those are in place, advocates say there will be other issues to contend with — like getting drug users to enroll in the programs and offering them mental health services to help them overcome addiction. 

The state will also have to tackle the lack of stable, affordable housing among at-risk communities in order to get a handle on its addiction crisis. Advocates say restrictions on public housing development are contributing to the increase in homelessness, which is, in turn, increasing rates of addiction. 

To read the Times’ full report inside Northern California’s heroin crisis, click here.