The small city of Mission Viejo, California has just over 96,000 residents. It is located in Orange County near the Pacific Coast but considered to be part of an area called the Saddleback Valley. This area is between two major metropolitan areas, Los Angeles and San Diego. Originally an area focused on cattle and sheep grazing, Mission Viejo was one of the last inhabited areas in Orange County to become urbanized. A plan to weave roads and homes through Mission Viejo’s hills was not completed until 1980.
While Mission Viejo is a relatively new, incorporated city, the small, suburban area struggles with substance abuse problems, leading to a growing need for treatment centers. Much of Orange County has suffered because of the opioid addiction epidemic, alcohol abuse, and illicit drugs like heroin, meth, and cocaine that come north from San Diego County. It is important for residents of Mission Viejo, California, to understand their risks of addiction and to know how to access help.
Both prescription and illicit drugs are widely abused around the US, but some substances are more common than others. In Orange County, opioids and alcohol are the main causes of community health issues; however, illicit substances, including cocaine and meth, are more widely abused than in many other areas in the country because they are more available after being smuggled from Mexico.
Opioids: Until recently, rates of opioid abuse and addiction in California were lower than the national average, leading many to believe that the crisis was not as bad in the large state as the rest of the United States. Drug overdose deaths, driven mainly by opioid abuse, are the leading cause of unintentional death in the U.S., surpassing car accidents. However, more people in Mission Viejo, and Orange County in general, are beginning to struggle with opioid addiction and abuse, primarily through prescription narcotics.
A report from August 2017 found that emergency room admissions due to opioid abuse were rising in Orange County, and cities that struggled were often the most affluent. Mission Viejo was among these, with an average of 56 ER admissions per 100,000 residents per year between 2011 and 2015. Better insurance, more frequent doctors’ visits, and more money for prescription medication is believed to contribute to higher rates of painkiller abuse and subsequent hospitalization.
In Orange County overall, there were 7,457 ER admissions for opioid overdoses between 2011 and 2015. In addition, 7 out of every 10 overdose deaths investigated by the county’s sheriff-coroner in this period involved narcotics. Although the rate of overdose deaths has remained relatively level since 2011, the rate of drug overdose deaths due to narcotics doubled since 2005, so much of the spike in abuse, overdose, and opioid-related deaths occurred between 2005 and 2010.
Orange County residents in middle age—between 45 and 54 years old—made up most of the opioid overdose deaths between 2011 and 2015, and half of all opioid-related overdose deaths in the county occurred among those 45–64 years old. This is, in part, because chronic pain and repetitive injuries often become prominent during middle age, so people in this age range are more likely to receive prescriptions for opioid painkillers. Unfortunately, if these drugs are not taken as prescribed, taken with other drugs like alcohol, or not monitored properly, they can cause addiction.
In Mission Viejo, there were about 37 ER admissions for opioid overdose per 100,000 residents, in 2011. That number rose to 64 admissions per 100,000 people by 2015, almost doubling the opioid overdose emergency treatment rate in this city.
There were about 1.7 million prescriptions for opioid painkillers dispensed to Orange County’s residents in 2015, according to the Controlled Substance Utilization Review and Evaluation System (CURES).
Alcohol: A 2012 survey found that 82% of Orange County adults had tried alcohol at least once in their lives, which is slightly lower than the national average of 86.4% of people ages 18 or older, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). About 62% of Orange County adult residents drank at least one alcoholic beverage in the past year compared to 70.1% nationally; about 47% of adult residents in Orange County drank at least once in the prior month compared to about 56% across the U.S.
In Orange County, the adults who reported drinking in the past month also reported that they drank alcohol at least once every 4–5 days, or about 6–7 days out of the month. Like the U.S. average, more men drank than women, and men drank more frequently than women.
More middle-aged and older adults report drinking more days of the month. For example, those 18–24 years old reported drinking 5.2 days in the month on average; those 45–54 years old reported drinking 6.8 days; those 55–64 years old reported drinking 6.9 days; and people older than 65 years old reported drinking 9.8 days in the month.
The number of alcohol servings consumed on each drinking occasion decreased as Orange County adults grew older. Those 18–24 years old reported consuming an average of 3.7 drinks per occasion, with 24% of the group drinking five or more beverages per occasion. Compared to middle-aged and older adults, this younger group was more likely to binge drink, though older adults in Orange County were more likely to drink heavily. People 45–54 years old drank an average of 2.1 drinks per occasion; those 55–64 years old drank 1.6 drinks per occasion; and people at least 65 years old drank 2.2 drinks per occasion. They drank more often, but consumed fewer servings.
Data from 2015 shows that the prevalence of excessive drinking in Orange County is about 17.7%, which is lower than many places in the country, but still about average for the state of California. Roughly 27% of car crashes in Orange County in 2015 involved a drunk driver. While this is statistic is tragic and preventable, Orange County drivers were less likely to drink and drive compared to their neighbors in Riverside and San Diego counties.
Although older adults in Orange County binge drank less often than younger adults, on average, about 35.1% of adults in the county binge drank in the prior year, according to a 2014 survey. This was slightly higher than California’s state average of 34%.
Binge drinking and heavy drinking are not exactly the same as alcohol use disorder (AUD), the medical term for alcohol addiction. However, they can indicate problem drinking that may lead to AUD, and they can also indicate community health issues.
Marijuana: In 2016, California passed Proposition 64, a measure that made recreational marijuana use in the state legal. The drug remains a Schedule I banned substance at the federal level, according to the Drug Enforcement Administration (DEA), but many states are legalizing some form of marijuana use.
California’s Prop 64 went into full effect at the beginning of 2018, but the measure allows cities and counties within the state to manage medical and recreational marijuana use at their own discretion. Because of this, many cities have decided not to allow recreational or even medical use of the drug because it is addictive, like other legal intoxicants like alcohol and nicotine.
Orange County is largely restrictive with regard to marijuana use for either medical or recreational reasons. Mission Viejo allows indoor cannabis growing, but no other forms of marijuana use, including sales, outdoor growing, distribution, or commercial activities.
Although recreational marijuana use was not legal in California until recently, a 2012 survey found that many adults in the county abused the drug regardless of legality. About 33% of adults in Orange County had tried marijuana, representing about 758,000 people. Around 8% used the drug in the year before the survey, and 4.5% used marijuana in the 30 days before being surveyed. Most of these adults were 18–24 years old (19%) or 25–34 years old (12%). A surprising 7% of people ages 55–64 abused marijuana, which is a higher percentage than those 35–44 years old, 45–54 years old, and 65 or older.
Illicit drugs: Because of Orange County’s proximity to San Diego County, which struggles with illicit drugs shipped over the California-Mexico border, many people in Mission Viejo and other cities in the county are exposed to drugs like cocaine, heroin, and meth. These substances are very potent and addictive.
The 2012 survey found that 13% of Orange County residents ages 18 and older had tried cocaine at least once in their lives; 1% abused this drug in the prior year; and 0.3% abused cocaine in the prior month. Amazingly, 21% of the people who abused cocaine were between the ages of 45 and 54; only 13% of those 25–34 years old abused cocaine; 17% of those 55–64 years old abused the drug; and only 3% of people 65 and older abused the stimulant. More men than women abused cocaine.
The survey also found that 6% of Orange County’s adult residents tried methamphetamine at least once; 0.6% abused this dangerous stimulant in the year before the survey; and 0.1% abused the drug in the month before being surveyed. Men abused meth more than women, but only slightly—7% of men compared to 5% of women struggled with meth abuse.
A 2016 survey found that 7.5% of Orange County adolescents had ever tried an illicit drug, which included cocaine, marijuana, meth, sniffing glue, or abuse of other inhalants.
Cigarettes: About 10% of adults in Orange County were current smokers per a 2014 survey; this was lower than California’s rate of 11%, and the national rate of 15.8%. Almost 22% of Orange County’s adults were former smokers. Unfortunately, teenagers in Orange County smoked more than their peers across the state on average: 5.5% of teens in the county smoked compared to 3.1% in California. Fewer adolescents smoked e-cigarettes or used vaporizers at 3.2% compared to the same age group around California at 10.3%.
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Mental and Behavioral Health Contributing to Mission Viejo’s Substance Abuse
A survey from 2012 reported that there were, on average, 50.6 behavioral health hospitalizations in Orange County, out of every 100,000 residents. This was lower than California’s rate of 61.1 hospitalizations for every 100,000 people. While the hospitalization rate for adults over 65 years old declined about 40% between 2003 and 2012, indicating that more older adults got the help they needed to maintain a healthy lifestyle, the rate of hospitalization for children and adolescents rose 14%. For adults ages 18¬–64, the hospitalization rate rose about 2%.
On average, behavioral and mental health-related hospitalizations made up 6% of the causes of hospitalization in Orange County in 2013.
Mental health and mood disorders: Major depression or another mood disorder, except bipolar disorder, were the major causes of hospitalization among children ages 0–17. Bipolar disorders were the second-leading cause of hospitalizations for this age group, and the “other” category was the third cause. Substance abuse-related admissions were fairly low on the list for children and adolescents.
Among working-age adults, 18–64 years old, substance abuse was the leading cause of behavioral and/or mental health hospitalization, with major depression/other mood disorders ranking second, and bipolar disorders ranking third. Older adults, ages 65 and older, were hospitalized predominantly due to major depression/mood disorders, with “other” listed as the second reason, schizophrenia or psychotic conditions being third, and substance abuse ranking fourth.
Suicide: Suicidal ideation and completion are associated with mental health and substance abuse struggles. Among the biggest counties in the United States, Orange County had the greatest increase in suicide from 1999 to 2001 and from 2011 to 2013. The county experienced a 45% increase in rates of suicide in that timeframe. Across the United States, there has been a 22% increase in rates of suicide.