IT’S ABOUT 10:30AM ON A CHILLY FRIDAY MORNING IN FEBRUARY, and the streets of Chinatown in Salinas are crowded with tents and tarps, although few people are out. A white Ford F-150 rolls up and parks along Soledad Street. A team of five from Central Coast Overdose Prevention (CCODP) steps out to offer the unhoused people who live under these tents and tarps a path forward, one without drugs.
Dr. Reb Close, Jeremy Reigart, Hector Perez, Anna Alamo-Lopez and Aidan Pettit-Miller begin their rounds. Close is immediately greeted by one of her patients, while Perez and Reigart check in with familiar faces, asking about their well-being. Pettit-Miller grabs boxes of Narcan – the brand name for naloxone, which can reverse the effects of overdoses – and starts handing out doses, ensuring each person understands how to use it.
Pettit-Miller is an AmeriCorps volunteer who has been working with CCODP since July 2024. He places boxes of Narcan on the window ledge of an abandoned building. A woman approaches, curious about the Narcan. Nearby, a couple hunches over a folded piece of aluminum foil, preparing to smoke. While the smoke drifts into the cold morning air, Pettit-Miller talks to the woman about treatment options and demonstrates how to administer Narcan. She listens intently and says that she and her husband want help. Close joins the conversation, and together they walk a block to meet the woman’s husband. The couple expresses a desire to get sober and start medication to curb their cravings. Close hands them her business card, offering a direct support line.
This is the type of boots-on-the-ground outreach, patient by patient, that a collaborative team is taking on in an effort to get people with an opioid addiction on a path to sobriety. Their rounds take them not just to homeless encampments on streets and in riverbeds, but also inside the county jail and juvenile hall. They use a range of tools – pharmaceuticals, referrals to organizations that can help with housing, and simply a listening ear in their effort to address the opioid epidemic, one person at a time.
CCODP WAS FOUNDED AS A NONPROFIT IN 2020 and aims to eliminate overdoses, increase awareness, educate the public and improve access to community support and treatment options. The team, composed of doctors and people recovering from addiction, works to connect individuals struggling with substance abuse to treatment programs, while also distributing essentials.
CCODP is one of several groups in the nonprofit and government sectors working together in a unified front to fight the opioid crisis. The Monterey Police Department’s Multi-Disciplinary Outreach Team (MDOT), for example, works closely with CCODP, as does the County Probation Department, the Sheriff’s Office, Public Defender’s Office and more. On May 1, the County of Monterey’s Health Department set up four free vending machines at various places in Salinas and Marina to distribute naloxone and fentanyl test strips, which allow users to test the composition of the drug before consuming it.
Leading CCODP’s street team is Close, a former emergency room physician at Community Hospital of the Monterey Peninsula, who saw firsthand the pressing need for change. Over a decade-and-a-half, she would see patients return again and again, treating them only when their illness became a medical emergency.
In 2012, she treated a 19-month-old who was admitted to the ER; the toddler died of an overdose. “That’s when it crystallized for me that something dramatic had to change,” Close says. So she took the fight to the streets.
The idea of CCODP began in the ER with collaboration in mind. “Law enforcement and medicine haven’t always been compatible,” Close says. “Fortunately, one of our leaders at CHOMP, the head of security, I reached out to him [and asked]: How can we figure this out? These are our community members. We have to make this easier. And he was in full support.
“We had all these different groups that we realized were taking care of the same people, so we just decided to bring them all together,” Close says. “It’s all just kind of growing because it has to.”
In 2024, 864 suspected overdoses were reported in Monterey County, 64 of those resulting in confirmed deaths. Another 47 deaths are pending as possible overdoses. (Year over year, California experienced a 14-percent decrease in overdose deaths from July 2023-2024 compared to 2022-2023, according to a provisional report from the U.S. Centers for Disease Control, although final numbers for 2024 are still pending; in 2023, the state reported 7,847 deaths. That year, Monterey County reported 932 suspected overdoses and 145 fatalities.)
Treating opioid dependency can be complex due to the fact “every patient is different,” Close says. “What works for one might not work for another. We find the treatment plan that will work for the patient we are taking care of.”
One tool is buprenorphine, available in tablets, films or injections. The synthetic opioid activates receptors in the brain, treating opioid withdrawal and cravings, but not causing euphoria or overdose like drugs such as fentanyl or heroin. “It’s relatively safe – you essentially can not overdose on it in isolation,” Close says. “It’s the perfect and safest answer we have.”
In addition to buprenorphine, treatment options include methadone and Sublocade. CCODP operates a clinic out of Dr. Salar Deldar’s Pacific Rehabilitation & Pain office in Monterey, where patients can receive once-a-month Sublocade injections. (Sublocade is a slow release of buprenorphine.) Close says it’s extremely powerful in stopping relapse, easing cravings or withdrawal symptoms.
With those medications in hand, Close and her group tailor treatment plans to every patient’s needs, aiming for safe, lasting healing.
Sometimes, patients commit to a plan and successfully get off of drugs and off the streets. But not always. The couple from Soledad Street in Chinatown on that cold February morning never followed up, and the team has been unable to locate them since.
BEYOND THE STREETS, THE CCODP TEAM MEETS WITH PATIENTS inside the county jail in Salinas on Thursdays and hosts mobile clinics at Lake El Estero in Monterey on Wednesdays. The Access Support Network (ASN), a harm reduction mobile service, joins these outreach efforts, providing clean paraphernalia – such as pipes, needles and wound treatment kits – to help reduce the spread of disease and infection.
“We provide medical care, we provide a doctor. We give them necessities – hygiene products, dog food, cat food. We offer donated clothes. Sometimes we have food items, sometimes butane,” says Hector Perez, a peer support specialist. “We just do whatever the homeless community needs to help them feel a little more comfortable in their situation.”
At El Estero Park, as the sun reflects off the lake midmorning on a bright, warm Wednesday, a patient approaches Close, explaining he’s unable to retrieve his prescription. Without hesitation, Perez hops into the truck and drives to pick it up at the pharmacy. He understands the stakes all too well.
Perez, recovering from methamphetamine and heroin addiction himself, once lived on the streets of Chinatown and cycled in and out of jail. He met Close while he was incarcerated and he participated in a medication-assisted treatment program.
“She was the doctor who came in every week and provided us with medication for substance use,” Perez recalls. “I built that relationship with her for about a year-and-a-half until I was released in May 2023.”
Now clean for two years, Perez shares his lived experience with people who are still struggling.
“I give them hope and inspiration that it is possible to change,” he says.
He often tells clients: “If I can do it, you can too.”
Perez now coordinates with patients preparing to be released from the jail, helping them transition directly during that vulnerable moment into rehab programs. This vital service provides an effective example of helping at all points in recovery. Being released from jail and not having a plan can be a catalyst for relapsing.
On the morning of Monday, March 10, the rising sun casts an orange glow over the Monterey County Jail. The air is brisk as Perez waits outside at the back entrance to the jail for Jon “Dakota” Farrald, who is being released after a misdemeanor drug charge. He’s there to provide Farrald his prescription for buprenorphine and drive him to Sun Street Centers in King City, where he will begin a 90-day treatment program. This friendly ride waiting for him stands to make all the difference, and can remove the opportunity for a patient to find themselves back in a familiar situation prone to use again.
Early on during their hour-long ride, Farrald tells Perez, “I appreciate you guys being here, bro. If you guys weren’t here, you know where I’m going.”
For Perez, the mission is personal: “It’s very important to me to continue doing what I do,” he says. “I feel like I’m needed out here – I want to be a role model for the people I’ve done drugs with, the people I lived that life with.”
For Close, this kind of connection is part of the success of the coalition. “The stigma, I think, is probably our greatest killer, because people are afraid of seeking treatment, afraid of how much they’re going to be judged. This is somebody’s son, somebody’s daughter, somebody’s sister. This is our community. These are the people.
“Can you imagine if we give them the opportunity and the resources to not have to live in that level of pain? That’s what it takes.”
Watch a video that accompanies this story here.