Proposal: California RELIEF Act: Restorative Evidence-based Low-risk Integrative Expansion for Functional Pain Care
The RELIEF Act in three sentences: Use a small share of existing opioid settlement money —
about 1.6% of what California and its counties already receive each year — to test whether better
access to non-opioid pain care (acupuncture) reduces opioid prescribing and repeat emergency room use. Evaluate it independently. End it automatically if it does not perform.
The Problem in Plain Terms
Nearly 8,000 Californians died from opioid-related overdoses in 2023. That is roughly 22 people every day.Despite billions spent on addiction treatment and emergency response, those numbers have plateaued at a high level — not fallen. Something upstream is not being addressed.
That something is chronic pain. For a significant share of people who end up dependent on opioids, the path began with pain that was undertreated, with a prescription that was the easiest option available, and with no practical non-opioid alternative that was affordable and accessible at the point of care. That is not a personal failure. It is a system failure.
What the RELIEF Act Proposes
The RELIEF Act proposes a five-county, five-year pilot program that places licensed acupuncturists inside existing healthcare and emergency room pathways in Los Angeles, San Francisco, Sacramento, Kern, and Humboldt counties.
The goal is to give patients with chronic pain a non-opioid option before they are prescribed long-term opioids or end up in the emergency room repeatedly because their pain is unmanaged.
This is not a claim that acupuncture cures addiction. It does not. The proposal is clear about that. What it tests is a simpler question: if we make non-opioid pain care more accessible earlier, does that reduce howmany people end up on the opioid path in the first place?
How the Money Works
The RELIEF Act requires no new taxes and no new state budget appropriation. California is already
receiving hundreds of millions of dollars each year from lawsuits won against opioid companies. The law requires that money to be used for opioid remediation. Preventing future opioid dependency by improvingpain care qualifies as remediation.
What Makes This Responsible
Five counties only, five years only. This is not a statewide program. It is a bounded test with a
defined end date.
Independent evaluation with public results. A separate evaluator, not connected to the program, will assess whether it is working. Results will be published annually.
Pre-specified success thresholds. Success criteria are set before the pilot starts, not after. The
program cannot move the goalposts.
Automatic sunset. If the pilot does not meet its targets by Year 5, it ends. There is no default
continuation.
Does not replace existing treatment. This pilot does not touch funding for medications for opioid use disorder, naloxone, counseling, or harm reduction.
Equity built in. County plans must show they are reaching the populations that bear the greatest
burden of overdose deaths, with language access and transportation support required.
What the Science Says
Acupuncture for chronic pain is not fringe medicine.
- The Centers for Disease Control and Prevention lists it among recommended non-opioid pain options.
- Medicare covers it for chronic low back pain.
- The Department of Veterans Affairs uses it in pain management programs.
- A 2025 clinical trial funded by the National Institutes of Health, involving 800 adults over 65 with chronic low back pain, found that acupuncture recipients had measurably less disability and better physical function at both six months and one year, with few side effects.
The evidence for acupuncture as a treatment for addiction — by itself — is not strong enough to make that claim, and this proposal does not make it. The pilot is about pain care before opioid dependency develops, not about treating dependency after the fact.
Who This Is For
The RELIEF Act is designed for people who are in pain, who are at risk of being prescribed long-term
opioids, or who have already had an overdose-linked emergency encounter and need a non-opioid
follow-up option. It is designed for communities — like Humboldt County, which has an opioid death rate five times the state average — that are carrying a disproportionate share of the crisis. And it is designed for a healthcare system that currently defaults to opioids not because they are always the best option, but because non-opioid alternatives are not reliably available at the point of care.
We are looking for feedback on this proposal. We are stress-testing this before it goes any further. Three questions we are actively looking to
challenge:
• "Why acupuncture specifically, not physical therapy or something else?" (We argue: faster deployment in high-throughput settings, minimal equipment, established Medicare coverage pathway.)
• "Is this scope creep on settlement funds?" (We argue: preventing future dependency is remediation. The settlement framework supports it.)
• "What about the acupuncture workforce — are there enough practitioners?"
Does this hold up to your scrutiny?
What is the strongest argument against it? We want to hear the hardest questions before proposing fully.