Pubdate: Thu, 01 May 2014
Source: Worcester Telegram & Gazette (MA)
Copyright: 2014 Worcester Telegram & Gazette
Contact:  http://www.telegram.com/
Details: http://www.mapinc.org/media/509
Note: Rarely prints LTEs from outside circulation area - requires 
'Letter to the Editor' in subject
Authors: Kathleen M. Jordan and Lee Dalphonse
Note: Kathleen M. Jordan is Senior Vice President & Chief Program Officer of
Seven Hills Foundation. Lee Dalphonse is Vice President of Seven Hills
Behavioral Health.

FIGHT AGAINST OPIOID ABUSE

The full impact of the abuse of opioids -- illegal drugs such as 
heroin, and potent prescription pain medications such as hydrocodone 
and oxycodone -- has not been widely known by the public.

Until now.

The opioid addiction epidemic and its life-altering consequences have 
generated countless newspaper headlines and television reports in 
recent months, including the Telegram & Gazette's special report, 
"Painful Prescription," which closely examines how the problem 
affects people in Central Massachusetts.

Effective action must be taken soon and some critical policy changes 
made. This public catastrophe is affecting too many lives, not only 
men, women, and youths directly, but with broader painful impacts on 
families and relationships. And it affects our economy, as those who 
cannot get the proper treatment and continuing care to maintain their 
health are frequently unable to support themselves or others.

This crisis is not confined to a particular geography. From urban 
Boston and Worcester streets to the affluent western suburbs to the 
Cape and the Berkshires, the problem is seen throughout the state. 
The effects of this powerfully addictive narcotic are seen among the 
employed and the unemployed, old and young (but increasingly the more 
vulnerable young), among students and dropouts, among the privileged 
and the poor.

Drugs, more powerful than ever before in our lifetime, sometimes 
contaminated, are also cheaper today than ever before. Increasingly 
the drugs are not even injected but simply inhaled, thereby 
eliminating one of the traditional barriers to heroin use: the need 
to use a syringe. The effects are often immediate, and the casualties 
are our fellow human beings, ill or fatally injured, sometimes 
tragically found in doughnut shop bathrooms or dark corners of 
parking garages by strangers, if not at home by loved ones.

Addiction is the root of the problem.

The commonwealth has reasonably extensive capacity for detoxification 
of victims of some drugs, but the only detox for opiate abuse lies in 
methadone clinics, and there are too few of those. In any case, detox 
alone does not solve the problem.

The state lacks rehabilitation capacity that is even remotely up to 
the scale of the crisis that we are seeing today. People who use and 
abuse drugs are detoxified for a day or a week. But they often go 
right back to their addictive ways -- that is what addiction is about.

We as a society are not powerless to let this explosion of pain and 
death continue. There are ways to treat the problem, and treat it 
effectively. Studies have demonstrated that timely access to 
substance abuse treatment, with integrated primary medical care, is 
effective at reducing fatal and nonfatal overdoses and the drain on 
fiscal and health care resources.

The drug naloxone (known often by its brand name Narcan) is nothing 
short of a wonder drug in the context of an overdose. When it is 
administered, physical revival is almost immediate, averting costly 
hospitalizations as well as many deaths. Many first responders are 
now carrying naloxone, but more must be done to improve access to the drug.

For the longer term, a crucial financial inconsistency must be 
addressed. Many Massachusetts-based addiction programs are severely 
threatened by inadequate reimbursement rates. Massachusetts Medicaid 
reimbursement rates for these programs often cover only 70 percent of 
the actual cost of care. An estimated 80 percent of the mental health 
and substance programs have been shuttered or are at risk of insolvency.

Funding for behavioral health programs has plummeted, with states 
slashing budgets by a combined $4 billion in a four-year span ending 
in 2012, according to Mental Health America. This at a time when we 
are in full-blown crisis.

Despite goals set by the commonwealth itself, there is also a serious 
shortage of truly integrated addiction and primary-care programs. And 
integration of services at the provider level is hampered by 
ever-changing regulatory hurdles, not to mention a fragmented funding regime.

The state and its private partners in care and treatment must find a 
way to provide care that is community-based and focused more on 
outpatient care -- it is better for those treated and less costly. 
And we need to eliminate barriers that prevent same-day medical and 
behavioral health billing by care providers. It is not duplicative -- 
it is collaborative and it is what works.

The evidence is clear. Massachusetts is in a state of emergency that 
is preventable, and its citizens are dying every day. We must take 
actions that are right in front of us to stem this unconscionable 
tide of suffering.
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MAP posted-by: Jay Bergstrom