Pubdate: Wed, 11 Jun 2014
Source: Boston Globe (MA)
Copyright: 2014 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Brian MacQuarrie

PATRICK AIRS $20M PLAN TO COMBAT OPIOID USE

More Treatment and Insurance, Regional Strategy

Governor Deval Patrick unveiled plans Tuesday to upgrade treatment 
for opioid addicts, expand insurance coverage, and coordinate with 
the other five New England governors to stem an epidemic that has 
claimed hundreds of lives in Massachusetts since last fall.

Key elements of the $20 million plan, which could create hundreds of 
new treatment beds, target the needs of adolescents and young adults, 
who made up about 40 percent of clients treated in fiscal 2013 by the 
state's Bureau of Substance Abuse Services.

Among other recommendations, developed by a task force created in 
March, the state would provide four more residential treatment 
programs and five home-based programs to serve teenagers and young adults.

"These actions will help enhance our network of treatment and 
recovery services to help communities and families struggling with 
addiction," said Patrick, who unveiled the plan in Boston at William 
J. Ostiguy High School, which supports adolescents struggling with 
substance-abuse issues.

The governor also announced that New England governors will meet next 
Tuesday at Brandeis University in Waltham to discuss a regional 
strategy to confront a crisis that transcends state borders.

In January, Governor Peter Shumlin of Vermont devoted his entire 
State of the State address to the opioid epidemic. And in Rhode 
Island, state officials have acted swiftly and aggressively since 
large clusters of overdoses and related deaths began increasing early 
this year.

Cheryl Bartlett, the Massachusetts public health commissioner, said 
the plan reflects a "heightened level of awareness" among families, 
government, and law enforcement officials across the state that more 
needs to be done.

Many of the additional programs proposed by Patrick would require 
legislative approval for funding, and the state Senate has put 
forward a parallel plan.

 From 2000 to 2012, fatal opioid overdoses increased 90 percent in 
Massachusetts, according to the state Department of Public Health.

But deaths appeared to rise dramatically beginning last fall, 
prompting cities and towns to urgently develop a response as 
overdoses accumulated in often-unprecedented numbers.

"This is a wave of a crisis that is coming across the country," 
Bartlett said by phone.

Hard-hit regions and demographic groups are addressed in Patrick's plan.

In one example, a detox facility would be created in Franklin County, 
which has no such service now. Addicts and others struggling with 
substance abuse in that sparsely populated county, which borders 
Vermont, often forgo treatment rather than travel elsewhere for help.

"This is a home run for Franklin County," said John Merrigan, the 
county's register of Probate and Family Court. "It's a start for us. 
It's the first step in the treatment aspect of what we need to do for 
our region."

In other efforts to fill gaps in services, the task force recommended 
creating a family residential treatment program and two adult 
residential facilities that would give priority to Hispanic people 
and single adults with children.

The recommendations also push for a mandatory level of treatment that 
private insurers should cover.

To reach that goal, the Health Department, state Division of 
Insurance, and state Health Policy Commission will undertake a 
thorough review of current coverage.

Patrick said he has heard "story after story" from patients whose 
private insurers have told them to look for coverage instead with 
MassHealth, the state's insurance plan for low- and moderate-income residents.

"I'm done with it," he said. "That has to get fixed."

The plan would also create a central database, accessed through a 
toll-free number, that provides a real-time inventory of beds and 
other treatment resources. Many counselors complain that they call 
facilities over and over, often every day, only to be told that no 
beds are available or to call back for clients who need help immediately.

Another key recommendation, Bartlett said, is to develop state 
regulations that help reduce the diversion and misuse of prescription 
painkillers, often cited as a gateway to heroin addiction.

Under Patrick's emergency declaration in March, physicians are 
required to register with the Prescription Monitoring Program, which 
can provide doctors with a history for patients, some of whom might 
try to "doctor-shop" and stockpile opioids quickly from different prescribers.

One drug that Patrick has targeted is Zohydro, a new opioid 
painkiller that critics say is dangerously potent. The state banned 
the drug in April, but US District Court Judge Rya Zobel overturned 
that prohibition, saying the state had no authority to ban a drug 
approved by the federal Food and Drug Administration.

Patrick's administration responded by placing new restrictions on 
Zohydro, such as requiring doctors to prescribe the drug only when 
all other treatment remedies fail.

On Tuesday, lawyers for Zogenix, the maker of Zohydro, called on 
Zobel to strike down those restrictions.

Zobel said she would consider the case.

The task force recommendations call for an aggressive campaign to 
educate the public about the drug epidemic and encourage discussion 
about an illness long branded with a stigma that discourages some 
users from seeking help.

"I hope this work results in more families talking openly about 
issues of addiction in order to spark the process of healing and 
recovery," Patrick said.

Merrigan, the Franklin County register of probate, said awareness of 
the scope and signs of the problem is crucial. Some of Merrigan's 
family members have been afflicted by addiction, he said.

"From what I've seen personally, you can get blindsided by this 
because you don't know what the signs are. You don't know what to 
look for," Merrigan said.

The task force also called for enhanced counseling and treatment 
programs for inmates, particularly those preparing to leave prison 
and rejoin society. That would include additional money to expand the 
use of Vivitrol, a drug that can be self-injected to reduce the 
cravings for opioids.

Joanne Peterson, founder and director of Learn to Cope, an 
organization that offers support to families of substance abusers, 
called the plan an important step forward, particularly its emphasis 
on tightening the distribution of prescription opioids.

"This has been a crisis for many years, particularly the last year, 
which has been the worst I've ever seen since I've been running this 
organization," Peterson said. "Too many people have lost their loved ones."

Milton Valencia of the Globe staff contributed to this report.
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MAP posted-by: Jay Bergstrom