Government leaders crafting response to heroin epidemic

06.16.2015

This article originally appeared in the  Gloucester Times

By Christian M. Wade

BOSTON – A surge in deadly heroin overdoses is forcing state leaders in Massachusetts to rethink how to combat drug trafficking while improving access to treatment for addicts.

Last year the Massachusetts Legislature approved a raft of laws to fortify the state’s response to substance abuse. Many go into effect this year.

But a sharp increase in overdoses – more than 1,000 in the past year, which public health officials largely attribute to cheaper and purer heroin – has lawmakers revisiting the issue.

Their latest efforts focus on prescription painkillers as a gateway to heroin addiction. Lawmakers and other state officials say they’ll start targeting doctors who over-prescribe opioids, devote more dollars to early-intervention programs and beds at treatment centers, and beef up the powers of police to bust narcotics dealers.

Attorney General Maura Healey, a Democrat who took office in January, said she plans to unleash the power of her office to get control of the problem.

“Families across Massachusetts are being torn apart by this epidemic,” Healey said in an interview. “And what we have learned is that the majority of people who get hooked on heroin started with prescription drugs.”

Healey’s multifaceted plan includes expanding the authority of the state’s prescription drug monitoring program, a website that allows doctors and pharmacists to view a patient’s recent prescriptions, while making it easier for law enforcement and clinicians in other states to share data.

She wants to crack down on pain management clinics — so-called “pill mills” — that generously dole out addictive prescription drugs like Oxycontin. She aims to address ways that painkillers are marketed, prescribed and dispensed that lead to opiate abuse.

She also pledges to ramp up prosecution of narcotics traffickers and she supports proposals to update wiretapping laws to target dealers.

In April, her office filed a lawsuit against The Center for Psychiatric Medicine in North Andover, alleging that it was “unlawfully profiting” from patients who sought treatment for opiate addiction, charging hundreds of dollars in cash per visit and allowing them to avoid counseling services.

Last month, two Lawrence men were arraigned in connection with a massive drug trafficking operation in which more than $1 million of heroin was seized.

Healey has created an internal task force of prosecutors, civil enforcement attorneys, health care professionals, drug abuse prevention experts, investigators and law enforcement officials.

One issue the group is taking up is the rising cost of naloxone - a drug that reverses the effects of opiate overdoses. Recent news reports have detailed how prices for kits containing the drug have gone from $22 to $40 - in some cases more than $100.

Healey said she has asked at least one manufacturer, California-based Amphastar Pharmaceuticals, for answers.

“So many people increasingly depend on this life-saving drug, but we don’t want anyone to be profiting from this epidemic,” she said.

Massachusetts isn’t alone in its scramble to handle a spate of overdoses. In New Hampshire, lawmakers are considering immunity from arrest and prosecution for drug possession for anyone who seeks medical help on behalf of someone else dying of an overdose. Massachusetts lawmakers approved a similar measure in 2012.

Health officials in several other northeastern states -- Maine, New York, New Jersey and Pennsylvania -- say they’ve been overwhelmed by waves of fatal overdoses, as well.

On a national level, President Barack Obama is asking Congress for $133 million to fight overdoses from prescription painkillers and heroin. Nearly half of that money will go to states, while the rest will be devoted to federal programs.

Gov. Charlie Baker, a Swampscott Republican, has also pledged to make the opiate crisis a priority of his administration.

Baker, a former healthcare executive, has talked about requiring hospitals to report all overdoses to the state and forcing physicians to consult state guidelines when writing prescriptions for opiates.

Baker will get plenty of support from the Democratic-controlled Legislature. Both Senate President Stanley Rosenberg and House Speaker Robert DeLeo have identified the opiate crisis as a major concern of the two-year legislative session that began in January.

Lawmakers have filed dozens of bills related to the crisis -- increasing prison terms for traffickers, putting more money to prevention and treatment, and expanding police powers.

Sen. Barabra L’Italien, D-Andover, said she, like many other lawmakers, is focused on the progression from prescription drugs to heroin addiction. She urges the need to change a culture of over-reliance on pain medication.

“I’ve had three of my children, 18 to 20 years old, get wisdom teeth removed, and they’ve been prescribed opioids,” said L’Italien. “The reality is there’s a certain percentage of kids who are going to get hooked.”

Lawmakers have also earmarked tens of millions of dollars in the coming budget year to combat the opiate epidemic. Money is pegged to a range of treatment services, including detoxification, clinical stabilization, transitional support, residential services and outpatient treatment.

The Senate also authorized a bulk-buying program to help communities stockpile Naloxone at discounted rates.

The Legislature’s efforts this session will build on laws approved in recent years. They include a requirement that insurers cover two weeks of inpatient drug treatment. Insurers are also forbidden from requiring a physician referral for drug treatment.

Another provision increased access to Naloxone by law enforcement and other first responders. Lawmakers set aside more than $20 million last year for programs and initiatives.

In addition, they required medical examiners to report overdose deaths to state health officials, making it easier to spot trends and intervene to reduce the risk of additional overdoses.

Sen. Jennifer Flanagan, D-Leominster, who chairs the Legislature’s Joint Committee on Mental Health and Substance Abuse, is leading a special committee to monitor the state’s response to the heroin crisis.

The committee, which includes Sens. Joan Lovely, D-Salem, and Kathleen O’Connor-Ives, D-Newburport, is reviewing how existing laws are working and could propose new measures.

Flanagan said a major issue is access to drug treatment at methadone clinics or inpatient detoxes.

“We need to treat addicts with more than just emergency room visits,” she said. “We need a better system where people have the tools to kick their addiction, not just treating them and sending them on their way.”

Overprescribing pain medication -- in what she described as a “pill-popping society” -- is another concern.

“We’re not trying to take away pain medication from people who have chronic illnesses,” she said. “But there’s a significant difference between someone who is suffering from a chronic illness and wants to be pain-free and someone who has a tooth extraction and gets prescribed three months of narcotics.”


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