Opioid Addiction Crisis

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New England Governors Converge To Address Opioid Epidemic

Seated from left are Vermont Gov. Peter Shumlin, Rhode Island Gov. Gina Raimondo, Connecticut Gov. Dannel P. Malloy, Maine Gov. Paul LePage, Hassan, and Massachusetts Gov. Charlie Baker. The governors met Tuesday in Boston to discuss strategies to deal with the opioid addiction problem in all their states. (Michael Dwyer/AP)

Seated from left are Vermont Gov. Peter Shumlin, Rhode Island Gov. Gina Raimondo, Connecticut Gov. Dannel P. Malloy, Maine Gov. Paul LePage, Hassan, and Massachusetts Gov. Charlie Baker. The governors met Tuesday in Boston to discuss strategies to deal with the opioid addiction problem in all their states. (Michael Dwyer/AP)

Pressing for the same or nearly the same limits on opioid prescriptions is one of the ways New England’s Republican and Democratic governors are working together to address the drug epidemic.

The six regional governors gathered in Boston Tuesday for an opioid panel.

There are some signs that efforts to slow the surge of opioid overdoses are working, but the death toll is grim. Narcan, or naloxone, the drug that reverses the effects of many overdoses, is becoming more widely available — and that’s a good thing, says Gov. Charlie Baker.

“We lost 1,500 people in Massachusetts in 2015, but my own speculation, based on the data I’ve seen, makes me think the number without Narcan would have been north of 5,000,” he said. “And it has a ton of, still, negative momentum.”

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New Addiction Treatment Implant Will Hit The Market Next Month At $4,950

A graphic shows how the implant is placed inside the skin of a person's upper arm. (Courtesy Braeburn Pharmaceuticals)

A graphic shows how the new addiction treatment implant Probuphine is placed inside the skin of a person’s upper arm. (Courtesy Braeburn Pharmaceuticals)

There’s a new tool in the fight against the nation’s raging opioid epidemic.

The FDA on Thursday approved an implantable version of the drug buprenorphine, which staves off opioid cravings. Labels for the new device are rolling off printing devices today, and trainings begin Saturday for doctors who want to learn to insert the four matchstick size rods into patients.

The implant, called Probuphine, is expected to be available by the end of June.

“This is just the starting point for us to continue to fight for the cause of patients with opioid addiction,” said Braeburn Pharmaceuticals CEO Behshad Sheldon.

But one day after the FDA approved this first long-acting delivery method for buprenorphine, debate continues about how effective the implant will be and whether insurers will cover it.

A Game Changer … Or Set Up For Failure? 

The head of the National Institute on Drug Abuse calls the new implant a game-changer because it will help addiction patients stay on their meds while their brain circuits recover from the ravages of drug use. And addiction experts say it will be much harder for patients prescribed the implant to sell their medication on the street, which is a problem for addiction patients prescribed pills.

“I think it’s fantastic news,” said Dr. Sarah Wakeman, medical director of the Substance Use Disorder Initiative at Massachusetts General Hospital. “We need as many tools in the toolbox as possible to deal with the opioid epidemic.”

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The Promise And Price Of New Addiction Treatment Implant

Amid a raging opioid epidemic, there’s a plea for more treatment options. The Food and Drug Administration expects to have a decision on one by May 27.

It’s an implant. Four rods, each about the size of a match stick, inserted in the upper arm. This new device, called Probuphine, delivers a continuous dose of an existing drug, buprenorphine, but with better results, says implant maker Braeburn Pharmaceuticals.

A graphic shows how the implant is placed inside the skin of a person's upper arm. (Courtesy Braeburn Pharmaceuticals)

A graphic shows how the implant is placed inside the skin of a person’s upper arm. (Courtesy Braeburn Pharmaceuticals)

In clinical trials, 88 percent of patients with the implants abstained from opioids, as compared to 72 percent of those taking buprenorphine as a daily pill. (Buprenorphine is commonly referred to by its brand name, Suboxone.)

“I felt completely normal all the time,” said Dave, a paramedic in a small town outside Boston who was on the implant during a clinical trial. He does not want his last name made public so that coworkers won’t find out he is addicted to opioid pain pills.

Dave, 47, has been in recovery for four years with the help of buprenorphine. Dave said he prefers the implant to the pills for several reasons. With the pills he would sometimes feel the drug wear off. He worried about his 2-year-old granddaughter getting into the bottle. And sometimes Dave would just forget to take his medication, which he’s supposed to do in the morning, 15 minutes before he has anything to eat or drink.

“With the implant you didn’t have to worry about that, you just, it was just there and you felt good all the time,” Dave said.

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State’s Opioid Epidemic Is Vividly Seen On Boston’s ‘Methadone Mile’

On “Methadone Mile,” a one-mile stretch of Massachusetts Avenue in Boston, it is not uncommon to witness people using drugs. Here, we’ve digitally blurred this person’s face to prevent identification. (Jesse Costa/WBUR)

On “Methadone Mile,” a one-mile stretch of Massachusetts Avenue in Boston, it is not uncommon to witness people using drugs. Here, we’ve digitally blurred this person’s face to prevent identification. (Jesse Costa/WBUR)

The ravages of the state’s opioid epidemic are perhaps nowhere more visible than in an area of Boston known as “Methadone Mile” — a one-mile stretch of Massachusetts Avenue in the shadow of Boston Medical Center. Continue reading

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Sudders, Bharel Discuss Release Of 2015 Opioid Death Numbers

There is still no sign that Massachusetts’ opioid epidemic is slowing.

New numbers released Monday show that 1,379 people died from unintentional opioid overdoses in the state in 2015. And that number is expected to top 1,500 once all death investigations are complete.

The data also show that more than half of the deaths last year involved the potent painkiller Fentanyl, which is sometimes mixed with heroin.

Health and Human Services Secretary Marylou Sudders and Department of Public Health Commissioner Monica Bharel joined WBUR’s All Things Considered to discuss the crisis.

The numbers the state released provide real-time information, they told us. Bharel also said the data help officials understand who is most affected by the opioid epidemic.

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Mass. Opioid Crisis Continued To Worsen In 2015

Exacerbated by the potent painkiller fentanyl, the opioid crisis in Massachusetts continued to worsen in 2015, with more people dying of overdoses, according to the latest quarterly snapshot from the state Department of Public Health.

There were 1,379 confirmed opioid-related overdose deaths in Massachusetts last year, an 8 percent increase over the number of confirmed deaths in 2014 (1,282). More alarming still, the 2014 figure represents a 41 percent increase over the number of overdose deaths in 2013 (911). Continue reading

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Some Doctors Say Focus Of Opioid Addiction Treatment Must Shift From Medication To Long-Term Recovery

While most say medication-assisted treatment for opioid addiction improves patient outcomes, some doctors are questioning seeking a cure from the same industry they say caused the problem. Pictured here, OxyContin, an opioid, is seen in a pharmacy in 2013. (Toby Talbot/AP/File)

While most say medication-assisted treatment for opioid addiction improves patient outcomes, some doctors are questioning seeking a cure from the same industry they say caused the problem. Pictured here, OxyContin, an opioid, is seen in a pharmacy in 2013. (Toby Talbot/AP/File)

While addiction treatment providers are increasingly recommending that medication be used to help wean people off opioids, some doctors are concerned there is now too much of a focus on medication and not enough on the harder work of long-term recovery from substance use disorder.

During the annual American Society of Addiction Medicine conference in Baltimore last month, a frequently heard statistic was that every 20 minutes someone in the U.S. dies from an opioid overdose.

“Imagine if we had someone in America dying from terrorism every 20 minutes,” Vermont Gov. Peter Shumlin said. “You wouldn’t have to just take your shoes off at the airport, you’d have to take everything off.”

Shumlin became a leading political voice on the opioid epidemic after dedicating his 2014 state of the state address to the problem in Vermont. Shumlin told the 1,800 people at the Baltimore conference that the nation needs their help to reduce the 250 million prescriptions written for opioid painkillers every year.

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As Mass. Grapples With Opioid Crisis, More Babies Are Being Born Exposed To Drugs

Shortly after birth, James, who is now 1, was diagnosed with neonatal abstinence syndrome and given small doses of morphine to get him through the withdrawal. Here, James works with occupational therapist Victoria Peake at MGH's Newborn Developmental Follow-Up Clinic, as Dr. Leslie Kerzner, left, and James' adoptive mother, Kristen Fontaine, center, look on. (Jesse Costa/WBUR)

Shortly after birth, James, who is now 1, was diagnosed with neonatal abstinence syndrome and given small doses of morphine to get him through the withdrawal. Here, James works with occupational therapist Victoria Peake at MGH’s Newborn Developmental Follow-Up Clinic, as Dr. Leslie Kerzner, left, and James’ adoptive mother, Kristen Fontaine, center, look on. (Jesse Costa/WBUR)

Massachusetts hospitals are seeing evidence that the opioid epidemic is affecting the next generation, with an increasing number of babies being born exposed to drugs.

The most recent state hospital data suggest that the rate of drug-dependent newborns has skyrocketed to about 16 in every 1,000 births — about three times the national average.

At Massachusetts General Hospital, doctors started following drug-exposed babies about three years ago. Dr. Leslie Kerzner, director of the Newborn Developmental Follow-Up Clinic at MGH, tracks the babies until age 2. She says the vast majority of infants exposed to drugs in utero will experience withdrawal symptoms similar to those of an adult going through withdrawal. (Click here for a video from MGH of an infant displaying symptoms of withdrawal.) 

“A baby going through withdrawal is very disorganized,” Kerzner explained. “They go from state to state, from alert awake to crying, you know, it’s like zero to 60 in just a couple of seconds. They have increased muscle tone, a high-pitched cry. They’re not easy to soothe. They may be throwing up, have diarrhea, mottled skin. They are not healthy looking.”

Most of the moms that gave birth to exposed babies at MGH in the past year were white, their median age was about 30. More than 30 percent of the moms were prescribed opioids for chronic pain. Close to 90 percent of the pregnancies were not planned.

One of those babies was 1-year-old James. Shortly after birth he was diagnosed with what’s called neonatal abstinence syndrome and given small doses of morphine and another drug to get him through the withdrawal.

James crawls after a rubber duck during a recent checkup at the Newborn Developmental Follow-Up Clinic at MGH. (Jesse Costa/WBUR)

James crawls after a rubber duck during a recent checkup at the Newborn Developmental Follow-Up Clinic at MGH. (Jesse Costa/WBUR)

“James did go through neonatal abstinence syndrome, requiring medical therapy with both morphine and phenobarbital — which is not unusual when a baby might have been exposed to other things,” Kerzner said. “Many of the moms are poly-substance users.”

Doctors knew that James had been exposed to methadone. Kristen Fontaine and her husband got involved when they were contacted by a social worker caring for the infant. They were looking to adopt and came to see James at MGH’s special care nursery.

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Sudders: Combating Mass. Opioid Crisis ‘Is Going To Take Us Time,’ Even With New Law

Secretary of Health and Human Services Marylou Sudders speaks about the opioids legislation signed into law just moments earlier by Gov. Charlie Baker on Monday. (Jesse Costa/WBUR)

Secretary of Health and Human Services Marylou Sudders speaks about the opioids legislation signed into law just moments earlier by Gov. Charlie Baker on Monday. (Jesse Costa/WBUR)

A new law designed to stem the deadly opioid drug abuse crisis in Massachusetts was signed into law Monday by Gov. Charlie Baker. On Tuesday, the governor will also meet with his opioid working group to discuss implementing the new law.

Massachusetts Health and Human Services Secretary Mary Lou Sudders is part of that group and joined Morning Edition to discuss the new law. Continue reading

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Baker Signs Compromise Opioid Bill Into Law

Surrounded by lawmakers and health and public safety officials, Gov. Charlie Baker signs the opioid bill into law on Monday at the State House. (Jesse Costa/WBUR)

Surrounded by lawmakers and health and public safety officials, Gov. Charlie Baker signs the opioid bill into law on Monday at the State House. (Jesse Costa/WBUR)

Massachusetts Gov. Charlie Baker has signed into law a compromise bill that seeks to alleviate the state’s opioid crisis.

The Republican governor signed the legislation Monday morning at the State House, surrounded by a bipartisan group of lawmakers and various health and public safety officials. The Democratic-led state House and Senate both unanimously passed the measure last week.

The bill includes a seven-day limit on first-time opioid prescriptions, new efforts to evaluate patients within 24 hours after an overdose and addiction screening for middle and high school students.

“This is a very important day here in the commonwealth of [Massachusetts]. Today, I just signed the most comprehensive measure in the country to combat opioid addiction,” Baker said to applause from the audience.

The governor delivered an emotional speech following the signing, choking back tears as he spoke about the stories he’d been told by those affected by the state’s opioid addiction epidemic. Continue reading

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