Opioid Addiction Crisis

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Compromise Opioid Bill Caps First-Time Prescriptions At 7 Days

Update March 9 at 3 p.m.: The House has unanimously passed the compromise bill (PDF). The Senate is expected to take it up Thursday.

Our original story:

BOSTON — A Massachusetts House and Senate compromise bill on how to tackle the state’s opioid epidemic includes new limits on first-time opioid prescriptions, a push to evaluate patients after an overdose and addiction screening for middle and high school students.

The provisions are not as dramatic as those proposed by Gov. Charlie Baker, but a spokeswoman said the Legislature is taking a strong step in the right direction.

Baker ignited controversy last fall when he proposed a three-day limit on first-time opioid prescriptions. The House took a step back and suggested seven days, and seven is the number in the compromise bill House members are expected to vote on Wednesday.

Liz Malia, chair of the House Mental Health and Substance Abuse Committee, said this restriction, coupled with the expectation that doctors and dentists will talk to patients about the dangers of addiction, will shift the thinking about opioids.

“We’re changing some of the culture, and in my mind that’s of the things that really has needed to to happen,” she said.

The seven-day limit includes an exception for adults with chronic pain. It has the support of the Massachusetts Medical and Dental societies.

“I think seven days is a lot more reasonable than the original three days,” said David Lustbader, an oral surgeon who is also vice president of the dental society. “That generally is enough time to get people through the acute period of pain, post surgically.”

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The Opioid Treatment Business Is Booming

Recovery Centers of America is spending some $20 million to renovate the former Hunt Hospital in Danvers into what will eventually be a 210-bed substance use treatment center. (Jesse Costa/WBUR)

Recovery Centers of America is spending some $20 million to renovate the former Hunt Hospital in Danvers into what will eventually be a 210-bed substance use treatment center. (Jesse Costa/WBUR)

Ray Tamasi, the president and CEO of Gosnold on Cape Cod, has been working in addiction treatment for more than four decades. But he’s never seen anything like what he’s seeing now: private equity investors lining up to get into the treatment business.

“I’ve been doing this for 40 years, and I’ve been doing presentations at private equity firms [that] want to understand behavioral health because they want to understand and invest in it,” Tamasi said. “I’ve done more of those in the past year than I’ve done in my entire career.”

Tamasi says several things are fueling this interest — the biggest of which is the opioid epidemic.

Only 10 percent of the estimated 700,000 Massachusetts residents who could use substance treatment actually are able to get it. There are also state and national legislative and insurance changes that have made substance use treatment a projected $35 billion-a-year business in the United States.

Hundreds of new treatment beds are being created in New England this year alone. One of the largest projects — which also represents one of the biggest private equity investments in addiction treatment — is now under construction in Danvers. Recovery Centers of America (RCA) is spending some $20 million to renovate the former Hunt Hospital into what will eventually be a 210-bed substance use treatment center. It’s set to open Aug. 1. Brad Greenstein, CEO of Recovery Centers of America, Danvers, says the center will help with the state’s opioid crisis. Continue reading

Gov. Baker Appears To Be Growing Frustrated With Lack Of Movement On Opioid Bill

Gov. Charlie Baker listens as President Obama speaks during a meeting with fellow governors at the White House on Monday. The governors spoke about the opioid addiction crisis. (Jacquelyn Martin/AP)

Gov. Charlie Baker listens as President Obama speaks during a meeting with fellow governors at the White House on Monday. The governors spoke about the opioid addiction crisis. (Jacquelyn Martin/AP)

As the second month of the year draws to a close, Gov. Charlie Baker appears to be growing more frustrated with the Legislature’s pace in passing his comprehensive opioid bill.

The legislation remains bottled up in a conference committee that’s working out the differences between the House and Senate.

“I’m hopeful that we’ll get something passed through the Legislature that we can sign and we can begin implementing … when [legislators] come back in January,” the governor said last November, after testifying in favor of his opioid bill. “If the clock’s still ticking and nothing’s happening in February or March, I’m going to start to get pretty impatient.”

And there has been progress. Last month, the House passed its version of the legislation, which is slightly different than the one passed by the Senate last fall. The major difference is the number of opiate-based pills a doctor could prescribe to a first-time patient.

A major provision of the package, the part banning the involuntary commitment of female opiate users to the state women’s prison in Framingham, was busted out of the overall bill, approved in its own right, and signed into law by the governor. But with March just a few days away, the governor says he’s worried that other initiatives will be vying for attention on Beacon Hill. Continue reading

Health Leaders Want Warnings Highlighting Deadly Risks Of Opioid, Benzo Combos

Many patients who take an opioid to relieve pain also have anxiety, headaches or trouble sleeping and take a benzodiazepine like Valium or Xanax or Klonopin. But together, these two classes of drugs slow breathing and can be deadly, especially if the patient is using one or both of them to get high.

In 2013, traces of both drugs were found in one third of men and women across the U.S. who died from an unintentional overdose. In Massachusetts, 13 percent of overdose deaths in 2014 involved heroin in combination with a benzo.

Public health leaders are calling on the FDA to make sure doctors and patients understand the risks. Continue reading

Price Of User-Friendly Form Of Overdose Reversal Drug Spikes

Evzio’s “Trainer.” (Jesse Costa/WBUR)

Evzio’s “Trainer.” (Jesse Costa/WBUR)

In the midst of the opioid epidemic, there’s a spike in the price of injectable naloxone, the drug used to reverse an overdose.

Evzio, made by Richmond-based Kaleo, is a user-friendly, pocket-sized device. The wholesale price for a kit was $690 when it hit the market in July 2014. In November 2015, the wholesale price rose to $900. At the beginning of February, it increased 400 percent to $4,500.

Health plans in Massachusetts cover Evzio. It’s “a very important component of dealing with the heroin and opioid epidemic,” said Massachusetts Association of Health Plans CEO Lora Pellegrini. “So it’s really shocking to see these price increases and I’m not sure that they’re justified.”

Kaleo CEO Spencer Williamson says the price hike is justified by the behavior of insurance companies. He has a story that explains what he means.

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Salisbury Woman’s Death Shows The Complications In Responding To Opioid Crisis

Anna Jaques Hospital in Newburyport is seen on Friday. (Jesse Costa/WBUR)

Anna Jaques Hospital in Newburyport is seen on Friday. (Jesse Costa/WBUR)

The death of a Salisbury woman this month shows how difficult it can be to coordinate the response to the opioid addiction crisis.

Gretchen Fordham received the opioid overdose reversal drug Narcan in an emergency room. But she still left the hospital with a prescription for opioid pain pills.

Hours later, police say Fordham was found unresponsive in her home.

Here’s what happened:

It was shortly after 6 a.m. on Jan. 10 when police received a 911 call from the boyfriend of 44-year-old Fordham saying she was unresponsive.

“She was transported to the hospital but was pronounced dead at the hospital,” Salisbury police Chief Tom Fowler explained. “My detective speculates that it could possibly be an accidental overdose.”

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Mass. Men Hit Particularly Hard By Opioid Crisis, New Data Show

The opioid crisis in Massachusetts is hitting men particularly hard.

Over the first nine months of 2015, 76 percent of the confirmed overdose deaths in the state were men, according to the latest quarterly opioid snapshot from the Department of Public Health.

From January through September of last year, 604 men died of opioid-related overdoses, compared with 187 women who overdosed and died over the same period, the department said.

Wednesday’s snapshot is the first time the state has released demographic data on the crisis. Continue reading

Earlier Overdose Estimates:

Health Insurers Step In To Help Stem Opioid Crisis In Mass.

For some health insurers, there are critical costs to helping members struggling with drug addiction succeed at staying healthy and off drugs. As a result, these insurers are trying new ways to offer support to those at risk. (Toby Talbot/AP)

For some health insurers, there are critical costs to helping members struggling with drug addiction succeed at staying healthy and off drugs. As a result, these insurers are trying new ways to offer support to those at risk. (Toby Talbot/AP)

For many people struggling with opioid use, a key to their success in recovery is having support. Some are getting that support from an unlikely place: their health insurer.

Amanda Jean (or “A.J.”) Andrade, 24, has been drug- and alcohol-free since October, the longest amount of time she’s been off substances in a decade. She gives a lot of the credit for that to her case manager, Will, who works for her insurance company. He’s helped her find the sober house where she moved after inpatient treatment, and he’s helping her figure out where she’ll go from there.

“Having Will is the best thing in the world for me. If I have the slightest issue with anything to do with my insurance, that included like prescriptions, even when I had a court issue, I know that I can call him,” Andrade said.

Her insurer, CeltiCare Health Plan, is one of several health insurance companies taking new steps to deal with the nation’s growing opioid epidemic. CeltiCare has about 50,000 members in Massachusetts and mostly manages care for low-income patients on Medicaid. Continue reading

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Mass. House Approves Bill Aimed At Combating Opioid Overdoses

Massachusetts House lawmakers have approved a bill aimed at addressing the state’s alarming spike in opioid overdoses and deaths, while rejecting a proposal that would have allowed doctors to involuntarily commit those suffering from overdoses to drug treatment facilities for up to three days.

The bill, which passed Wednesday on a unanimous vote, would limit initial opiate painkiller prescriptions to a seven-day supply and set an evaluation requirement within 24 hours for overdose victims seeking help at hospital emergency rooms.

State Rep. Jeffrey Sanchez said there has been a change in the public perception that no longer sees individuals struggling with opioid addiction as “junkies” and “crackheads” but rather as individuals with an illness who need help.

“With this bill, we’re trying to help people not get to the lowest of their low and never reach that trap door,” said Sanchez, a Boston Democrat and House chairman of the Joint Committee on Health Care Financing.

The House bill has significant differences from a bill filed by Republican Gov. Charlie Baker.

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In 2015, The Opioid Crisis Continued To Ravage Massachusetts

Massachusetts’ opioid crisis continued to be a major story of 2015.

Early in the year, the state released staggering statistics showing that close to four people die in Massachusetts every day from opioid overdoses. Just last week, Gov. Baker became emotional when speaking during the screening of a new HBO movie, set on Cape Cod, about the nation’s heroin problem.

WBUR’s Martha Bebinger joined Deborah Becker on Morning Edition to discuss the issue.

Earlier Coverage Mentioned: