Opioid Addiction Crisis

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Overdose Deaths From Opiates May Be Down In Mass. — But It’s Too Early To Say

The number of unintentional opioid overdose deaths may be dropping in Massachusetts. (Click to enlarge)

The number of unintentional opioid overdose deaths may be dropping in Massachusetts. (Click to enlarge)

The bars to the far right of the above chart could signal a really good story. They might show that the number of unintentional opioid overdose deaths is dropping after a period of historic highs. But hold those sighs of relief.

It does look like the trend is moving in the right direction, “but a three-month time is really too short to say that,” said Department of Public Health Commissioner Monica Bharel. “The epidemic continues to take a heavy toll on our residents.”

The overdose death numbers are fluid. Take a look at the data posted this summer by the Baker administration — which, by the way, is fulfilling a promise to release updates quarterly rather than every two years, as had been the rule. Back in July, it also looked like the number of men and women dying after a lethal dose of heroin or other opioid-related use was on the decline. But the data out Wednesday shows that was not the case. Continue reading

Legislative Leaders Caution On Aspects Of Baker’s Plan To Tackle Opioid Crisis

State House and Senate leaders are expressing serious skepticism with a part of Gov. Charlie Baker’s plan to tackle the opioid abuse crisis: a proposal to let doctors hold addiction patients against their will for up to three days while trying to place them in treatment.

House Speaker Robert DeLeo is worried that the governor’s plan for involuntarily holding drug users takes a judge out of the decision-making process.

“Further discussion is going to be necessary, I think, to ease my mind that we have that independent person whether their freedom would be taken away or not taken away,” DeLeo said Monday afternoon.

Senate President Stan Rosenberg says he gives the governor’s plan a “yellow light.”

“We know that people are in rough shapes in many of these situations, but we have to be really careful that we don’t deny them their liberties and their ability to make decisions and choices,” Rosenberg, who met with DeLeo and Baker Monday, told reporters.

Both leaders also expressed concern with the governor’s plan to limit first-time prescriptions for opioid painkillers to a three-day supply.

Aides to the governor have said there would be exceptions for emergency medical conditions and palliative care, but Baker has said he believes it’s time to crack down on opioid prescribing.

The Massachusetts Medical Society and the Massachusetts Dental Society expressed opposition to Baker’s pain pill proposal, when he unveiled it last week as part of a larger package.

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Baker’s Proposed Limit On First-Time Opioid Prescriptions Ignites Controversy

Gov. Charlie Baker faces reporters during a State House press conference Thursday, during which he announced legislation aimed at addressing the state's opioid abuse epidemic. (Steven Senne/AP)

Gov. Charlie Baker faces reporters during a State House press conference Thursday, during which he announced legislation aimed at addressing the state’s opioid abuse epidemic. (Steven Senne/AP)

Updated at 7 p.m.

BOSTON — Gov. Charlie Baker is igniting controversy with two parts of a bill he says is needed to fight the state’s growing opioid epidemic.

Baker wants to reduce the chances that patients will become addicted to opioid pain pills, and then heroin, by capping all first-time opioid prescriptions at a three-day supply. Continue reading

Earlier:

‘Dealing With The Immediate Crisis’: What It's Like For EMTs Responding To Overdose

Boston Emergency Medical Services Deputy Superintendent Edmund Hassan (Jesse Costa/WBUR)

Boston Emergency Medical Services Deputy Superintendent Edmund Hassan and his colleagues regularly revive people struggling with drug addiction from overdose. (Jesse Costa/WBUR)

His ambulance sirens blaring and several police scanners transmitting information simultaneously, Boston Emergency Medical Services Deputy Superintendent Edmund Hassan is speeding to a call that someone is unconscious. Because his workers administer the overdose reversal drug naloxone (more commonly known by its brand name, Narcan) about three times a night, he suspects it’s an opioid overdose.

The radios crackle, and it’s confirmed: an overdose. Additional workers are dispatched to the scene.

Hassan stops at a single-family home in South Boston. A team of emergency workers and firefighters is already there. Several people are running to the back of the house and down some steps into the basement. In the far corner, a middle-aged man is on the ground, two people are sobbing nearby. The crew rushes to administer the Narcan, squirting it into the man’s nose.

“OK, he’s getting some Narcan now,” Hassan explains to a woman standing nearby clenching her arms around her body. “You just found him here?” he asks.

“Yes,” she says, tears in her eyes. “He’s my husband.”

Continue reading

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To Help Combat Drug Abuse, Drop Off Your Old Medications At Drug Take-Back Day Saturday

Gov. Charlie Baker is urging residents to take part in Saturday’s national drug take-back day by dropping off their old or unused prescription medications at one of the state’s 170 participating sites. (e-MagineART via Flickr)

Gov. Charlie Baker is urging residents to take part in Saturday’s national drug take-back day by dropping off their old or unused prescription medications at one of the state’s 170 participating sites. (e-MagineART via Flickr)

Gov. Charlie Baker wants you to clean out your medicine cabinet this weekend.

Baker is urging residents to take part in Saturday’s national drug take-back day by dropping off their old or unused prescription medications at one of the state’s 170 participating sites.

Across the state Saturday, sites from schools to police stations to senior centers will be accepting prescription drop-offs from 10 a.m. to 2 p.m. Collection sites can accept any pills or patches, but no liquids or needles.

“I urge the Commonwealth to open their medicine cabinets and take advantage of this convenient and effective program in your communities,” Baker said in statement released Friday. “Medications can be misused, and as we’ve seen with the opioid crisis, the results can be deadly.”

Holding and promoting drug take-back events was one of several recommendations from the governor’s Opioid Working Group, which was charged with coming up with ways to help stem the opioid addiction crisis in the state.

“Certain medicines that are left lying around, such as painkillers, are highly susceptible to being stolen and sold on the street,” Lt. Gov. Karyn Polito said in the statement. “This free service addresses a vital public safety issue. Old prescription drugs can be dropped off — no questions asked.”

A full list of participating sites is available here.

After 7 Overdoses, Joey Searches For A Reason Why He’s Still Here

Joey feeding the birds in the morning in Bellingham Square. (Jesse Costa/WBUR)

Joey, who recently started using methadone to try and kick his heroin addiction, feeds the birds in Bellingham Square in Chelsea. “People say that you OD two or three times, the third time you usually die. I OD’d seven times and I’m still here, so someone up there is watching me,” he says. “Someone has a purpose for me or a plan, but I keep waiting for that purpose of plan or purpose and I can’t find it.” (Jesse Costa/WBUR)

It’s the first few minutes of the early morning that are really hard for Joey. For about nine years, until just a few months ago, he’d wake up — in a bed or on a park bench or under the Tobin Bridge — and immediately put a needle in his arm.

“I would always save a shot of heroin for myself for the morning to get myself going,” Joey, 47 says — just enough to keep the vomiting and tremors of withdrawal at bay. (He asked that we only use his first name because he’s still using the drug, and dealing a little, and we agreed.)

Joey says he misses the whole morning routine in a small way — like how some people crave the smell, look and taste of coffee in the morning. His face softens as he describes “opening the bag, pouring [heroin] in the cooker, pouring the water in it, drawing it up, seeing the blood in the needle, that’s all a part of the high,” he said — all part of the anticipated euphoria, all part of the power of heroin. Continue reading

No Blame, No Shame: Treating Heroin Addiction As A Chronic Condition

Ever heard of a diabetic patient who ate a large muffin before having a blood glucose test, was scolded for giving in to temptation, and then told to just say no to carbs?

How about a cardiac patient who has a worrisome stress test and is shown the door when she admits to eating a few Big Macs?

That kind of response is all too familiar for patients whose brains have been altered by heroin or other opiates.

“We blame patients for their disease,” says Dr. Sarah Wakeman. “We also kick people out of treatment for having symptoms of their disease with addiction, which would honestly be malpractice if we did that with other conditions.”

Wakeman runs the Substance Use Disorders Initiative at Massachusetts General Hospital, where treating addiction as a chronic condition, like diabetes or asthma or high blood pressure, is the norm.

Patients are screened using questions that determine if they are at risk for addiction. There’s an assessment. Then Wakeman and her patients work on lifestyle changes, decide what medication will help break the addiction, and meet frequently to monitor progress. Continue reading

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Baker Enlists Help Of Medical Schools In Fight Against Opioid Addiction Crisis

Gov. Charlie Baker met with the deans of the state’s four medical schools on Wednesday to enlist their help in fighting the opioid addiction crisis here.

Deans from UMass Medical School, Harvard Medical School, Boston University School of Medicine, and Tufts School of Medicine, as well as the leadership of the Massachusetts Medical Society, met with the governor to discuss an effort to better educate medical students in pain management and “safe opioid prescribing methods.”

“The avenue prescription pain pills can provide to addiction and heroin use further stresses the need for advancing safe and responsible prescribing methods in the medical community,” Baker said in a statement.

According to that statement, those at the meeting agreed to work together towards developing best practices, enhancing their school’s curriculum, and identifying opportunities for collaboration across institutions.

Developing better training for doctors was one of several recommendations made by Baker’s opioid working group, which was tasked with figuring out ways to help stem the addiction crisis in the state.

Continue reading

Everett Families, Doctors And First Responders Work To Combat Spike In Overdose Deaths

Struggling to find resource for her son as he battled his heroin addiction, Patti Scalesse decided to start the group Everett Overcoming Addiction. It brings together parents and patients who are learning to manage  substance abuse disorder. (Hadley Green for WBUR)

Struggling to find resources for her son as he battled his heroin addiction, Patti Scalesse decided to start the group Everett Overcoming Addiction. It brings together parents and patients who are learning to manage substance abuse disorder. (Hadley Green for WBUR)

Patti Scalesse says she never saw it coming. Even when she found a syringe cap in her car three years ago and called her son, Francis Kenney, to tell him not to let his friends get high in her car. When Kenney then told her they needed to talk, Scalesse never expected to hear that her boy was addicted to heroin.

“Not my kid, my kid would never use drugs, he was a Marine,” Scalesse remembers thinking. “Well guess what, he did.”

Kenney, then age 21, was discharged from the Marines with a prescription for pain medication. Within a year of his release, Scalesse says, he had switched to heroin and was asking her for help.

“I thought, OK, I’ll pack him a bag, give him a pillow, bring him to detox, five days later he’ll be home and everything will be OK. No one tells you that the next two to three years of your life is just pure chaos.”

– Patti Scalesse, speaking about her son's battle with addiction

They met in a park, down the street from a pizza joint where Scalesse learned her son routinely went into the bathroom to get high. Scalesse absorbed the shock and started figuring out how to fix the problem.

“I thought, OK, I’ll pack him a bag, give him a pillow, bring him to detox, five days later he’ll be home and everything will be OK,” she says with a dry laugh. “No one tells you that the next two to three years of your life is just pure chaos.”

Chaos, because Kenney relapsed several times, and Scalesse realized she didn’t know what to do.

“I went to the police station and city hall to see what sort of information I could get to get my son some help. Nobody had anything. They gave me a 1-800 number with a Post-it note,” Scalesse says.

So she started a group, Everett Overcoming Addiction, that brings together parents and patients who are learning to manage this chronic illness. Her son, now 24, spoke at a rally. Kenney has been off heroin for 10 months and has a job. But as Scalesse was building a website, planning events and reaching out to other families, the disease hit her family again.

“My nephew was just 17,” Scalesse says, sighing. “We did not know he was using, and we got the call that he had died.”

Continue reading

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Mass. Revises Up The Number Of Opioid-Related Deaths In 2014

OxyContin pills are arranged at a pharmacy in Montpelier, Vt. in this 2013 file photo. Opioid drugs include OxyContin. (Toby Talbot/AP)

OxyContin pills are arranged at a pharmacy in Montpelier, Vt. in this 2013 file photo. Opioid drugs include OxyContin. (Toby Talbot/AP)

The announcement, in late April, stunned many: that last year’s number of opiate overdose deaths in Massachusetts had topped 1,000. Now the state Department of Public Health has revised that estimate — and it’s even worse than initially reported.

Now, 1,256 is the latest estimate of men and women whose deaths last year are attributed to a fatal dose of heroin or an opioid-based painkiller. That’s nearly four people a day statewide. Two dozen cities and towns had 10 or more overdoses (see the table at the bottom of this post). Some municipalities saw a three- or fourfold increase in overdose deaths, as compared with 2013.

CLICK TO ENLARGE. (Courtesy of the Massachusetts Department of Public Health)

CLICK TO ENLARGE. (Courtesy of the Massachusetts Department of Public Health)

“When you are in an epidemic and crisis — which is what we have labeled the opioid deaths in the commonwealth of Massachusetts — the numbers will increase until such time that our efforts at intervention, prevention, treatment really start to take hold,” Marylou Sudders, the state health secretary, told WBUR in an interview.

Added Gov. Charlie Baker in a statement: “[W]e are fighting this disease with every approach available including better analysis of where and why people succumb to the disease.” Continue reading

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