Editorial: Our public health emergency: opiods and heroin

Friday, April 11, 2014
Gov. Deval Patrick has rightly declared opioid and heroin addiction a public health crisis. The toll exacted on society by the increasing number of people addicted to prescription painkillers — often a route to heroin addiction — cannot be underestimated.

These drugs ruin the lives of addicts and their families and threaten the safety of communities. They are driving a true public health emergency.

Massachusetts is not alone. Nationwide, the number of fatal overdoses of opioids increased 313 percent from 4,030 in 1999 to 16,651 in 2010.

The numbers in the Bay State are equally alarming. According to the Department of Public Health, opioid-related deaths increased from 363 in 2000 to 642 in 2011. In the last several months alone, 140 people have died from suspected heroin overdoses — “levels previously unseen” — the governor’s office reported. In response, Patrick last month unveiled a multi-pronged effort that aims to save lives now as well as develop a long-term response to the epidemic.

Among the emergency steps is one that gives first responders the ability to carry and administer the drug naloxone, more widely known by the brand name Narcan. When used quickly in the face of a suspected overdose, the drug saves lives. Patrick’s order also bans physicians from prescribing and pharmacies from dispensing the new painkiller Zohydro until safeguards are in place to prevent its misuse. Zohydro is a controversial and particularly potent drug that experts say is vulnerable to misuse and abuse through crushing the pills and then snorting or injecting them.

On that measure, Patrick has experienced pushback from a federal judge who says she will likely strike down the ban, calling the governor “out of line on this one.” Though Zohydro has been approved by the FDA — which is why the judge objects to Patrick’s action — experts say it is highly addictive and prone to abuse. Patrick wants to ban its use until its makers can make it “crush-resistant.” Patrick defends his action by noting that the state is in the throes of “a real emergency” and that Zohydro is one of the few prescription drugs not yet in an abuse-resistant form.

Vermont has passed an emergency order making it harder for doctors to prescribe the drug, while attorneys general from 28 states want the FDA to revoke its approval of Zohydro.

Another measure called for in Patrick’s directive is to mandate prescription-monitoring programs by physicians and pharmacies, efforts that previously had been voluntary.

A vital piece of the puzzle is treatment.

Patrick established a multi-agency task force and assigned it a big job: Within 60 days, the panel must come up with actions the state can take to make treatment services more available to people who need them regardless of what kind of insurance they carry.

The task force, made up of people from law enforcement, substance abuse services, families of addicts and public health experts, has also been instructed to suggest ways to get non-violent criminal defendants struggling with addiction into treatment.

Patrick earmarked $20 million for substance abuse treatment programs, which we believe is an investment in the health of the entire community.

Untreated addiction is a threat to public safety and a financial burden on the commonwealth in the form of lost jobs, increased crime, wrecked families and lost lives.

Possibly the most effective step the state can take is to increase the number of beds available in treatment facilities — and to find a way to stop insurance companies from placing obstacles in the way of people who seek treatment.

We urge Patrick’s task force to look long and hard at this problem. This is an addiction notoriously hard to overcome — and recovery from it is fraught with dangers of relapse. When addicts finally admit they need help, it is imperative they find a place to get it, not be told there are no beds, or be kicked out of treatment before they are ready.

It’s been said desperate times call for desperate measures. In this case, given the toll already taken — and the devastation ahead if nothing is done — Patrick is right to take decisive, dramatic action. To do nothing would cost a great deal more than $20 million.