Panelists cite need for combined efforts in battling opioid addiction

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    Marcy Julian, Western Massachusetts Senior Regional Manager for Learn to Cope, and Ken Duckworth, Medical Director for Behavioral Health at Blue Cross Blue Shield of Massachusetts, take part in a panel discussion, "Collaborating for Solutions", during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. —GAZETTE STAFF / KEVIN GUTTING

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    Peter Halperin, Medical Director of the Integrated Behavioral Health Program at Cooley Dickinson Hospital, takes part in a panel discussion, "Collaborating for Solutions", during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. —GAZETTE STAFF / KEVIN GUTTING

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    New England Public Radio reporter Karen Brown, left, moderates a panel discussion, "Collaborating for Solutions", during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. Panelists are West Springfield firefighter and paramedic Sara Boucher, second from left, Peter Halperin, Medical Director of the Integrated Behavioral Health Program at Cooley Dickinson Hospital, Marcy Julian, Western Massachusetts Senior Regional Manager for Learn to Cope, and Ken Duckworth, Medical Director for Behavioral Health at Blue Cross Blue Shield of Massachusetts. —GAZETTE STAFF / KEVIN GUTTING

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    New England Public Radio reporter Karen Brown, left, moderates a panel discussion, "Collaborating for Solutions", during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. Panelists are West Springfield firefighter and paramedic Sara Boucher, second from left, Peter Halperin, Medical Director of the Integrated Behavioral Health Program at Cooley Dickinson Hospital, Marcy Julian, Western Massachusetts Senior Regional Manager for Learn to Cope, and Ken Duckworth, Medical Director for Behavioral Health at Blue Cross Blue Shield of Massachusetts. —GAZETTE STAFF / KEVIN GUTTING

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    West Springfield firefighter and paramedic Sara Boucher takes part in a panel discussion, "Collaborating for Solutions", moderated by New England Public Radio reporter Karen Brown, left, during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. —GAZETTE STAFF / KEVIN GUTTING

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    Marcy Julian, Western Massachusetts Senior Regional Manager for Learn to Cope, takes part in a panel discussion, "Collaborating for Solutions", during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. —GAZETTE STAFF / KEVIN GUTTING

  • ">

    Ken Duckworth, Medical Director for Behavioral Health at Blue Cross Blue Shield of Massachusetts, takes part in a panel discussion, "Collaborating for Solutions", during the Western Massachusetts Municipal Forum, "Addressing the Opioid Crisis", held at the Hotel Northampton on Monday. —GAZETTE STAFF / KEVIN GUTTING

  • Peter Halperin, medical director of the Integrated Behavioral Health Program at Cooley Dickinson Hospital, and Marcy Julian, Western Massachusetts senior regional manager for Learn to Cope, take part in a panel discussion, “Collaborating for Solutions,” during the Western Massachusetts Municipal Forum “Addressing the Opioid Crisis” at the Hotel Northampton on Monday. GAZETTE STAFF / KEVIN GUTTING

@DHGCrosby
Published: 9/26/2016 9:26:50 PM

NORTHAMPTON — Blue Cross Blue Shield of Massachusetts claims it has prevented 21 million doses of prescription opioids from entering communities in the space of a few years.

Still, the health insurance company is just scratching the surface of the state’s opioid epidemic, Andrew Dreyfus, the company’s president and CEO, said Monday.

Dreyfus and Senate President Stanley Rosenberg, D-Amherst, joined in hosting a municipal forum at Hotel Northampton addressing the crisis with the goal of building stronger partnerships.

Gov. Charlie Baker earlier this year signed legislation that limits access to opioid painkiller prescriptions, which have been a driving force in the state’s growing addiction crisis, Dreyfus said.

Under the new law, doctors are limited from prescribing more than seven days worth of opioids for first-time users, with some exceptions made for chronic pain management and life-threatening illnesses. The law came after Blue Cross Blue Shield made early efforts to address the public health issue, by developing new protocols in 2012 to crack down on inappropriate prescriptions.

“Patients were either getting long-acting opioids when they could be getting short-acting, or they were getting both for too long,” said Dreyfus, explaining that long-acting drugs include OxyContin, while Percocet and Tylenol with codeine are classified as short-acting.

Protocol changes included requiring doctors who prescribe long-acting opioids to contact Blue Cross Blue Shield for approval, as well as restricting short-acting opioid prescriptions to the first and one refill.

Those two actions cut the group’s long-acting opioid prescriptions by 50 percent and short-acting by 25 percent from 2012 to the start of 2015.

Rosenberg lauded that early work by Blue Cross Blue Shield to reduce the supply of opioid prescriptions. He said Dreyfus and the health insurance group “set the stage (and) … planted the seed” for the new legislation.

But, there is much more work to be done, panelists at the forum agreed. They said it’s too early to tell exactly how the law will impact the crisis.

The panel was moderated by Karen Brown, an independent journalist, and consisted of four members who have front-line roles dealing with impacts of the opioid epidemic: Sara Boucher, a first-responder at the West Springfield Fire Department; Dr. Peter Halperin, a psychiatrist and medical director of the Integrated Behavioral Health Program at Cooley Dickinson Hospital in Northampton; Marcy Julian, western Massachusetts regional manager for Learn to Cope, an addiction support network; and Dr. Ken Duckworth, medical director of behavioral health at Blue Cross Blue Shield.

Worst offender

Boucher said her department and local police are responding to significantly more overdose service calls in the last few years. Previously, she would come across one or two such calls over months, but now sees eight to 10 overdoses in one shift.

During the mid-1990s, Halperin said, an “extreme distortion” by academics in medicine hugely underestimated the addictive properties of painkillers. He said doctors were taught that pain was undertreated.

“I think Massachusetts, ironically to some degree, became one of the worst offenders — because we have great, cutting-edge docs that do everything that seems to be the right thing to do, at the time,” he said.

The result was that the state began prescribing what Halperin called “ridiculous amounts of opiates.” Over time, a new population of addicted persons emerged, he said.

He said they now turn to street opiates such as heroin because they’re cheaper and easier to get.

About 80 percent of those addicted to heroin got their start on prescription pain medication, Julian said.

This drug crisis affects everyone regardless of stereotypes, Boucher said.

“No matter where you’re born, where you grow up, how you grow up, your educational background, your skin color — it doesn’t matter,” she said.

According to Halperin, the issue grabbed the medical community’s attention only after opioid addiction began to negatively affect the “predominantly middle-higher socioeconomic white culture.”

Julian added that because drugs like heroin are affecting all kinds of people, families more recently have become a real force for change in practice and policy.

Treatment failures

Tracy Wilkie of Agawam lost her son, Shane, to opioid drugs two years ago. Since then, she started Shane’s Foundation, a charity group that provides education and prevention methods in relation to the crisis.

She told the panelists that treatment centers often drain bank accounts and provide little help in treating the problem correctly. Her son went to seven rehabilitation programs and none was successful, she said.

Julian noted that focus groups convened by Baker are, in part, looking at how to assess the quality of a treatment program.

“There has to be a continuum of care that goes on,” she said.

While limits have been placed on prescription painkillers and treatment options have increased, Springfield Police Commissioner John Barbieri said, each positive step also has a downside. He said that while he supports decriminalizing the problem, addicts previously were at least court-ordered into treatment. Now, there is no way to force treatment, he said.

“There is no one-size-fits-all,” said Duckworth, referring to the loss of leverage in a more thoughtful, treatment-oriented policing approach to addiction. “There are a subset of people for whom leverage is the linchpin of recovery.”

The complexity of different needs to be addressed in the crisis cannot be disputed, panelists agreed. They said success lies in the combination of efforts.

“There are a lot of silos of excellence, but there’s very little unity of effort,” Barbieri said of what the Springfield police force is witnessing.

Attendees were strongly encouraged by Rosenberg to bring any and all of their ideas to local government leaders.

“We’re moving in the right direction,” said Julian. “It’s just going to take some time.”

Sarah Crosby can be reached at scrosby@gazettenet.com.


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