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Governor declares an emergency on opiate abuse

Governor Deval Patrick.

Jonathan Wiggs/Globe staff

Governor Deval Patrick.

Governor Deval Patrick declared a public health emergency Thursday to combat the growing abuse of opiates, directing that all the state’s police, firefighters, and other emergency personnel be equipped with a drug that can quickly reverse heroin overdoses.

“Heroin today is cheap and highly potent,” Patrick said. “We have right now an opiate epidemic.”

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Using his emergency powers, Patrick told the Department of Public Health to make Narcan available immediately to all first responders, as well as more accessible to families and friends of drug abusers. Narcan, the brand name for naloxone, halts overdoses almost instantly.

Many first responders have been barred from administering the drug by state regulations written before the opiate crisis.

In addition, the governor said, the state will prohibit the sale of Zohydro, which he called “a potentially lethal narcotic painkiller.” The drug was approved last year in a controversial decision by the Food and Drug Administration.

Patrick said the powerful drug, which is not yet made in tamper-proof form, will be banned until safeguards are implemented. Addiction-treatment providers have warned of Zohydro’s high potential for abuse.

The governor also pledged to spend $20 million more to increase treatment and recovery services for the public, state prisons, and county jails.

The moves, approved Thursday by the Public Health Council, were applauded by state officials and first responders, who have been startled by an alarming increase in heroin overdoses across Massachusetts. The Globe reported last month that at least 185 people died of heroin overdoses between November and February.

Bridgewater Fire Chief George W. Rogers Jr., president of the Fire Chiefs Association of Massachusetts, said that “giving these tools now to every first responder is going to be huge to get that early intervention to people who need help.”

The state of emergency empowers DPH Commissioner Cheryl Bartlett to take immediate action and make regulatory changes over the next 90 days. The department will seek to make the changes permanent, Bartlett said.

“I couldn’t be happier,” said Hilary Jacobs, director of the Bureau of Substance Abuse Services at DPH. “This package will make an enormous difference, absolutely.”

Another component of the state’s action will be a mandate that physicians and pharmacies monitor prescriptions of narcotic painkillers and other drugs linked to abuse. Such checks had been voluntary, the governor’s office said.

“We must have more rigor over the overprescription of pain medication,” Patrick said. Opiate overdoses in Massachusetts rose 90 percent from 2000 to 2012, the governor said.

A keystone of the plan is making Narcan more available to police, firefighters, and people close to drug addicts. A state pilot program has trained 22,539 people in administering Narcan since 2007 and allowed several hard-hit communities to use the drug. But first responders have been clamoring for more access to Narcan.

Under the emergency directives, every first responder will be permitted to carry and use Narcan immediately. The state also will work with medical directors of large pharmacies to write standing orders that will allow Narcan to be purchased by individuals, Bartlett said.

Judge Rosemarie Minehan, the presiding justice at Plymouth District Court, attended Patrick’s announcement at DPH headquarters in downtown Boston. The fallout from opiate abuse has become an increasing part of the workload in many courtrooms, she said.

On March 18, a man in the jury pool at Plymouth District Court crumpled from an overdose, the judge said in an interview. He turned blue as police, firefighters, and medical personnel, all potential jurors, frantically tried to revive the man’s heart.

As they worked, a woman rushed forward and pulled Narcan from her purse. Within minutes, two doses of the drug had halted the overdose.

“Intervention was very important,” Minehan said.

Widespread access to Narcan “should be a no-brainer; this should be something that should be on every firetruck,” said Edward Kelly, president of the Professional Fire Fighters of Massachusetts, which had voted unanimously to try to put Narcan in the hands of all first responders.

The drug, administered nasally, is easy to use, requires minimal training, and is almost immediately effective, Braintree Fire Chief James O’Brien said this week. Asked why more first responders had not been allowed to carry Narcan, he replied: “That’s the million-dollar question.”

The cost of expanded Narcan use is expected to be covered by a combination of state and local funding.

In Quincy, whose Police Department became the first in the country to equip all cruisers with Narcan, the results have been startling since it joined the state pilot program in 2010. In the 17 months before joining, the city recorded 47 opiate-related deaths, Lieutenant Detective Patrick Glynn said. In 17 months afterward, the number plummeted to 16.

Quincy police have used Narcan to reverse 236 overdoses, with 32 reversals since Jan. 1, Glynn said. “There’s a 100 percent correlation between the introduction of Narcan and the reduction of the deaths,” the lieutenant said.

Stoughton also has been in the vanguard of efforts to confront addiction. Deputy Police Chief Robert Devine said the town saw a spike in fatal overdoses last summer and asked to become part of the Narcan pilot program.

When Stoughton’s bid was turned down, the town turned to a physician, who wrote a Narcan prescription for the Police Department. “We didn’t want to stand there and watch someone die when we could possibly do something,” Devine said.

State Senator John F. Keenan, a Quincy Democrat who co-chairs the joint Public Health Committee, welcomed the governor’s actions but cautioned that the opiate epidemic will not be curbed easily.

“These are critical steps,” he said. “We also have to recognize that these are just first steps, second steps, and third steps.”

Brian MacQuarrie
can be reached at macquarrie@globe.com.
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