Poll finds great awareness — and fear — of opioid abuse
Nearly three-quarters of Massachusetts adults believe heroin use is an extreme or very serious problem in the state, and almost four in 10 adults know someone who has abused prescription painkillers in the last five years, according to a survey by The Boston Globe and the Harvard T.H. Chan School of Public Health.
The poll also found that Massachusetts residents are more worried about opioid abuse than are Americans generally, and that more adults here believe prescription drug abuse is getting worse.
Despite increased awareness of the problem, just 36 percent of adults in Massachusetts said they have been warned by doctors about the risk of painkillers prescribed to them, the survey found. Nationwide, 61 percent of respondents said they had been cautioned.
The surveys, conducted separately in Massachusetts and nationwide between April 7 and 19, are believed to be among the first to gauge public perceptions of opioid abuse, said Robert J. Blendon, a Harvard School of Public Health professor who codirected the poll.
The results come at a time of rapidly increasing concern in Massachusetts about the abuse of heroin and prescription painkillers. More than 1,000 people in the state are believed to have died from opioid overdoses last year, a 33 percent increase over 2012.
The poll showed that 71 percent of Massachusetts adults believe heroin use is an extreme or very serious problem, compared with 45 percent nationally. In addition, 49 percent of respondents in the state believe that painkiller abuse has become worse since 2010, compared with 39 percent across the country.
Blendon said he was struck that 39 percent of Massachusetts adults reported knowing someone who has abused prescription drugs. “That’s a staggering number of people,” Blendon said.
Of those adults, 20 percent said the abuse led to the user’s death. In addition, 74 percent of people who know someone who abused prescription drugs said the user’s family suffered major harm. Sixty-four percent said the addict’s work life was hurt significantly, and 57 percent said the user’s health deteriorated greatly.
Marylou Sudders, the Massachusetts health and human services secretary, said the poll affirms what she and other officials have heard during their travels across the state. “The opioid epidemic is widespread and does not discriminate based on geography or any other factor,” Sudders said.
In Massachusetts, 51 percent of those who know someone who abused prescription drugs said they believe the painkillers led to heroin or other illegal drugs.
State health officials have long warned that prescription painkillers often are a gateway to heroin, which is much cheaper.
“We are at the stage that people recognize the problem,” Blendon said. Despite growing awareness, the poll suggests that many physicians in Massachusetts are not warning their patients about the addictive dangers of prescription drugs.
Blendon called that finding evidence of one of the biggest differences between Massachusetts and the nation. “For some reason in the Commonwealth, people who are taking painkillers do not remember having this conversation,” he said.
The surveys also found that Massachusetts residents are more aggressive than the rest of the country in pushing for tools to help addicts, both at the time of overdose and in treatment afterward.
Massachusetts adults showed greater support for making naloxone, a drug that reverses opioid overdoses, available to the public, and a greater willingess to require insurers to cover treatment for drug addiction.
Massachusetts adults favored pharmacy sales of naloxone, often marketed as Narcan, by 54 percent to 35 percent.
In the rest of the nation, 42 percent supported public sales of Narcan.
Many Massachusetts pharmacies now sell Narcan, which a growing number of emergency workers carry at all times. However, critics say Narcan encourages opioid abuse by making users less concerned about the consequences.
Massachusetts adults, by 58 percent to 36 percent, also favored requiring insurers to cover more drug treatment, even if that coverage raises premiums.
Nationwide, the figure was 48 percent in favor and 46 percent opposed.
Many insurers in Massachusetts now provide limited coverage to treat opioid addiction. And although most Massachusetts adults want expanded coverage, only 33 percent believe that effective, long-term treatment is possible. The survey found 31 percent do not believe such a remedy exists.
Dr. Monica Bharel, the Massachusetts public health commissioner, said state government needs to do a better job informing people about treatment successes. In addition, she said, health officials must help combat the stigma of addiction so that more users, and their families, will seek help.
“One of my personal goals is for us all to think about addiction just like any other chronic disease,” Bharel said.
The surveys showed a disconnect, both in Massachusetts and nationally, between a belief that prescription drugs are easily obtained, and a reluctance to strengthen regulations to curb access to them.
Fifty-eight percent of Massachusetts residents said that the illegal purchase of painkillers is too easy and a major cause of abuse.
However, 50 percent of respondents said that state and federal regulations on access to prescription drugs are “about right.”
“We have this dichotomy where people recognize that overprescribing is one of the problems, but when you ask if there should be more regulation, people say no,” Blendon said.
White House drug czar Michael Botticelli said the poll affirms the need for a comprehensive response.
The Obama administration, he said, is working “with federal, state, and local partners to increase access to effective treatment, reduce overdoses with naloxone, and prevent the spread of infectious disease” through needle-exchange programs.
Governor Charlie Baker reacted to the polls by emphasizing that he also is committed to fighting the epidemic.
“Opioid addiction is a problem that has touched far too many people in the Commonwealth,” he said. “We are taking aggressive action on this issue, and have made it a top priority to get people the re-sources and education they desperately need to prevent and treat this disease.”