Baker shocked that more doctors aren’t warning of opioids
Governor Charlie Baker said Tuesday he is shocked that few Massachusetts patients have been warned by their physicians about the addictive dangers of prescription painkillers, a finding contained in a poll released this week by the Globe and the Harvard T.H. Chan School of Public Health.
“We have a lot of work to do,” Baker said in an interview with the Globe.
The poll found that only 36 percent of Massachusetts adults said their doctors had cautioned them when prescribing strong painkillers, compared with 61 percent who had been warned nationwide.
The finding means that physicians must be “full-fledged partners” with the state, Baker said, as officials search for ways to combat an opioid epidemic that took the lives of more than 1,000 people in Massachusetts last year.
Abuse of strong painkillers is considered a gateway to heroin, a deadly opioid that is much cheaper to buy.
The governor said he was heartened by a finding in the poll that 71 percent of Massachusetts adults believe heroin is an extreme or very serious problem in the state, compared with 45 percent nationally.
That striking difference means that many more people in Massachusetts are aware of the crisis, Baker said.
“I actually took some comfort that this meant we have been . . . willing to talk openly and often about this issue,” Baker said. “The dialogue seems to have penetrated.”
Baker reacted to the poll shortly after meeting with local leaders in Plymouth, which has recorded 144 overdoses and 10 drug-related deaths this year. “They were talking about this issue publicly long before other people were,” the governor said.
Baker praised the work of a broad-based task force that is fighting the epidemic there, and he cited the efforts of Rosemary Minehan, presiding justice at Plymouth District Court. Minehan leads a special session called Drug Court, which attempts to divert nonviolent offenders from jail and into treatment and strictly supervised probation.
The governor said he is close to releasing the recommendations of a state panel that has traveled across Massachusetts to gauge the scope of the crisis. As part of that work, the panel recently received suggestions from the Massachusetts Health Council about ways to increase awareness.
The Health Council, a nonprofit organization, found that local coordinators “were passionate and hard-working but some felt isolated with insufficient support and are running a risk of burn-out.” These foot soldiers in the opioid battle expressed a need for reliable funding, technical support, and better information about effective strategies.
The council based its report on interviews conducted statewide in February and March with community coordinators and agencies.
Among its recommendations, the council urged that a pool of startup grants be available to local coalitions. In the past, small grants of $2,500 have helped launch these grass-roots efforts, the council reported.
To reduce the isolation that hampers some coalitions, the council suggested scheduling more workshops and conferences where activists can meet, float ideas, and learn. Many groups feel pressure to “re-create the wheel,” the council said, possibly because they lack the experience gained in hard-hit areas such as Franklin and Norfolk counties.
The council also urged funding for drug-prevention classes, many of which have been cut or eliminated in schools, and universal screening for student drug abuse. Parents should be involved in the education effort, the report suggested.
“Require parents to attend a class to help them understand the realities of substance abuse on adolescent brain development and recognize the warning signs of abuse,” the council said. “ ‘Not my kid’ is just not an acceptable excuse for parents anymore. This class should be offered in every school in the state.”
The council also called for better data on overdoses and opioid-related deaths. The state Department of Public Health has recently improved its reporting of these numbers, but local officials continue to clamor for real-time statistics to help them gauge the scope of the crisis.
The Health Council also called attention to a shortage of beds in detoxification facilities and longer-term treatment, as well as a lack of insurance coverage, and urged the state to establish enforceable guidelines to address these problems.
Enforcement of the Prescription Monitoring Program also should be on the state’s agenda, the council said. The program, which is intended to curb the abuse of prescription painkillers, allows physicians and pharmacists to review a patient’s prescription history in an online database.