Stunning rise in drug deaths puts new focus on treatment
The rising number of opioid-related deaths in Massachusetts is prompting serious rethinking of the way government approaches drug addiction. Criminal-justice reforms are part of the equation; low-level drug offenders should get the care needed to keep them from reoffending. But drug addicts shouldn’t have to enter the criminal justice system to get treatment. Fortunately, political leaders are quickly waking up to the need for action. Public attitudes are shifting, as well. Gone is the old view that addiction is a private shame; here to stay is the idea that it’s a public-health threat. The evolution is long overdue.
Mayor Marty Walsh, a recovering alcoholic, vows to create an Office of Recovery Services at Boston City Hall that would help find a detox bed for any addict in need of one. On the state level, Democratic gubernatorial candidate Joseph Avellone, the former chief operating officer of Blue Cross/Blue Shield, is promising to create a dedicated Office of Recovery. It would feature regional “recovery coordinators’’ who would work with local detox and rehabilitation services to find immediate treatment for those in need.
Both Walsh and Avellone make good cases for an urgent response. In 2000, there were 363 opioid-related deaths in Massachusetts. In 2011, that figure jumped to 642 deaths. Just since November, state officials report at least 185 deaths from suspected heroin overdoses. It’s a crisis, all right.
Walsh’s proposal is straightforward. Drug prevention and treatment services provided by the Boston Public Health Commission would be folded into the new Office of Recovery Services. The new office, in turn, would concentrate on helping addicts navigate the treatment system. Walsh has enormous credibility in this area. During his years as a state legislator, he was the go-to person on Beacon Hill for addicts in search of treatment.
The task is more challenging at the state level. The state Bureau of Substance Abuse Services is responsible for licensing drug programs and counselors, monitoring treatment services at about 500 sites, analyzing data, and serving as a point of contact for those in need of treatment. Avellone, a former surgeon, proposes to move the bureau from its current home in the public health department and absorb it into the new agency. It won’t be an easy shift. But the overarching value of Avellone’s plan is that it would push treatment for addicts to the top of the state’s agenda.
Both Walsh and Avellone stress the need for additional treatment beds. There are roughly 4,000 state-supported treatment slots, but they are often at or near capacity. Substance-abuse experts stress that there is only a small window of opportunity when dealing with addicts, who are notoriously difficult to treat. A whopping 95 percent of them refuse even to admit they have a problem, according to federal surveys, never mind enter treatment. When they are ready for help, it has to be there almost immediately.
More beds isn’t the only solution, however. There is great potential in the area of medication-assisted treatment, especially in cases of opioid addiction, including new drugs such as buprenorphine that have good records of decreasing withdrawal symptoms. And they can be prescribed in the privacy of a doctor’s office. Defeating drug addiction isn’t a single-front war, and won’t be won quickly. But it’s time for Massachusetts to improve its battle plan.