The Patrick administration has stepped up to address the alarming issue of opioid abuse in Massachusetts, most significantly with an infusion of $20 million for treatment, recovery and prevention. There is, however, no substitute for local action on a problem that must be addressed at the grass-roots level.

On Tuesday, Berkshire District Attorney David Capeless appeared with representatives of several Berkshire agencies to discuss the effort to develop a comprehensive strategic plan to combat growing opioid abuse. The misuse of legal painkillers regularly leads to addiction to heroin, which is less expensive and too often deadly. Mr. Capeless referred to heroin as the major drug involved in criminal investigations, adding that substance abuse plays a role in most of the cases his office investigates. Agencies from North to South County are involved in developing the plan, which will be released in June.

Jennifer Michaels, the medical director at the Brien Center, cast light on an unconscionable situation that must be rectified at the state or federal level when she spoke of a long-time heroin addict whose insurance only covered six days of treatment at the McGee Center, after which she had to leave. This gets at the essence of the counter-productive cruelty of our for-profit health care system -- no bureaucrat should be able to deny coverage to anyone fighting addiction.

Physicians must combat the over-prescribing of the prescription pain-killers that can lead to addiction. On Thursday’s opinion page, Dr. Ronald Dunlap, the president of the Massachusetts Medical Society, said doctors need more data on how prescription drugs are making their way from pharmacies to the open market. Accumulating and disseminating this data would be a role for government.

Pharmaceutical companies can be a part of the problem or a part of the solution. As part of his executive order addressing the opioid issue, Governor Patrick banned doctors from prescribing Zohydro on the grounds that the painkiller is so addictive. This triggered a lawsuit on the grounds that the drug is federally approved from a San Diego company called Zogenix, which has been described in media reports as the maker of the drug but is in fact the marketer. The maker is the Massachusetts-based Alkermes, and the issue can be resolved and the lawsuit negated if the company pulls the drug from the market.

The drug addiction issue in the state is a knotty one to be fought at many levels. The Berkshire battle plan to be revealed will be critical to the success of that fight.