Getting insurance companies to regard mental health and substance abuse like they regard other illnesses is perhaps the most important step local lawmakers are advocating to stem Berkshire County's opiate abuse problem.

Despite 2008 legislation ostensibly aimed at the problem, state Rep. William "Smitty" Pignatelli told The Eagle it still exists.

"It's something I think is critically important that we're not truly enforcing, and I blame the insurance companies," Pignatelli said.

According to Pignatelli, "back in the day" one used to be able to check into substance or alcohol detox in the city for up to 28 days.

"Insurance companies will now pay for five to seven days," he said. "You cannot get legitimately detoxed in five or seven days."

With private treatment inaccessible to the overwhelming majority of addicted people, at upward of $40,000, Pignatelli believes insurance companies should pick up the entire tab. People need more avenues to receive treatment, or it will cost communities still more, he said. Crime, legal and prison costs, lost labor potential and fewer tax dollars would result.

A bill Pignatelli co-sponsored and currently up for consideration by the House has just such an aim. It simply states that insurers ought to follow the Massachusetts parity law or face penalties.

This constitutes one piece of the puzzle in fighting opiate abuse locally, said Pignatelli and state Sen. Benjamin Downing during a recent interview at The Eagle.

Downing identified others as prevention through youth education, "the right regulation" and law enforcement.

"All of those require a community," Downing said.

Berkshire Health Systems' prescription monitoring program and the county Drug Task Force's efforts to raise awareness are examples of this, Downing said.

After an Nov. 17 story in The Eagle depicting the problem and how it's ballooned in recent years, the lawmakers sought to shine a light on what they're doing about it.

Other bills filed by Pignatelli this session seek increased jail time for dealers, stiffer penalties for drug activity in school zones, enhanced prescription monitoring programs, limits on emergency rooms ability to dispense painkillers and requirements of prescribers to conduct routine drug testing.

In addition to his related work on economic inequality, Downing has placed the issue high up on his own legislative agenda.

A former manufacturing center where the jobs have slowly dissipated, Berkshire County's opiate problem has become particularly pervasive.

Almost all Pittsfield's robberies and break-ins are drug-related, police say, and abuse treatment centers in the city have seen increases of up to 70 percent in clients being treated for opiate dependency over the past three years.

"It's heroin and prescription meds now; it was crack cocaine before that," Downing said. "The constant throughout all of it is alcohol.

"We just have to continue to be vigilant and working on the ancillary issues like education and economic development so that as we address these things we not only: One, have the resources to fund them, but, two, have less and less to do."

The problem, too, is mirrored state and nationwide. More residents of Massachusetts died of opiate overdoses than soldiers died in Iraq throughout the duration of the U.S. invasion and subsequent war of 2003 to 2011, Downing said.

On Nov. 20, Downing and Pignatelli co-sponsored a new bill aimed at the problem.

It seeks to impose diversion controls such as required toxicology screens and maximum take-home dosages on the drug suboxone, or buprenorphine, which is used to treat opioid addiction but is also subject to widespread abuse.

The two received visits at their Boston offices from representatives of the marketing company, Reckitt Benckiser, within days, hinting at the pushback these well-funded companies are willing to bring to bear.

But Downing said opiate addiction has been recognized as a problem by the state at every level -- and no matter their level of opposition -- drug companies should recognize that it's ultimately in their best interest for their products to be responsibly prescribed and land in the right hands.

"I don't see there being huge barriers to action," Downing said. "Doesn't mean things will happen overnight, but I do think that we can continue to press ahead until someone tells us we've run far astray. But I don't think we're anywhere near that."

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