NORTH ADAMS -- Northern Berkshire County doctors could soon start prescribing exercise along with pain medication.
The Northern Berkshire YMCA is launching a new initiative, Exercise is Medicine, that would have doctors sending their patients to a 12-week exercise course at the YMCA to encourage healthier living.
"We think this idea is something that really needs to spread like a wildfire," Justin Ihne, chief executive officer of the Northern Berkshire YMCA told a group of Berkshire County health professionals.
The new initiative was pitched during an opiate abuse forum on Saturday at the Clark House at North Adams Regional Hospital. The initiative, which requires physicians to opt in, was recommended as one of several steps the county can take to reign in the county's well-documented problem with opiate abuse by embracing alternatives to pain medication.
The Northern Berkshire Community Coalition, which hosted the forum, is working with Berkshire Opioid Abuse and Prevention Collaborative to raise awareness about abuse. In Pittsfield, police attribute most break-ins and shoplifting directly to drugs.
Countywide prescriptions for narcotic painkillers have risen by more than 500 percent over the past 12 years, according to the Berkshire District Attorney's Office.
"We want the community as a whole to understand how quickly, easily and unintentionally people can become addicted to opioids," said Lois Daunis, grants manager and prevention coordinator for Northern Berkshire Community Coalition.
The presentation followed a lecture from Dr. Ruth Potee, a family doctor who specializes in pain and addiction at Valley Medical Group in Greenfield. She graduated from the Yale University School of Medicine and performed her residency at the Boston University Medical Center.
Potee said seven deaths related to opiate overdoses have occurred since the start of the year in Franklin Country, where she works, highlighting the urgency of her message that doctors need to be more vigilant.
"It's on the front page of our newspaper every day," said Potee, who added, "The Berkshires and Franklin County, we are the same."
The Exercise is Medicine program was originally launched in Franklin County. It started with two participating physicians offering 12 referrals several years ago, Ihne said. Last year, the fast-growing program received more than 500 referrals.
The Northern Berkshire YMCA, which is recruiting doctors, follows up with patients who have been prescribed the exercise program and schedule an appointment. The workshop costs $99 for three months, but he said the YMCA will work with people who are on a tight budget.
"We have an opportunity to really get you trying something else," Ihne said.
On Saturday, health professionals received an earful about opiate abuse -- a local problem that mirrors the national trend.
Opiate abuse recently received prominent attention when Vermont Governor Peter Shumlin dedicated his entire State of the State speech to the state's escalating abuse problem. The state had twice the number of deaths from heroin overdoses last year compared with the prior year. The state has also seen a 250 percent increase in heroin treatment since 2000.
Potee's presentation was for prescribers, but it also provided a revealing glimpse at how opiate abuse starts.
The most commonly cited range when it comes to addiction for those dealing with chronic pain is four to 26 percent, according to several studies she cited. Potee estimated the number is closer to 25 percent.
Potee said it's routine to have patients come up with excuses why they need an early refill, including their cat knocking the prescription in the toilet. Her office stands firm about maintaining a set refill schedule.
In the past, that has created tension. Patients have shown up at her home to vent, while in other cases she has been reported to the Board of Health, which followed up and then told her she was right not to refill the prescription.
"The drug really starts to take control of your life," Potee said. "You're spending all day thinking, ‘When will I get my next pill.' Your life becomes defined [by the pill]."
The addiction can set in quickly. The most commonly abused opiates are Vicodin and Oxycodone, which can lead to heroin use. The body can become addicted after only six to eight weeks, Potee said.
There is no typical opiate abuser: Anyone who uses opiates can become addicted.
Individuals more highly susceptible are those under the age of 45 with a personal or family history of substance abuse. Other red flags include a legal history that could include DUIs or jail, mental health problems, and a history of sexual abuse.
Young adults are also prone to experimentation -- more than 71 percent of abusers say they get their opiates from family and friends, according to the 2010 National Survey on Drug Use and Health.
Potee said addictive use should encourage people to securely lock up pills where others can't get access to them.
The transition from pills to heroin is common in addiction, she said, because while a single pill might cost $5 to $10, heroin will only cost half as much.
While more institutions and states are adopting a regulatory framework, Potee said the real problem is the cheap and easy availability of heroin on the streets.
Potee said steps need to be made to move away from providing pills, and examining other options for dealing with pain. That would start with exploring alternative ways to relieve pain, which includes offering support groups and encouraging participation in exercises like Zumba and yoga.
"We need to pull back from thinking that pills are the solution to all the pain and reduce the number of pills on the street," Potee said.
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