DPH chief takes up opioid crisis

Calls for response to come from multiple sectors and addresses damage of stigma

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PITTSFIELD —With the question of a needle exchange being established in the city on the table, community stakeholders met with the state commissioner of public health to discuss the opioid crisis and a number of other concerns on Friday.

Monica Bharel, Massachusetts public health commissioner, spoke with about 40 stakeholders from Berkshire County including health care providers and advocates, state legislators, and mayors. She listened to questions and comments and took questions for about 70 minutes at the Brien Center.

Opioids — both treatment, for those gripped by this type of drug, and education about the harmful effects it can have — are "the number one public health priority" in the state, Bharel stressed, and that an approach from across sectors is key to addressing the "opioid crisis" facing Massachusetts residents.

"Until we do that, we won't be able to come up with solutions to this complex problem," she said.

There were 1,465 unintentional opioid overdoses, with as many as 514 suspected opioid-related deaths in 2016, according to DPH data released last month. There were 1,597 opioid overdose deaths in 2015 and 1,321 in 2014, according to DPH.

In Berkshire County, 32 people died from opioid overdoses, 17 of which took place in Pittsfield, according to the most recent DPH data from 2015.

Earlier this month, the Pittsfield Board of Health voted in favor of opening a syringe access program, commonly referred to as a needle exchange, in the city. The Department of Public Health, which pays for the programs then run by an independent vendor, is reviewing the request. And Mayor Linda M. Tyer advocated for the program during Friday's meeting.

Omar Cabrera, a spokesman for the state Department of Public Health said it "intends to contract with a vendor" in the city, in an email response to a question from the Eagle.

"Pittsfield is a priority location for one of these programs," he wrote.

He did not have a specific date for opening, but said it typically takes two to three months after the state gives its formal approval.

The topic of collaboration came up several times during the discussion.

"Nobody does collaboration better than Berkshire County," State Rep. Tricia Farley-Bouvier, D-Pittsfield, told Bharel. "So whatever dollars you put here go a lot farther."

But that collaboration is sometimes inadvertently limited by the state.

Pittsfield Police Chief Michael Wynn said grants are often narrow in scope, which makes it difficult for more than one organization to address an issue. He urged Bharel to speak with state leaders about more flexibility for how grant money is spent and opening the door to additional collaboration.

State Rep. William "Smitty" Pignatelli, D-Lenox, said Pittsfield is often unfairly characterized as a community with an opioid problem.

"Many of the services are here," he said. But "this is a Berkshire County problem and people need to start thinking of it that way."

Jennifer Kimball, of the Berkshire Regional Planning Commission, pointed out that the rates of Hepatitis C, which can be spread by sharing needles, among other ways, has spiked in the region. The Berkshires are one of 11 "hot spots" in the state for both Hep C and HIV, she said, citing research from Tufts. And as many as 2,000 of the county's approximately 130,000 residents are infected with it.

The need for additional substance abuse recovery homes, education about the harmful effects of marijuana, especially for youth, and treatment for drug addicted pregnant mothers and newborns were among the other topics raised by those present.

Prior to being named commissioner in February 2015, Bharel spent 20 years as a primary care doctor in Boston. There she said she often treated people with substance abuse disorder, which she stressed needs to be regarded by the public as a disease, just like cancer or diabetes.

She said that is important because stigma surrounding substance abuse can often impede treatment.

"The system doesn't work well right now," she said, which is an observation she said she made as a doctor that informs her work as public health commissioner. "As we do this work, I know we have a long way to go," she said.

Reach staff writer Carrie Saldo at 413-496-6221 or @carriesaldo

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