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Our Opinion

Our Opinion: As opioid crisis worsens, we must redouble harm-reduction efforts

marcia brown holds photo of daughter erika (copy)

Marcia Brown holds a photo of her daughter Erika that hangs in her bedroom in North Adams. Erika, who struggled with addiction, died at 30 in May 2021.

Based on a grim batch of recently released data, the opioid crisis in Massachusetts shows no signs of easing its destructive grip on our communities.

In fact, that grip sadly seems to be tightening. Last year, the commonwealth’s opioid overdose death rate rose to 32.6 per 100,000 residents, surpassing not just 2020’s rate but the state’s previous high point in 2016. As bad as those statewide numbers are, the Berkshire figures are even worse. Annual fatal opioid overdoses in the county reached the highest level ever recorded in 2020 — until last year when an increase of six pushed that macabre milestone to 62. That’s an 11 percent year-to-year jump from one high water mark to an alarming new one, and this deadly tide appears to be continuing the alarming trend of rising across the commonwealth while rising even quicker in Berkshire County.

As the overdose epidemic bears down on our county and countless other corners of the country, these statistics show the broad scope of the crisis. But they can’t even begin to relate its painful depth. Since 2010, fatal overdoses have extinguished the lives of 374 people in the Berkshires. Every one of those is not just a number but a life full of potential cut short, a grieving family, a community robbed of a neighbor. Scale that up to the national level, where fatal overdoses claim about 100,000 Americans a year — more than gun violence and traffic fatalities combined.

That trauma is immeasurable, but doing something about it is only impossible if we allow ourselves to become numb to this repeating tragedy. We must do away with the false notion that addiction is solely a failing of individual character; it is a public health crisis that takes all kinds and spares no communities. The evidence is clear that the war on drugs is long past failure.

We must have the wisdom to see this scourge for what it is to better combat it. It is a multidimensional problem for which there is no silver bullet solution that will not abate immediately even with the correct mix of policy and cultural shifts. The U.S. must do a better job of fending off fentanyl from our borders. We should target youth with robust (and far more frank) educational campaigns about the realities and dangers of opioids and other drugs, especially given the recent spike in teen ODs. Our leaders must address intersecting issues — housing, economic opportunity, accessible mental health care — that often deprive entire communities of the footholds needed to climb out of deadly despair.

But we also must have the moral courage to meet this crisis’ most vulnerable victims where they are and stem the bleeding with real harm-reduction measures. That means embracing ideas that have been around for some time, such as boosting access to addiction recovery treatment and diversion programs to steer nonviolent drug offenders who pose more harm to themselves than others toward that treatment. Meaningfully reducing this brutal toll, though, will require bolder action, too.

Vermont, Rhode Island decriminalized a lifesaving opioid treatment. Should Massachusetts?

Massachusetts should decriminalize possession of small amounts of buprenorphine, a partial opioid agonist that curbs opioid cravings without producing euphoria with a “ceiling effect” that deters use above a regular dose. For those seeking a path to recovery, it’s a potentially powerful tool for limiting opioid use, making it less likely that they’ll use and/or overdose. Vermont and Rhode Island have pursued this policy with promising initial results. At the least, Massachusetts should heed the University of Massachusetts School of Medicine Specialists and remove the waiver requirement for Bay State doctors to prescribe buprenorphine.

Pittsfield Police, other Berkshire County first responders to carry Narcan. Addiction experts say it will save lives

The so-called HOPE Act — introduced by state Rep. Smitty Pignatelli, D-Lenox — has unfortunately languished in the Legislature, but another round of disturbing OD data should spur lawmakers to finally act on it. All Massachusetts first responders should be carrying naloxone, which can reverse overdoses and save lives. This is particularly crucial for more rural corners of the state like ours, where response times and hospital trips are often longer. It also protects the first responders, who can come into contact with small but deadly amounts of powerful synthetic opioids at a scene. We have praised the Pittsfield Police Department and other Berkshire County first responders who took this initiative on their own, but it’s past time to make this life-saving policy universal across Massachusetts.

A Public Health Committee hearing is scheduled Monday on legislation that would authorize safe-injection sites, which doctors aligned with the Massachusetts Medical Society say is "an evidence-based intervention that fill a dangerous gap in our state's capabilities to address the opioid overdose crisis." 

Another measure that has received far less attention than it should on Beacon Hill is a pilot program proposal for supervised injection sites. While some will decry the appearance of encouraging drug use, the reality is that people in the throes of addiction will consume drugs. Getting them off the street, reducing their likelihood of health risks and giving them compassionate access to treatment services could function as both a powerful harm-reduction measure and a new pathway to recovery, which merits real consideration for such a measure.

Still, Massachusetts embarking on such a bold if necessary policy path raises further questions. Would it expose the commonwealth to federal legal troubles? And would it behoove such sites to also provide clean drugs to prevent the increasingly deadly reality of fentanyl lacing? Some might view providing currently illegal drugs as an anathema, but this harm-reduction measure could also benefit entire communities that suffer from users resorting to property crimes to pay for their habits and other knock-on effects of the black market.

While even broaching these topics might seem a bridge too far for some, the painful reality is that what we are doing is not working. The numbers bear that out, and we cannot look away. From the local level to Beacon Hill to our federal representatives, we need leadership that recognizes the need for action on behalf of our hurting communities that we might mitigate this needless, incalculable suffering.

These proposals should be a start — sooner rather than later.

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