Attorney General Maura Healey talks toll of opioid epidemic with Berkshire leaders

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NORTH ADAMS — Massachusetts Attorney General Maura Healey pulled together a group of a dozen community stakeholders on Monday morning, for "a candid conversation" about the opioid epidemic and substance addiction in the region to learn about "where you can use more resources and support."

The summation of the subsequent hour-long discussion that took place in North Adams City Hall was "everywhere."

Before opening up the discussion, Healey thanked the people at the table for their ongoing collaborative leadership on this issue. She then gave an overview of the work her office has been doing and highlighted some current areas of focus.

"With regards to prescribing, we're still not happy where we're at," said Healey.

A landmark law last year was established in the commonwealth, to, among other things, limit an opioid prescription to a seven-day supply for first-time adult prescriptions and a seven-day limit on every opioid prescription for minors. It also mandates doctors to check the Prescription Monitoring Program database before writing a prescription for drugs listed as being prone to being abused, like an opiate.

Healey said despite this legislative effort, the state's only seen a 10 percent drop in the amount of opioid prescriptions being written. To offer an example, she spoke of a constituent who recently had surgery and was sent home with 40 pills.

"She only needed four of them," the attorney general said.

Healey said she then asked the woman to, instead of storing the remaining pills in her medicine cabinet, to dispose of them through her local police department's prescription round-up program.

The Massachusetts Department of Public Health estimates that more than 2,000 people — the highest number ever recorded in the state and a 17 percent increase from 2015 — died from opioid-related overdoses in 2016. Massachusetts has lost over 5,000 people to opioid overdoses in the last three years, according to state incident reports.

Healey said her office is also being a watchdog with the use and distribution of naloxone, also known as Narcan, which is a medication that can reverse the effects of an opioid overdose.

In 2015, after reaching a $325,000 settlement with one of the manufacturers of naloxone, Healey's office partnered with the legislature and public health department to create a Narcan Fund for cities and towns, known as the Municipal Naloxone Bulk Purchase Trust Fund, to allow first response groups to carry an active supply in case they encounter such an overdose in process.

The attorney general said her office is preparing to replenish those funds to continue the program, with doses costing $20 each. Healey said her office will continue to watch for any price-jacking to make sure that Narcan remains affordable to cities and towns.

Back in May, Healey and the GE Foundation announced a $2 million public-private initiative, named Project Here, to bring substance use prevention resources to students in every public middle school in Massachusetts. Project Here partners with The Herren Project, which has been utilized by several Berkshire County schools, and mobile information sharing platform called Epicenter Experience.

Additionally this year, Healey's office is committing a $1 million grant from the U.S. Department of Justice to a fund a new Fentanyl Strike Force to crack down on heroin and fentanyl traffickers and disrupt distribution and the cycle of abuse.

About 30 people die each year from opioid-related overdoses in Berkshire County, and there's a mounting concern about fentanyl-laced drugs driving that figure upwards. Anecdotally, North Adams Police Director Michael Cozzaglio told the group that there's been an uptick in incidents in the city in the last 10 days. "Four overdoses and two deaths in a 10-day period, that's high for us," he said.

With such alarming statistics and urgent need for attention and infrastructure, Healey said she's become exceptionally concerned "with what's happening with the health care debate right now," referring to a GOP-lead federal health care reform effort.

"Now's not the time to disrupt the flow of dollars to Medicaid. People need access to care," she said.

Healey said insurers also have a role in supporting access to affordable care, not only for substance abuse treatment, but also mental health and well-being, which are often correlated.

The attorney general also ripped into President Donald Trump for making a big deal last month in declaring the opioid crisis as a national emergency, but doing nothing yet to create a way to support revenue for states to address the issues.

"We need more support from the federal government," she said.

In the meantime, the stakeholders Healey met with explained why the Berkshires needs more from the state, to establish more accessible methods of treatment and support, like peer-run recovery groups and residential treatment centers in North County and South County, in addition to Pittsfield.

"One recovery center is not a model that would serve the community in North Berkshire well," said Wendy Penner, Northern Berkshire Community Coalition's director of prevention and wellness.

Recruiting clinical and support staff to the more rural area that is Berkshire County is also a challenge, even more so when employees in this field struggle to earn a living wage.

Northern Berkshire Community Coalition Executive Director Amber Besaw said supporting healthy, educated families and keeping them safe is part of her organization's mission, and that she'd like to be able to offer more services to fill in the gaps, but, she said, "I don't have the staff to do that."

Reintegration specialist Frank Busener of the Berkshire County Sheriff's Office echoed others' perspectives in that more physical centers need to be established to offer a place of support and resources for people who have initially kicked their addictions, but may be struggling to stay substance-free over a long period of time.

North Adams Mayor Alcombright said local law enforcement and municipalities are working together to try to break the cycle of chronic recidivism.

Jennifer Kimball, senior planner for Berkshire Regional Planning Commission and coordinator for the Berkshire Opioid Abuse Prevention Collaborative, said that ultimately change can't happen to steer people away from using substances until they can cope with the social issues and systemic inequalities that are putting individuals and families into chronic states of distress and crisis. She cited how instead of getting the health care or support services they need, they instead are folded into the criminal justice system, when they "don't need to be there."

Attorney General Healey told the group, "I hear you on all these fronts. I think about people who are set up to fail before they even come into the world. And I completely agree with the points of social determinants of health."

Healey was also joined by two staffers who focus on these issues, from an internal task force level, to a statewide policy position. All three of them during the meeting took copious notes.

She acknowledged the collaborative work the stakeholders have been doing at the community level. "There is so much will in this room, so much great work, so much ongoing cooperation, but you need help, and that's what I hear loud and clear in terms of resources."

"I am deadly serious about doing everything we can and being very, very aggressive" in addressing these issues, said Healey. But, she noted, it "will take some time."


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