Maintain momentum on opioid addiction

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At last, the scourge of opioid addiction that has cast a shadow on every city, town and rural hamlet in the land shows the beginning signs of diminishing (Eagle, April 20). Thanks to increased awareness by both patients and the medical establishment, the number of prescriptions for opioid painkillers nationwide is falling. Every state has shown improvement according to data revealed in the IQVIA's Institute for Data Science report reflecting an 8.9-percent nationwide drop in total prescriptions, and an even greater 12 percent drop in total dosage. In Massachusetts, the number of patients receiving prescription opioids in the 4th quarter of 2017 (the most recent period for which data are available) is down by 30 percent from the first quarter of 2015, according to the state Department of Public Health.

This positive sign is by no means a signal that the battle against the debilitating drugs that sap lives, destroy families, erode communities and depress national productivity has turned a corner. Legally obtained painkillers are only part of a problem that includes illicitly obtained and illegally manufactured drugs like fentanyl that have flooded the street. Nevertheless, the nation's health care providers, who a quarter of a century ago were seduced by the marketing efforts of Big Pharma to begin prescribing what appeared to be miracle drugs, are not only more cautious but have altered their prescribing practices accordingly. In Massachusetts, for example, state regulations restrict the time period covered by prescriptions to seven days before renewal is required in order to cut back on abuse.

Clearly, news of opioids' dangers has begun filtering down to those who seek treatment for legitimate reasons, like the alleviation of temporary and chronic pain. These cases, though, largely comprise non-addicts still capable of making a choice as to whether to use them. Proposed legislation submitted by Governor Baker would tighten the prescription-writing process further by eliminating oral and written prescriptions for opioids, requiring use of an electronic system.

For those who are addicted, the governor's proposal includes measures designed to facilitate access to substance abuse treatment. Its elements include expanding the number of those who can provide substance abuse evaluations to overdose victims taken to hospitals, recording overdose and treatment in a patient's electronic records, enabling hospital staff to authorize a patient's involuntary transport to a treatment facility. Additionally, a $2-million trust fund would be set aside to promote anti-opioid education, particularly for at-risk youth.

In related news, the number of overdose deaths from opioids has also been in decline in Massachusetts from a peak of 2,155 estimated deaths in 2016 to 1,977 in 2017."We are cautiously optimistic," Dr. Jennifer Michaels, medical director of the Brien Center in Pittsfield told The Eagle. "Partially, we can ascribe that to the greater availability of Narcan (an anti-overdose drug). We now have highly effective evidence-based medications that can treat addiction. There's also a greater awareness that opioid addiction is a treatable disease. "

Dr. Michaels welcomes another of Governor Baker's initiatives — his vow to allocate federal Medicaid money to expand access to residential and medication-assisted treatment. "We need more residential care and inpatient rehabilitation beds. Recovery takes time." Rehabilitation includes equipping clients to conduct their lives without resorting to addictive drugs, a process that cannot be rushed, she said.

Each addiction case presents a challenge, and each overdose death is an individual tragedy, but at least the trend is favorable. The governor's proposal could not be more timely.

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