Our Opinion: Promising initiatives for opioid epidemic

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While opioid-related deaths have declined in Massachusetts, they increased in Berkshire County from 28 in 2017 to 40 last year. As state Rep. Liz Malia said at a Beacon Hill hearing on Wednesday, "There is much work to be done," and there are several approaches to be explored.

Rep. William "Smitty" Pignatelli, a Lenox Democrat, has filed a bill requiring all communities to stock police, fire and EMTs with naloxone, an overdose-reversal medication. At Wednesday's hearing of the Joint Committee on Mental Health, Substance Abuse and Recovery, Rep. Pignatelli recounted the heartbreaking story of an overdose victim in the Berkshires who died last year even though a police officer had arrived quickly. The officer did not have naloxone (the medication, under brand names Evzio and Narcan, that reverses the effects of an overdose) with him, however, and the victim died while the officer and the family waited for an ambulance.

"No family should have to watch a loved one die in front of them, in front of a first responder, awaiting Narcan to show up," said Rep. Pignatelli. He told the Joint Committee on Wednesday, according to the State House News Service, that there are gaps in Western Massachusetts and in rural communities where first responders are still not provided with naloxone. Ideally, passage of his bill will prevent this kind of tragedy from ever happening again, in the Berkshires or anywhere else in rural Massachusetts.

A related measure would create an opioid stewardship fund using money from opioid manufacturers and distributors. The bill would target this money to addicts who are provided with Narcan prescriptions but too often go without it because they can't afford the copay.

Berkshire District Attorney Andrea Harrington believes that supervised injection sites could have value ("Point...and counterpoint. Opioid Crisis: Safe Injection Services," Eagle, Sept. 1.) At supervised sites, users of illegal drugs are joined by medical professionals who guard against accidental overdoses. Users can be offered addiction treatment in the hope they will pursue it. Canada and Australia claim their programs are successful in reducing overdoses, cutting the number of discarded needless found in public places and reducing the number of cases of diseases related to drug use, such as hepatitis. Brian Andrews, the head of Berkshire County Ambulance described the sites in The Eagle as "overdoes prevention centers" that keep people alive until they are willing to accept treatment.

Opponents, Gov. Baker among them, argue that the sites would legitimize the use of illegal drugs, and their introduction would be controversial. U.S. Attorney Andrew Lelling has threatened prosecution if they are introduced in the state. In March, a panel commissioned by the Legislature recommended that a pilot program in supervised drug consumption be established. While this concept was not discussed at Wednesday's committee hearing, House Chair Marjorie Decker indicated that it would be in the near future.

The above-mentioned Rep. Malia filed a bill requiring private insurance companies to cover up to 30 days of acute addiction treatment. Under current law, they must cover only 14 days, which supporters of the bill maintain is not enough time to complete detox programs and enter the next phase of treatment. Rep. Malia said at the hearing that this fuels the "spin cycle," in which addicts are discharged too soon, pick up their former drug habits, and return to detox centers to begin the 14-day program again. Public insurance like that provided by Mass Health provides 90 days of acute addiction treatment. For the spin cycle to be broken, private insurers must do their part by funding at least 30 days of treatment to addicts.

The hearing included testimony on behalf of a bill that would increase the use of fentanyl strips to enable drug users to determine if drugs are tainted with this highly dangerous drug before consumption. 

With the federal government slow to react to the opioid epidemic the states have had to take the lead, and Massachusetts has done so over the past couple of years. So much more must be done, however, and we urge lawmakers to follow up on the promising initiatives that have now come forward.

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