For the second straight year, the social-services programs in Massachusetts led to a decline in opioid-related overdose deaths. In Massachusetts the three-year state-level commitment to policy, legislation, and agency action has made it the only state in which the death-rate of the epidemic has declined.
While the death-rate diminished by 4% from that of 2017 (2% decline vs. 2016), the state lost more than 2,000 citizens to opioid-related overdoses—more than double the number of lives lost in 2013. The epidemic, which is nation-wide and growing, continues at a horrific rate even in a state with relatively effective programs in prevention, education, and access.
The slight decrease in the Massachusetts death-rate is attributed to a change in the understanding of addiction, from a choice made by an addict to a disease afflicting a victim. This paradigm shift is buttressed by public-health measures such as improved public awareness, greater access to treatment, and the widespread availability and use of the overdose-reversing drug naloxone, or Narcan. These programs are aimed at preventing deaths and ameliorating addiction, made possible by the specific programs implemented in the state’s communities as a result of policy enacted at the highest political level, the state’s commitment to near-universal affordable health insurance, and the implementation of both ACA and most elements of the Mental Health parity Act. All of this results in better access to therapy and to the medications that prevent overdoses, often through community-based facilities.
The illicit synthetic drug fentanyl, combined with heroin, accounts for the great majority of the opioid deaths. The epidemic began by the over-prescription, by physicians, of opioid-based pain-killers such as Oxycontin, manufactured and promoted by Purdue Pharma. Once set in motion through doctors’ offices, the addiction and epidemic has been fueled primarily through use of illegal drugs. Just 15% of the Massachusetts victims in 2018 had been taking prescription opioids.
Anti-opioid addiction programs in Massachusetts are working in terms of public education, awareness of the danger, and access to treatment and medication. Much work remains to be done to increase the distribution of medications through physicians’ practices and hospitals, as well as to facilitate access to stable housing for those recovering from addiction. In addition, there is a lag, in many places, in the implementation and enforcement of a new law requiring hospital ERs to provide medication to those who have overdosed and to connect them directly with treatment programs.
For more information about Massachusetts programs, visit mass.gov/opioidresponse.
As a clinical social worker, what are you doing to address the opioid addiction crisis in your community? In your state? If you practice in this area, why not share some of your experiences and approaches to treatment?