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Here in New England, it’s hard to get through a news cycle without at least one mention of the region’s opioid epidemic. Every media outlet covers it; governors are creating task forces faster than you can count; and the presidential candidates expect daily questions on the matter, often from parents who lost a child to an overdose. (Notably, Jeb Bush’s daughter has struggled with addiction for years, and Carly Fiorina’s stepdaughter died of an overdose.)
Is the problem worthy of the hype? More so than I had thought. In Massachusetts last year, there were nearly 1,100 confirmed deaths from opioid poisoning, and that number is likely to crawl higher as some investigations are completed. That’s up from 711 deaths in 2012, which constituted very nearly 30 percent of all accidental deaths in the state. Most depressingly, confirmed overdose deaths have increased every year since 2010, when the number was just 555. New Hampshire has only a fifth as many people as Massachusetts, but almost a third as many fatal cases. These rates are significantly higher than national averages.
Now, statistics like this are only a reflection of reality and often a distorted one: It’s wholly possible that the increase in the number of recorded incidents reflects, at least in part, a growing awareness of such causes of death (when you start looking for things, you tend to find them). Still, that’s a staggering number of deaths, both in absolute numbers and as a proportion of preventable deaths. I’m hesitant to use the word “epidemic” to describe things short of the Spanish Flu, but there’s a undoubtedly a very serious problem here.
One of the more interesting aspects of this is that a large and growing percentage of addicts start with prescription opioids and then progress to illegal ones. That is, they get hooked on OxyContin or similar pain killers — dangerous in itself — and then switch to heroin when their prescription runs dry or they can’t afford to refill it. (Like many folks, I know someone who got hooked on prescription narcotics. It was a mess. She’s recovered, but she had a really strong support network).
Indeed, the numbers of legal painkillers prescribed are astonishing (for a really interesting piece on pain treatment, do check out this one we published earlier this week). Via the Boston Globe, consider:
The council also received new data on prescriptions for controlled substances, such as painkillers, derived from the monitoring program. It showed that prescriptions had declined slightly in 2014, returning to 2011 levels. But the numbers remain staggering: In a state with 6.7 million people, 4.4 million opioid prescriptions — including 240 million pills, capsules, or tablets — were dispensed in 2014.
One of the more interesting responses to the crisis has been the distribution of naloxone, a drug that can reverse the effects of an opioid overdose. Though effective, safe, and available to medical professionals for more than three decades, some municipalities have experimented with distributing it widely, including to treatment facilities, police, family of addicts, and — controversially — the addicts themselves. A few years back, the police department in Quincy, Mass. spearheaded a program of training all officers to carry and administer emergency doses; they’ve saved dozens of lives locally in the last few years and have trained other departments in the region. Also controversially, the Gloucester, Mass. PD has unilaterally decided not to arrest addicts who walk in the door, and to divert them to treatment instead.
On the other hand, Massachusetts Governor Charlie Baker is considering a number of responses, including short-term involuntary treatment, restricting the number of pills that can be prescribed at any given time, and requiring pharmacies to do more reporting.
Of course, there’s only so much state and local agencies can do, and the real work is almost certainly best done by private institutions and churches. Laws and regulations might be able to mitigate the damage, but family and religion stand a much better chance of addressing the underlying human crisis.