Pubdate: Thu, 15 Nov 2012
Source: Worcester Telegram & Gazette (MA)
Copyright: 2012 Worcester Telegram & Gazette
Contact:  http://www.telegram.com/
Details: http://www.mapinc.org/media/509
Author: John J. Monahan

HEALTH REPORT VIEWED AS 'WAKE-UP CALL' ON HEROIN USE

BOSTON -- A privately produced report on the state's public health
trends is putting new emphasis on the level of heroin addiction
problems in the state, citing statistics that show Massachusetts had
some of the highest rates for heroin overdose emergency room visits in
the U.S.

The report from the Massachusetts Health Council Inc., a private
advocacy group promoting government action on prevention of obesity,
asthma, substance abuse and tobacco use, cited federal statistics
showing the Boston region had the most emergency room visits involving
heroin of the top 11 major cities in the country.

The council report also states that "lifetime heroin use in Worcester
is almost 5 percent, twice the state and national average." Lifetime
use refers to a report of using heroin at least once in a lifetime.

Karyn E. Johnson, coordinator of substance abuse programs for the
Worcester Department of Public Health, who attended a meeting on the
report Tuesday at the Statehouse, said the 5 percent lifetime use
assertion in the report is based on a 2011 survey of high schools in
Worcester and surrounding towns, undertaken for the city with public
and private funding.

"We threw in a question about heroin. The question around heroin
reported that 4.9 percent of the youth that participated in the survey
had used heroin, and that is double the state and national average,"
Ms. Johnson said. "The Department of Public Health was very concerned
about that statistic," she said, because grants to combat heroin abuse
and overdoses were directed at adults with a history of opiate overdoses.

"What this is telling us is we need to focus more upstream. If kids
are already reporting by the time high school comes around that they
are using heroin, that means we have to work with middle school
students," Ms. Johnson said, and efforts are under way to develop
programs for drug education in the schools.

She said the department believes the high level of heroin use reported
among youth stems from prescription drug abuse. "That is where we
believe this heroin problem is coming from," Ms. Johnson said, noting
that a crackdown on prescription drugs is making them harder to find
on the streets. "It's getting more difficult. Pills on the street are
very expensive. Heroin is only $6 to $8 a bag," she said.

"What surprised us was that youth in high school were reporting it at
such a young age and to that degree. That is what shocked us," she
said. She said the city wants to undertake a repeat survey to find out
more about the problem and has begun talking to schools about doing
social norm programs to discourage drug abuse.

Citing information from other studies, the health council report says
there were 4,821 people admitted to drug treatment programs in 2010
from Worcester, and about half of those involved addiction to
opiate-based drugs, including heroin and Oxycontin.

The report emphasized that Eastern Massachusetts has been particularly
hard hit by heroin abuse, citing national data that found the Boston
metropolitan area that includes Suffolk, Middlesex, Norfolk, Plymouth
and Essex counties had the highest rate of heroin-related emergency
room visits of the 11 major metropolitan regions of the country.

While the MHC's report, paid for by the Massachusetts Medical Society
and the drug firm NovoNordisk, shows a serious problem in Worcester,
state officials took issue Tuesday with a comment from the council's
executive director. At a press briefing at the Statehouse, Executive
Director Susan Servais said the group's report found an explosion of
heroin use and asserted, "Worcester has the No. 1 heroin addiction
problem in the entire country."

Hillary Jacobs, director of the state Bureau of Substance Abuse
Services, however, disputed Ms. Servais assertion that the city had
the worst heroin problem in the country.

"When we look at an indicator of opiate problems we do see that
Worcester is one of the high risk areas of the commonwealth, but is
essentially similar to all other major metropolitan areas in the
commonwealth," Ms. Jacobs said later.

"They are in line with other large urban areas in the commonwealth in
the kind of opiate problem they are experiencing," Ms. Jacobs said.
"The Bureau of Substance Abuse Services does not have data that
Worcester has the worst opiate problem in the nation," she said.

She said that is not to dismiss the serious opiate problem that does
exist in the city.

Ms. Jacobs said Worcester is ranked as being one of eight communities
in the state with the highest fatal and nonfatal overdoses by the
state. Nonetheless, Worcester officials remain concerned about the
problem and indications that it may be growing in recent years.

"It's clear from this report we have a lot of work to do in
Worcester," said state Sen. Harriette L. Chandler, D-Worcester. "This
report ought to be a wake-up call for everybody."

Ms. Chandler, vice chairman of the Senate Committee on Public Health,
said educational outreach and more access to drug addiction treatment
are two obvious needs identified by the report. She said state local
and federal law enforcement also have a role to play in cutting off
the flow of heroin into the city.

She said city public health and school officials and others working to
prevent drug abuse have focused much of their efforts on countering
the surge in prescription drugs, including Oxycontin abuse in recent
years, especially among school-aged children. "They have been very
hard at work on prescription drug abuse that may be a gateway into the
heroin problem," Ms. Chandler said.

Although heroin abuse has long been elevated in the city, she said,
"There is no reason why we should have this kind of problem."

In terms of educational outreach, she said, more work needs to be done
in the schools. "They have to understand that the immediate kick they
may get from heroin leads to really serious problems. They can be
addicts for life and it can ruin their life," she said.

Also, she said, young people need to learn that sharing needles causes
other problems, including the spread of HIV and Hepatitis. "We have to
make kids aware of it early on."

Treatment programs for addicts in the county jail need to be enhanced,
she said.

"They have a program now going in the jail and they should keep that
going," she said. "I tried last year and I am going to try again to
have a separate group of cells in the jail to separate them from the
general population. Obviously there are drugs in the jail and we have
got to give them some hope in terms of getting a job and moving on
with their own lives," Ms. Chandler said.

"And we have got to crack down on where the heroin is coming from,"
she said, which may require a focused effort by federal drug
enforcement agencies. "We absolutely need that."
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