Pubdate: Sat, 31 Dec 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Mark Arsenault

STATE REPORT REVEALS BARRIERS TO OPIOID ADDICTION TREATMENT

Lexi sat under a highway overpass where she sleeps near a stretch of
Massachusetts Avenue nicknamed "Methadone Mile" in Boston last April.

Just 49-percent of adult patients who check into state-licensed
residential substance abuse centers complete their treatment programs,
while a substantial portion of patients walk away from treatment or
relapse, according to a new state report.

And despite intense focus by advocates and government officials to cast
opioid addiction as not a character problem but a public health crisis,
the stigma attached to substance abuse remains "a significant deterrent to
seeking care."

"Stigma in emergency rooms manifests in various forms: not providing
substance use disorder treatment, derogatory comments toward people with
[addictions, and] not making an effort to screen insurance and connect to
treatment," reads the report of the commission that studied
Massachusetts-licensed addiction treatment centers.

The report further illustrates the difficulties Massachusetts faces in
combating an opioid epidemic gripping much of the state.

The state reported 1,005 opioid overdose deaths in the first nine months
of this year, with an estimated 392 to 470 suspected cases that may be
added later, the Globe has reported. There were nearly 1,200 confirmed
overdose deaths in the first nine months of 2015.

On this stretch of Mass. Ave., the lives of people struggling with
addiction - still using or in recovery - are lived in public sight.

The special commission was created by legislation last spring. The
11-member panel, which by law included addiction treatment advocates and
family members of patients treated at state-licensed treatment centers,
was chaired by state Health and Human Services Secretary Marylou Sudders.

The commission was charged with studying addiction treatment services and
recommending potential improvements to the House and Senate by Jan. 1. The
committee filed its report Nov. 21, though it received little public
notice at the time.

The commission recommends more training for hospital emergency departments
and the creation of substance abuse "trauma teams" to respond quickly to
drug-related emergencies, according to a copy of the report.

It recommended increasing patient access to recovery coaches, who should
receive ongoing training and supervision.

"Coaches are helpful at all stages in the recovery process," the report
states. "Inadequate aftercare increases risk of relapse."

The commission further suggested that hospital emergency departments lack
sufficient training and protocols to help patients get the right
treatment, and that patients and their families need more information
about treatment facilities to properly assess them.

The report recommends additional educational programs for "all staff that
interacts with individuals in recovery" to address stigma.

Joanne Peterson, a member of the commission and founder and executive
director of Learn to Cope, a nonprofit addiction support organization,
said people seeking treatment for a family member in an emergency room can
be "shoved aside and left in the corner where they can sit for hours upon
hours."

"There's nothing worse than asking for help and being pushed aside,"
Peterson said. "Is a heart patient treated that way? Is the mother of
somebody who's just been in an accident treated that way? No - but if it's
somebody on medication or actively using and they're trying to find a
place to get help, it's very, very different. Stigma is very much alive
and it's a huge barrier."

State Senator Jennifer L. Flanagan, a Leominster Democrat and chairwoman
of the Joint Committee on Mental Health and Substance Abuse, called the
report "a helpful tool" for lawmakers who continue to wrestle with the
crisis.

"This is such a difficult issue to tackle in its entirety," she said in a
telephone interview Friday. "I tell people all the time, I feel I should
have a picture of a wagon wheel on my wall because every time I think I
got it, another spoke pops up - something we didn't think would happen,
and someone is living through it. It's a different kind of war on drugs."

Governor Charlie Baker's administration said in a statement that it
"remains committed to fighting the opioid epidemic and in evaluating these
recommendations has continued to invest in prevention, education,
treatment, and recovery programming to curb this public health crisis
impacting citizens across the Commonwealth."
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