The Massachusetts Health Policy Forum held a forum Friday at the University of Massachusetts examining opioid addiction in the rural communities of Western Massachusetts as well as providing several policy recommendations to limit opioid use.
The event, titled “Addressing the Opioid Crisis in Small and Rural Communities in Western Massachusetts,” was based on a report that was created through a “detailed literature review and 24 stakeholder interviews” relating to the opioid crisis in Western Massachusetts. The report was authored by Robert Bohler, a doctoral student at Brandeis University’s Heller School for Social Policy and Management; Michael Doonan, an associate professor at Brandeis; and Constance Horgan, a professor and director at the Institute for Behavioral Health at Brandeis.
According to the issue brief that summarized the full report, “the most recent data” indicated a 73 percent increase in deaths due to opioids in western Massachusetts despite the number of Massachusetts deaths decreasing.
“While preliminary data in 2018 from the Center of Disease Control and Prevention indicate a decline in a fatal opioid overdoes epidemic nationally, we know this isn’t necessarily the case,” said Massachusetts Sen. Ed Markey in a pre-recorded video played at the forum.
In 2018, opioid deaths increased by 29 percent in Hampshire County, 48 percent in Berkshire County, 84 percent in Hampden County and 144 percent in Franklin County, according to the brief.
Bohler cited fentanyl, a highly addictive pain reliever, as a reason for increased opioid deaths in western Massachusetts, claiming the emergence of fentanyl in 2013 coincided with an increase in opioid deaths in the Commonwealth.
The emergence of fentanyl in the eastern part of the state has moved westward, leading to more opioid deaths, Bohler said.
There are also several “high-risk groups” that are more susceptible to opioid overdose deaths, he added. These groups can include those who have experienced a nonfatal overdose, the homeless, those diagnosed with a mental illness, the recently incarcerated, mothers with an opioid use disorder and those who have been prescribed opioids for three months or longer.
“It is very important to identify these groups so that we can tailor interventions at these high-risk populations,” Bohler said.
Bohler also described a “generational impact of opioid addiction,” which includes grandparents who take care of grandchildren with parents addicted to opioids and an increased “burden” on foster homes who take in children of parents suffering from OUD.
Also mentioned was the concept of “touchpoints,” which are places where there is a high concentration of opioid users and intervention techniques, such as the use of medicine to help users control OUD, can be implemented. These touchpoints include prisons, jails, emergency departments and community health centers.
The Drug Addiction and Recovery Team is also working on curbing OUD. DART “is an innovative program where a team comprised of police officers, recovery coaches and harm reduction specialists follows up with people after a nonfatal overdose, substance-related incident or referral,” according to the brief.
“[DART is] very innovative in that it’s a bonus if they can get the person linked to treatment, but they are trained under a harm reduction approach so it’s nonjudgmental, it’s compassionate and they are there to meet people where they are at,” Bohler explained.
Horgan later mentioned several policy suggestions based on their research and findings in the report. The suggestions included increasing medication to treat OUD, intervening to stop opioid prescribing practices, increasing the role of the criminal justice system in treating those with OUD and addressing “social determinants” of health to increase access to treatment.
Horgan also praised the role of activists in Western Massachusetts fighting the opioid crisis in the region.
“It has been amazing what’s happening in Western [Massachusetts] and the role you’ve played in bringing people together,” Horgan said to the audience. “That’s just been so key and important.”
Will Mallas can be reached at [email protected] and followed on Twitter @willmallas.
