STATE OF AFFAIRS: Heroin Crisis Blamed for Resurgence of Hepatitis C in Massachusetts
Opioids Surpass Alcoholism as Drug of Choice in Healthcare Reform State
BOSTON, Mass. – Health officials told the Telegraph Wednesday that in the past year over 2000 new cases of hepatitis C in people under the age of 30 have been discovered in Massachusetts, and they feel intravenous drug use is to blame. Officials warned the drug use could drive the state to a possible HIV outbreak like the one seen nationally 30 years ago.
The hepatitis C virus is much more contagious than HIV. Officials warned that even washing needles in bleach will not kill the disease, even though it has been known to be effective against HIV. Contaminated syringes and the drug Opana are also to blame for a state of emergency last month in Indiana after a small community reported 100 new cases of HIV.
Lydie Ultimo, Director of the Massachusetts Bureau of Substance Use Services, says patterns are occurring all over the state that mimic what is happening nationally. With prescription drug monitoring programs (PDMP), prescription painkillers are becoming a gateway drug to heroin once the pills are not accessible to the user.
“It’s a cheap way to keep the addiction,” says Ultimo.
The Bureau, which licenses substance use treatment centers and funds treatment in the state, works to provide coverage for individuals with no insurance.
“We are a health care reform state and approximately 90% of people in the state are covered with health insurance,” says Ultimo.
Still, Ultimo says, 15% of people who struggle with substance use addiction are uncovered, possibly because of their addiction. The Bureau believes the solution is in their 4-legged approach:
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Prevention: Reaching out to families, parents, communities and giving them resources so they know the signs. Support communities to raise awareness.
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Intervention: Working closely with people at risk so they can screen them for drugs early. The Bureau started a robust program in 2007 providing municipalities with Narcan (Naloxone), a drug that helps reverse an opiate overdose. They provide medication, technical assistance and training on when and how to administer the drug.
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Treatment: Addressing treatment across the lifespan of an addiction to set the individual on the right track once they leave a facility.
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Recovery support: Connecting them with peers, and keeping them plugged in with others in recovery.
Massachusetts is one of few states that operates 5 recovery high schools for students in recovery that don’t do as well in traditional schools.
“There’s a lot of work around not only educating them but offering them support,” says Ultimo.
Ultimo agrees that nationally there is a limit for bedded detox services, a practice that safely carries the patient through physical withdrawals, which can be deadly.
“Places are at capacity across the board,” says Ultimo. “More and more people are needing inpatient detox.”
Ultimo says the state has prioritized the need to ensure that enough treatment is available to people battling addictions. Like the state of Tennessee, opiates (prescription painkillers, heroin) have far surpassed alcohol as Massachusetts’ drug of choice.
“People are usually starting with prescription pain killers and then moving on to heroin,” says Ultimo. “There’s been a spiking of overdoses in general across the board.”
Most of the fatal overdoses the state is experiencing are opiate-related, with a heavy concentration in 16-29 year olds. There is also a growing trend of heroin overdoses in hot spots, where batches of fentanyl-laced heroin may cause 5-10 overdoses in a small area. Fentanyl, a potent pain reliever, was the subject of a warning from the Drug Enforcement Agency just a couple of weeks ago.
“It’s a very sophisticated market all across the state,” says Ultimo. “And it doesn’t discriminate.”
The Massachusetts Legislative Branch has recently been addressing several insurance barriers to fight its epidemic. One of the problems addressed was inadequate or inappropriate provisions that limit a client’s recovery, such as only covering a short amount of days for treatment.
Many other states have seen cuts in their drug prevention and treatment programs, which Ultimo says is not the case in Massachusetts.
“The Governor and the new Legislative Branch are not just talk,” says Ultimo. “They are very involved and are supportive.”
Just 2 weeks ago, Governor Charlie Baker organized an opioid use task force expected to make recommendations to the state later this year. Just this past week, the Massachusetts Medical Society, made up of 24,000 of the state’s top physicians, dedicated its entire annual meeting to the heroin crisis. The battle against opiate use is a long road ahead for Massachusetts and the entire United States, but kudos to one state for putting their shoes on and walking it.
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