How Healthcare Can Help Heal the Addiction Crisis
During one of the many snowstorms this past winter, a 56-year-old woman overdosed on heroin while caring for her grandchildren, Unlike so many recent tragic overdose deaths, she was revived with Narcan administered in time by the Fire Department. She was one of the lucky ones.
Throughout Massachusetts, children, teenagers, and adults are dying in alarming numbers as a result of the runaway use of heroin and other opioids. Plymouth County, and Plymouth in particular, is at the center of this epidemic that is destroying lives, families, and communities. Easy access to cheap heroin, a lack of support programs, and cumbersome insurance rules/regulations are fueling this epidemic.
The number of those addicted to heroin in Massachusetts is staggering. According to as study by the Massachusetts Department of Public Health Substance Abuse Task Force, 45% of adults admitted for substance abuse treatment in Plymouth identify heroin/opiates as their primary drug of choice versus 40% for alcohol. At the state level, it's 48% for heroin/opiates versus 35% for alcohol.
For healthcare workers, these numbers are not a surprise. In 2009, there were 33 overdose deaths in Plymouth County. Last year, this number jumped to 72 overdose deaths, according Plymouth District Attorney Tim Cruz's Office.
BID-Plymouth recently collaborated with Health Resources in Action to better identify issues contributing to the rise in substance abuse. The findings highlight that substance abuse and behavioral health go hand-in-hand. The question that healthcare workers, elected officials and citizens need to ask is: how do we address the issues contributing to the causes and impede recovery from behavioral health and substance abuse?
A few ideas come to mind:
1. Insurance reform: Cumbersome rules/regulations and exclusions that vary from one insurance company to another make it difficult for the proper care to be delivered when it's needed the most—when a patient presents at an Emergency Department or outpatient clinic. However, insurance red tape related to eligibility, coverage and too few insurance staff available to assist only delay access to urgent treatment.
2. Local inpatient and outpatient behavioral health/substance abuse programs: In healthcare, we know that there are 'not enough beds' for those requiring detox, inpatient psychiatry, or those in need of dual diagnosis inpatient care. As a result, substance abuse/behavioral health patients often are forced to receive inpatient care far from home and their support systems. This only makes it more challenging for those wanting to recover.
3. Increase family support services: Behavioral health conditions, like medical conditions, affect the individual and their family. If we treat the individual in absence of their family, the chances of long term recovery are hampered. Family members need education, support, coping strategies, and help navigating the morass of systems and services patients currently encounter.
4. Create housing, education, transportation, and employment opportunities:
Every individual wants and needs a sense of purpose, a connection to others and their community, and to know their life holds meaning. If we don't have a sense of purpose, we don't have hope. Housing, education, employment, and public transportation to schoolwork are the basics for building a foundation of hope.
Changing public policy and insurance reform takes time. Time that too many struggling with substance abuse and behavioral health issues don't have. As a leading provider of healthcare in the region, BID-Plymouth continues to be proactive in addressing, advocating, and developing treatment programs to help those with substance abuse get the help they need—when they need it.
Last fall, with a grant from the Massachusetts Health Policy Commission, we launched an
Integrated Care Initiative that brings together primary care providers and behavioral health specialists to better support the medical, behavioral health and substance abuse needs of those in our community. In addition, we now have behavioral health specialists working in our Emergency Department to assist in the care, and follow up care, of ED patients presenting with substance abuse/behavioral health needs and developing an outpatient opiate addiction treatment program.
Hospital emergency departments play a vital role in the battle against heroin use. Last week, the Massachusetts Hospital Association's Substance Abuse Prevention and Treatment Task Force, that I co-chair, issued new guidelines for how hospital ED’s should screen for opiate addiction to reduce abuse of pain medication.
These programs are an important and hopeful start for reversing the tidal wave of the heroin epidemic. More collaboration between hospitals, community groups, schools, and government agencies is needed. If not, the number of those overdosing on heroin, like the grandmother watching her grandchildren, will only result in more innocent deaths. As stewards of the public’s health, hospitals, in tandem with the communities we serve, simply cannot let that happen.