Beth Israsel Deaconess Hospital - Plymouth

          

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One Overdose is One Too Many

Tackling drug addiction in the region

Do you know someone who is addicted to drugs, has overdosed on drugs, or who has died as a result of an overdose? Chances are, you do. During 2014, 1,000 residents in Massachusetts died as a result of heroin and/or other opioid drugs. In past years, cities such as Taunton, Brockton, and Boston were considered ground zero for drug overdoses.

Not so, any more. Plymouth now holds the title as one of the towns with the highest number of overdoses and drug related deaths with 313 overdoses and 15 deaths in 2014 alone. How did this crisis become a crisis? According to Dr. Danny Mendoza, chief of Psychiatry, Beth Israel Deaconess Hospital-Plymouth, there are potentially three contributing factors to the recent surge in overdose deaths: a potent strain of heroin flooding the streets, suppliers cutting heroin with a synthetic substance such as the powerful prescription drug fentanyl, or addicts using heroin together with other drugs, such as Percocet or doing it in conjunction with benzodiazepines or with alcohol.

A Harvard School of Public Health report found that nearly 4 in 10 Massachusetts residents know someone who has misused prescription pain killers in the last five years. “We're finding out that this epidemic is hitting all socioeconomic classes and with the theory of downward social drift, people realize that rather than spending $30-35 for a Percocet tablet, they can buy heroin for $3/bag,” says Dr. Mendoza. This is often accentuated when people go into withdrawal and the level of desperation and risk taking goes up dramatically. “Unfortunately, you have no idea what you're getting with that $3 bag. You don't know what's been used to cut it and you’re taking your life into your own hands,” adds Mendoza.

Addiction starts slowly and often with prescription painkillers prescribed to control orthopedic or other types of pain. According to the Massachusetts Department of Public Health, many children and adults often access narcotic pills such as Percocet, Oxycodone, or Hydrocodone by "diverting" or stealing prescriptions meant for parents or grandparents. Also, many children and adults are receiving too many prescription pain killers from physicians when just a few are needed to manage their clinical pain.

Physicians and nurses at BID-Plymouth routinely find themselves consoling the family members of individuals who die in the Emergency Department or desperately try to direct a patient to outpatient care after an opioid-related drug overdose. “A few months ago, a car pulled up outside the Emergency Department and a young woman who was non-responsive was placed on the ED waiting area floor by her friends,” says Dr. Liudvikas Jagminas, chief of Emergency Medicine, BID-Plymouth. “The woman was turning blue and we quickly figured out that she overdosed on heroin and revived her. When she woke up, she declined outpatient treatment and said she’d take a ‘little less [heroin]’ the next time”.

Community response

In response to the growing number of opioid overdoses and deaths, BID-Plymouth along with the Plymouth School System, Town of Plymouth, and community groups have joined together to tackle the issue head-on. For BID-Plymouth, this has lead to the creation of the Integrated Care Initiative (ICI). The ICI is currently a pilot program that brings social workers and behavioral health specialists into the hospital’s Emergency Department and primary care offices to better support the medical, behavioral health, and substance abuse needs of individuals and families in the community.

When fully-implemented later this year, BID-Plymouth’s ICI will serve patients over age 12 with medical and behavioral health/substance abuse needs. The program’s social workers will also provide crisis intervention, needs assessment, information and referral to community resources, follow up and short-term individual and group counseling. Additionally, once up and running, a psychiatrist and psychiatric nurse practitioner would provide medication evaluation and management, follow up, and consultation to outpatient behavioral health and medical providers.

Why combine medical and behavioral health?

Research has shown a well-documented overlap of medical (diabetes, asthma, heart disease) and behavioral (anxiety, depression, alcoholism) health conditions. By addressing and providing help for both conditions from a team that collaborates closely, patients have a better chance at recovery and wellness. Patients feel comfortable coming to their doctor’s office for ‘one stop shopping. We want to reduce the stigma, increase the support, and make it easier for patients to get the help they need when they need it.

BID-Plymouth’s ICI is now developing an outpatient opiate addiction treatment program utilizing Suboxone in conjunction with comprehensive individual and group counseling. Support groups will also be offered to assist families who are coping with the challenges associated with living with and caring for family members who are afflicted with opiate addiction. These outpatient services are being designed to greatly reduce access to opiates while increasing help and treatment in order to address the epidemic and stop the deaths from overdoses.

How you can make a difference and available resources

If you suspect that a friend or family member has an opioid addiction, what can you do?

First, there is help available. With the right diagnosis, intervention and treatment plan, your loved one can escape the grip of this disease. You won’t be able to solve the problem on your own. By building a support network for you and the individual struggling with addiction, identifying a substance abuse counselor or treatment facility, and by educating yourself about this disease, you will be in a better position to help.

The Massachusetts Department of Public Health has many resources to help you start the conversation. For more information, go to: http://www.mass.gov/eohhs/gov/departments/dph/stop-addiction/ or call their Stop Addiction Hotline at: 1-800-327-5050.

For information about BID-Plymouth’s Integrated Care Initiative, please call 508.746.8590, ext. 5216.

BID-Plymouth
275 Sandwich Street
Plymouth, MA 02360
(508) 746-2000

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