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OxyContin Powwow Reports More, Younger Addicts & Reveals Rift In Treatment Protocol
Cape Cod Today
7/14/2009
http://www.capecodtoday.com/blogs/i...contin-powwow-reports-more-younger-ad?blog=53
Cape Cod Today
7/14/2009
By Bethany Gibbons
The number of lives destroyed and families torn apart by opiate addiction is soaring on Cape Cod, according to experts, and the face of today’s addict is younger than it was ten years ago and is more likely to be hitting the medicine cabinet and copping dope from doctors than cruising the streets to hook up with a high. Law enforcement members, treatment providers, physicians, addicts and family members affected by addiction gathered in Hyannis last Friday for a four-hour-long hearing of the Massachusetts OxyContin and Heroin Commission, the sixth in a seven-hearing series at locations across the state.
Barnstable County District Attorney Michael O'Keefe and Sheriff Jim cummings talk before the start of the meeting.
The panel included senators and state Reps - including Barnstable’s Jeff Perry – in addition to probation representatives and a judge. The common theme among those who testified was an increase in addiction to prescription pain medication, affecting more and younger addicts, and a scarcity of treatment options for those afflicted. But detoxification and treatment tools are not created equal, and it became clear as the hours of testimony wore on that some methods of treatment remain stigmatized.
An epidemic in the Bay State
Commission Chairman Steven Tolman (D-Boston) put the issue in perspective, describing the use of OxyContin and heroin in the state as an epidemic. “From 2002 to 2007, Massachusetts lost 78 soldiers in Iraq and Afghanistan,” Tolman said. “In that same time, 3,265 people ODed on the streets of Massachusetts. We need to talk about it – we need to do something about it.”
“She doesn’t think she has a problem; she thinks she can stop any time,” said Ray Tamasi, President and CEO of Gosnold Treatment Centers. “We get calls like this every day.”
“Our intake center is fielding 1,000 calls a week,” said Ray Tamasi, President and CEO of Gosnold Treatment Centers in Falmouth. “Over the last ten to 12 years, we have seen opiate intakes go from ten percent of intakes to 35 percent, and nearly 50 percent of those are addicted to the prescription drugs OxyContin and Vicodin.” For those struggling to escape from the grips of addiction, the prospects are not encouraging. “Over the last ten years, our length of stay has continuously dropped, and now the average length of stay is five days,” he said.
Tamasi reported seeing more young people addicted and recalled a recent phone call from a mother desperate to help her 21-year-old Oxy-addicted daughter, who had stolen large sums of money from the family. The parents reluctantly filed a criminal complaint, but the young woman refused to reckon with her addiction. “She doesn’t think she has a problem; she thinks she can stop any time,” said Tamasi. “We get calls like this every day.”
Taking on the insurance companies
State Representative Jeff Perry and Berkshire County DA David Capeless listen to testimony.
Tamasi’s suggestions for the Commission included more inpatient beds, funding for embedded addiction clinicians in primary care facilities, investment in family-oriented programs and drug courts, and education on chronic pain management for doctors. His final advice, that the Commission “take on the insurance companies” was met by a burst of applause, and he went on to describe how patients are refused coverage for detox because it “doesn’t meet medical necessity and they haven’t failed at other treatment methods.”
While OxyContin has received plenty of press due to its powerfully addictive quality and its knack for killing users, physicians and law enforcement alike have a new adversary. “Our biggest problem now is the Perc30 (or 30 milligram Percocet),” said Sergeant Jack Mawn of the Massachusetts State Police. “I think it should be banned.” Mawn worked undercover on the notorious bust of Cape physician Michael Brown, who over-prescribed opiates, particularly OxyContin and was popped buying them back from his patients. “Anecdotally, after Brown went down we saw a huge drop in Oxy pills on the street,” Mawn said. “Now we are dealing with the Perc30s.” A physician from the Barnstable County Jail infirmary concurred; “I think Perc30s should be banished from the land,” he said. “In all the years I worked with Hospice, I didn’t see one cancer patient who required a 30 mg Percocet.”
“Our biggest problem now is the Perc30 (or 30 milligram Percocet),” said Sergeant Jack Mawn of the Massachusetts State Police. “I think it should be banned.”
Advocating a national registry of drug offenders
Law enforcement officers, including Mawn, advocated for a national registry of drug offenders. The registry would mirror the sex offender registry, with offenders required to check in with local police departments annually and divulge their addresses. Individuals convicted of selling drugs would be targeted, and simple users spared. Level one offenders would have their information available to law enforcement, but not the public. Information about level two offenders would be available to the public, but only upon request, and level threes would have their photos and addresses posted at police stations, schools and post offices and in the newspaper. The proposal follows on the heels of similar programs in states like Tennessee, that were implemented to combat methamphetamine labs.
Barnstable County Sheriff Jim Cummings testified that 40 percent of the current inmate population has used heroin in their lifetimes. “Users are getting younger,” he reported, “and there are more snorters.” He claimed that most crimes resulting in incarceration are related to drugs. Sergeant Mawn agreed. “Drugs are the common denominator among crimes of violence and property crimes.”
Youth programs and school intervention suggested
Wareham High School Principal Pat Clark and a number of involved citizens suggested more intervention in the schools and more youth programs. Barnstable resident and University of Massachusetts Donahue Institute employee Steven Brown spoke about his 40 years on the “front lines of the so-called ‘war on drugs’,” and stated: “It’s not the supply; it’s the demand.” Brown described working with young drug users in Derby, CT in the late '60s. “The kids I worked with shot up heroin because they were chronically hungry… the cabinets in their homes were bare. The same is true here – to be poor in Massachusetts is to be chronically hungry and insecure about your next meal. If you overlay the census tract for drug arrests and poverty, you’ll see they correspond.” He asserted that investment in assuring a good foundation for our youth will pay off in decreased addiction. Brown suggested everything from parenting support and safe, structured activities for kids, to good nutrition and access to health care and even quality education ‘leading to marketable skills’ and opportunities for community service, and his comment that putting all our resources into treatment and law enforcement, without addressing the underlying social causes of addiction would find us “back here next year, next decade, next century” was met by thunderous applause.
Not all who testified were welcomed with open arms by the Commission. John Leavitt, clinical director of the outpatient Suboxone treatment program for heroin and OxyContin addicts at High Point in Plymouth, waited three hours and five minutes to testify. Armed with important data, Leavitt informed the Commission that dual diagnosis is prevalent, echoing the sentiments of Gosnold’s Ray Tamasi, and described the case of a patient who came out of the hospital in April in need of psychiatric counseling, only to find that the closest booking for an appointment was in June 2010.
Suboxone suggestion shot down at hearing
Leavitt also explained what makes the Suboxone clinic at High Point a success, including a highly structured program that utilizes frequent urinalyses to decipher how much Suboxone the patient has consumed during the previous week. He pointed to a study that indicated the average number of days sober on Suboxone, without inpatient detox, was 302 – a startling figure given the high rate of recidivism for opiate addicts.
Less than three minutes into his testimony, Leavitt was abruptly interrupted and summarily dismissed by Chairman Tolman, who said, “I don’t think Suboxone a good way to go… it’s used too quickly without the patient having gone through intensive treatment and taking time off work.” Tolman stated that the Commission wasn’t going to focus on that method of treatment, despite the Commission’s mission statement of looking at prevention, treatment and law enforcement. A member of the audience leapt to her feet and cried out, “But doesn’t there need to be a continuum of care? So that people get treatment at different stages of addiction?” Vicki Ward, who has worked in treatment on the Cape for seven years, described her comments in the hallway later. “There needs to be more of an understanding of the continuum of care,” she said. “Some people hate Suboxone, some people hate methadone, but some people need that kind of treatment to stay alive.”
http://www.capecodtoday.com/blogs/i...contin-powwow-reports-more-younger-ad?blog=53
