State Sen. Jennifer Flanagan, D-Leominster, is leading a special committee seeking to craft legislation related to opiod abuse and treatment. She was joined at a public hearing Tuesday by Sen. Benjamin B. Downing and Mayor Richard Alcombright.
NORTH ADAMS, Mass. — Training, support and treatment centers are critical to stemming the tide of heroin addiction in Berkshire County, as well as across the state.
And so is the funding to keep those resources going.
"Prevention is a fraction of the cost of incarceration. ... We need to move our funding to prevention," Gail Lesure, program director at The Brien Center for Mental Health and Substance Abuse, told the state Senate Special Committee on Drug Abuse and Treatment Options on Tuesday morning.
Lesure ticked off a list of problems preventing addicts and their families from getting help and support — from insufficient insurance coverage and state reimbursements, to waiting lists for treatment centers, to transportation issues, to short funding of family support systems, to lack of outreach on a grassroots level.
"We need to send the message that help and hope is available," she said.
"This is a community health problem and it will take a community effort to find solutions."
Lesure's message was repeated by more than a dozen representatives from social service agencies, schools, law enforcement, health care centers and the community.
The special committee, chaired by state Sen. Jennifer L. Flanagan, D-Leominster, was at City Hall for the sixth of eight planned public hearings across the state in anticipation of legislation designed to streamline and bulk up support for treatment options.
Flanagan, who holds a master's in mental health counseling from Fitchburg State College, said she was aware of the problems related to addiction, having worked with youth, addicts and mental health patients in the past.
Senate President Therese Murray, in recognizing the epidemic by appointing the committee and Gov. Deval Patrick, in declaring opioid addiction a public health crisis, was a start, she said.
"We need to start talking about this as a health care crisis and not as a criminal justice problem," she said.
"I've been dealing with these issues for over 10 years in the Legislature ... I need to know from you up here in Northern Berkshire County what's going on and how I can be helpful."
The array of speakers testified to the multifaceted complexity in dealing with the heroin and opioid epidemic.
Anne French, the service learning coordinator for the North Adams Public Schools, and Berkshire County Head Start Executive Director Stacy Parsons noted that substance abuse problems are affecting the community's children.
French, reading a statement from Superintendent James Montepare, said restoration of funding for school adjustment counselors and health counselors was needed to help deal with children affected, or afflicted, by addiction across all walks of life.
Parsons said Head Start was seeing more children from broken homes and being raised by grandparents, and is becoming more invested in helping parents with addiction issues.
"We've really come to be case managers and cheerleaders for families. ... When someone goes off the rails it really is emotionally difficult on the staff," she said.
Several speakers said funding for more beds in the Berkshires was critical. Addicts seeking help could wait four to six weeks to get into the centers at Holyoke or Springfield; there are only 24 residential beds in Berkshire County compared to 310 in Central Massachusetts.
They urged Flanagan and state Sen. Benjamin B. Downing, D-Pittsfield, to pressure insurance companies to pay for more than five-day detox treatments and for the state to reimburse at higher than the average 63 percent it does now.
After five days, the addict usually returns to the same environment within which they were using, unable to adjust and often relapsing. He or she may lack support from fractured families and be unable to find work because of their addiction or convictions, leading in a vicious circle back to jail or using.
"A five-day court-ordered stay in a detox facility is just not enough, forcing addicts into AA or NA is not enough, weekly therapy is not enough, jail is not enough," said Mayor Richard Alcombright. "This community and this commonwealth both need to become leaders not only in prevention and strict enforcement but also a commitment to addicts for the long-term, insurance-covered, dual-diagnosis treatment."
District Attorney David Capeless has laid the blame squarely on the proliferation of prescription pain medications that began in the 1990s and which has since led to an influx of cheaper heroin. Dr. Jennifer Michaels, a psychiatrist and medical director at the Brien Center, agreed, calling the trend for physicians to offer a quick fix by overprescribing drugs such as OxyContin a "perfect storm."
"We have a whole generation of people addicted to opioids," she said. "It is a disease, it is a genetic illness with environmental risk factors."
But there is no parity in how addiction and mental health, often inextricably linked, and other illnesses are treated, she said.
If a patient presented at a hospital suffering from diabetes, he or she would be treated; if the patient came in with depression, the doctor would have to plead with the insurance company for treatment.
"We have treatment that works, we just don't have insurance that will pay for it," Michaels said.
She and Capeless, represented by Assistant District Attorney Robert Kinzer, called for changes in insurance coverage, as well as stiffer regulations on opioid prescriptions and mandatory "real time" documenting of them electronically in the Prescription Monitoring Program.
Nearly a fifth of all Massachusetts residents have been prescribed Schedule II drugs; between 2000 and 2008, the rate of prescriptions rose 450 percent in Berkshire County alone.
"We need to redirect accepted prescription practices and at the same time ensure the availability of comprehensive, ongoing treatment that is supported by affordable insurance protection," read Kinzer. "In the end, that will undoubtedly require bold legislative action opposed by the powerful medical and insurance industry lobby."
Flanagan, vice chairman of the Senate Ways and Means Committee, said she was impressed with the amount of data collected by the speakers, the most she had heard in previous public hearings, and the amount of collaborative effort and solid ideas.
But it won't be a quick fix, she warned, and would come with a cost.
"I think you guys stretch the limit as to what you can do," she said, adding a call was in order to the Ways & Means chairman: "The price tag's going up."
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