For the month of January, the Public Interest Leadership Program (PILP) discussed the topic of the opioid epidemic. The PILP class first heard from Brendan Abel, Legislative and Regulatory Affairs Counsel for the Massachusetts Medical Society.
Abel informed the PILP class of some staggering statistics coming from the Massachusetts Department of Public Health, showing the vast increase in opioid related deaths among Massachusetts residents since 2000 (from 379 in 2000 to 2,190 in 2016). The opioid death rate is far greater for individuals experiencing homelessness or who have a history of incarceration and, at this point, it is believed that almost 5% of the population of Massachusetts is suffering from opioid use disorder. The supply of heroin that is bought and sold today is often laced with synthetic fentanyl and carfentanyl, which are much more powerful, and inadvertent consumption of heroin laced with fentanyl is believed to be a factor to the high number of overdoses.
Abel discussed some of the implications that the opioid epidemic has had and may have in the future, especially in the legal context. He foresees a number of guardianships that may be needed for adults who have experienced an overdose that resulted in permanent brain damage due to lack of oxygen to the brain for a period of time. Many believe the pharmaceutical industry is the root cause of the opioid epidemic, and some lawsuits have already begun for false advertising against pharmaceutical companies that produce painkillers.
Some interventions and efforts have been made to curb the use of opioids and to reduce the number of overdoses, but a lot of research on the efficacy of such efforts has not yet been completed. There has been a slight reduction in the number of opioid related deaths, largely attributed with the spread of use of Narcan (naloxone HCI) by first responders. The Prescription Monitoring Program in Massachusetts has seen a marked reduction in the number of opioid prescriptions. In March 2016, Governor Baker signed an opioid law, including restricting first time opioid prescription to a limit of 7 days. Under M.G.L. c. 128, s. 35, a person may be involuntarily committed as a result of his or her alcohol or substance use.
Abel also discussed some state legislative efforts on the horizon, including a pending opioid bill to establish a commission to evaluate prescribing practices and a pending criminal justice reform bill that would provide an evaluation of drug dependency and provision of medication-assisted treatment (MAT) for criminal defendants.
In addition, he addressed some of the difficulties facing the accessibility of services for opioid dependent individuals. There are few MAT facilities with limited capacity in Massachusetts, with large gaps in Western Massachusetts; doctors have to be specialized and take an additional course beyond their medical school/residency training order to prescribe medication such as methadone. Additionally, many health insurance providers do not fully cover alternate pain interventions such as acupuncture.
To view more details of state efforts to address the opioid epidemic, please visit https://www.mass.gov/massachusetts-responds-to-the-opioid-epidemic.
Meeting recap provided by PILP Member Alissa Brill (Volunteer Lawyers Project).