Column: The opioid epidemic: A complex social crisis requires a multi-pronged solution

While we have not yet seen the light at the end of the tunnel in the statewide opioid epidemic, what we have seen is a glimmer of hope.

Recent data from the Massachusetts Department of Public Health shows an almost 6% decrease in opioid-related overdose deaths in the first nine months of 2019, compared to the same time period in 2018. Furthermore, cross-sector collaboration, resulting in shared goals and systemic solutions, is breaking down work silos and embracing interdisciplinary connections between biology, psychology and socio-environmental factors.

This is progress. But it is no time to celebrate.

The statistics are still grim. There were 277 opioid-related overdose deaths in 2018 in Essex County alone, and drug arrests here are on the rise. Across the country – where Massachusetts is ranked among the top 10 states with the highest number of per capita opioid overdose deaths – 197 people are dying every day from drug overdose. And only 11% of people who need treatment for their addiction actually receive it.

In a 2018 editorial, board members of RIZE Massachusetts – a private foundation founded to fight the statewide opioid epidemic – wrote, “Ending the opioid epidemic in Massachusetts may seem overwhelming, but we are confident that when the public, nonprofit and private sectors fully come together, we will get it done and make the commonwealth even stronger.”

“Overwhelming” is right. The opioid epidemic is a complex and multi-layered social crisis with roots right here in Massachusetts, where we were an early adopter of prescribing opioid medications for the treatment of pain. This practice gave rise to skyrocketing oxycontin usage, which led to heroin abuse and now, even more deadly fentanyl use.

“We were the first to get into the opioid crisis, and we were the first to realize it was a crisis, and the first to develop a number of different interventions to try to deal with it,” said Alicia Sasser Modestino, a health economist at Northeastern University, who was interviewed in January for a two-part series on opioids for Freakonomics Radio.

It is said that necessity is the mother of invention. And here in Massachusetts, the severity of drug addiction is galvanizing a new type of response, one that is bringing people together to combat its devastating effects on individuals, families and, more recently highlighted, the economy. A late 2018 study by the Massachusetts Taxpayers Foundation, funded by a grant from RIZE, estimates that the opioid crisis is costing the state more than $2.5 billion annually in lost productivity from absenteeism and reduced job productivity alone.

Work to highlight the economic fallout of the opioid epidemic has made it clear that employers can and must play a critical role in the fight against opioid addiction. The resulting program, Mass CARES – the Massachusetts Communication and Awareness Around Recovery and Employer Support – is helping businesses make their workplaces more recovery friendly.

This kind of innovative work is not only helping to reduce the stigma of opioid addiction, but it’s also broadening the coalition needed to create a systems solution to this deeply embedded, complex crisis.

“No one industry or agency can solve this problem by itself,” said Allie Hunter, executive director of the Gloucester-based Police Assisted Addiction and Recovery Initiative (PAARI). “It really is about collaborating, sharing resources and sharing ideas.”

Founded in 2015 alongside the nationally recognized Gloucester Police Department’s Angel Initiative, PAARI is a nonprofit community policing movement to create non-arrest pathways to drug treatment. In its first five years, membership in PAARI – open to any law enforcement agency nationwide – has grown to nearly 500 departments. The group works with 130 law enforcement agencies across Massachusetts and 20 in Essex County alone. Members have access to program models, technical assistance, seed grants and a robust learning community made up of organizations with a shared goal: ending opioid addiction.

“We’ve grown so quickly because people see the need for this,” said Hunter. “This is an issue we need to approach differently.”

And PAARI’s approach is getting results. Recovery coaches embedded in local police departments are helping people gain access to the treatment resources they need. In Lynn and Lawrence, 181 and 163 individuals respectively were supported in 2018. In Gloucester, PAARI has worked with Department of Public Health to make narcan – a drug used to reverse opioid overdoses – available in public buildings and to the fishing community. And nationwide since 2015, more than 24,000 people have entered treatment through PAARI’s partner police departments. Together, they are changing the national dialogue about law enforcement’s role in tackling the opioid epidemic. And it started right here in Essex County. (For more information on the work of PAARI, visit paariusa.org.)

Furthermore, funders like RIZE and the Evelyn Lilly Lutz Foundation – a Beverly-based organization focused on health – are also changing the way we think about addiction treatment. RIZE’s focus on collaborative models that facilitate coordination among medical, behavioral and community organizations – like the addiction treatment program at Lynn Community Health Center – are highlighting the critical need for care that treats the many facets and effects of addiction. Recent grants from the Lutz Foundation – which has also supported PAARI – have not only expanded medication-assisted treatment programs in Danvers and Gloucester that incorporate counseling and community re-engagement, but are also providing caregivers with the tools and resources they need to keep up with the special demands of patients with substance abuse disorders. (To read about the many efforts of RIZE and the Lutz Foundation, visit rise rizema.org and evelynlillylutzfoundation.com.)

The fight is far from over, but in Massachusetts and in Essex County, we are fortunate to have so many government, for-profit and nonprofit organizations fostering an approach that is not only working to reduce the stigma surrounding this disease, but also recognizes that it is a fight best won when we face it together.

We urge you to find a way, no matter how small, that you can help Essex County face this challenge that affects us all. The first step to joining the fight is to learn about the many layers and effects of opioid use. The organizations mentioned here are a great place to start.

Stratton Lloyd is the COO and vice president for Community Leadership at Essex County Community Foundation.

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