Prescription for disaster: State commission looking at epidemic of opiate deaths says system ‘isn’t working’
In the days before he died, Robert May Jr. convinced doctors at three different hospitals to give him painkillers.
And it was those drugs — including fentanyl, methadone and a host of others — that were in the 29-year-old’s system when the Brockton man overdosed and died in a Malden apartment last year.
“One doctor gave him somewhere around seven prescriptions on the day he died,” said his father, Robert May Sr.
Now, one of the recommendations in a 71-page report released today by the state OxyContin and Heroin Commission calls for an overhaul of the state’s prescription monitoring program to identify patients who are trying to get drugs from different doctors and doctors who are over-prescribing certain types of drugs.
The recommendation is one of 20 by the 14-member commission to address OxyContin and heroin abuse and addiction in the state.
The recommendations range from longer treatment programs — a suggestion long urged by addicts, their families and those in the treatment field — to changing the law so parents are notified if their minor children are treated at a hospital for a drug overdose. It also calls for providing limited immunity from drug possession charges when someone calls for help in a drug-related overdose.
“I think there is the general recognition that whatever we have been doing isn’t working,” said state Sen. Steven Tolman, D-Boston, chairman of the commission. “There is not one single thing that needs to be done.”
He said there are many things that need to be done together to stop the overdose deaths in the state.
Between 2002 and 2007, there were 3,265 people who died of opiate related overdoses in Massachusetts, while 78 soldiers from the state died in Afghanistan and Iraq, according to the commission report. Some of the deaths were chronicled in The Enterprise series of stories called “Wasted Youth.”
And the death toll is continuing.
In Plymouth County, 18 people died between Jan. 1 and Oct. 19 of drug overdoses, according to the Plymouth County District Attorney’s office.
Tolman said the state is spending millions of dollars on drug-related issues and none of it appears to be working.
“We are not getting the bang for the buck for the money we are spending,” he said. “Whether it is methadone clinics or the millions spent for Suboxone. You can keep adding it up but we are still getting our butts kicked.”
Joanne Peterson, founder of Learn to Cope, a support group for families of opiate addicts, said the recommendations being made are nothing new. The key will be putting those recommendations into place, she said.
Monitoring prescriptions would be a first step, she said. “If they combat the real issue — where are the prescription drugs coming from and stopping it — we wouldn’t even need all the rest,” Peterson said.
The commission said if the state Department of Public Health can’t overhaul the Massachusetts Prescription Monitoring Program, another agency should take over. The program, ideally, should be able to identify who is prescribing drugs and who is getting them.
That is important in identify doctors who are over-prescribing pain medication as well as patients who “doctor shop” to get drugs.
It takes three to four weeks to analyze information through the program, making it difficult for law enforcement to investigate potential illegal behavior, the commission noted.
Mark Pearlmutter, chairman and vice president of Caritas Network Emergency Services, Caritas Christi Health Care, said overhauling the program would be a big help to doctors and prevent addicts from bouncing around to get more prescription drugs.
“If we want to do one thing, it would be to create a database that I can access and where I can look at the prescription habits of a particular individual,” he said.
The commission, in detailing prescription abuse, cites the case of a Sandwich doctor, Michael Brown, who was the single leading prescriber of OxyContin in the state. His prescriptions accounted for 288,859 of the 922,985 OxyContin tablets sold through pharmacies in 2004. If the monitoring program was working in “real time,” the problem would have been identified quickly, the report noted.
Money for treatment is also an issue, the commission noted.
The commission’s report notes only a fraction of the $4.5 billion — or 21.8 percent of the total state budget — the state spent on substance abuse and addiction issues in 2005 was for prevention, treatment and research.
And the state is in the lower 50 percent of states in terms of spending on prevention, treatment and research. The commission reports for every $100 the state spent on substance abuse and addiction, only $1.45 goes towards prevention, treatment and research. In Connecticut, that number is more than $10.
The remaining 98 percent was spent on public programs, such as justice, education, mental health services and public safety.
“A little bit of investment money now I think, ultimately, will save us a fortune in the long run,” Tolman said.
Maureen Boyle can be reached at email@example.com.