In part II of the event hosted by the Boston University School of Public Health, “The Opioid Crisis in America: A Conversation with the U.S. Surgeon General,” Dr. Monica Bharel, takes the stage. Dr. Bharel is the Massachusetts Commissioner of Public Health, along with several positions she holds at Harvard Medical School, a state funded opiate detox, Massachusetts General Hospital and Boston University.
Always having an interest in preventative health care and chronic disease management for under-served populations through system-based improvements, Dr. Bharel has years of experience and a passion for working to bring practical solutions to this ongoing opioid epidemic our country is facing.
She begins her speech by asking a simple question: “Why now?” There are a lot of reasons, she says. She acknowledges that addiction has been an ongoing issue since the 70’s and 80’s and that there could have been more done with opiate detox centers. Today, we have that opportunity to do more.
“And for those experts in the room today, I urge you, this is an opportunity for substance abuse disorder to be treated like the medical illness that it is and I ask you to use all of your energy to make that happen.”
She then goes on to talk about the opioid crisis by the numbers. Just in Massachusetts, there are on average 6 people that die a day from overdoses or other substance abuse related deaths. Its a devastating loss of life that needs to garner the attention of the country so we can work together to do something about it.
“We haven’t seen this kind of increase in a single cause of death since the HIV/AIDS crisis in the 80’s. There is no community that has not been affected. Whether its rural, suburban, or urban and all socioeconomic status.”
What Can Be Done?
The problem has been presented and is quite evident after understanding some of the statistics that describe this devastation. Bharel then goes on to providing hope by outlining the solution put together at the state level in an action plan. Beginning in 2015, Governor Baker of Massachusetts asked his officers to make this a key public health priority, and assembled a multi-sector working group to come up with an action plan involving 65 recommendations and 19 steps.
At a high level, this action plan can be outlined in 4 parts:
- Prevention
For many years, the focus had been on practicing resistance through the use of programs like DARE. Instead today, law makers are leaning towards taking preventative measures. These include involving grassroots campaigns and organizations to spread awareness and talk to the community. By spreading awareness of the current issue, it will destigmatize substance abuse disorder and allow people to start a conversation on what can be done at the grassroots level.
Another group to address, Dr. Bharel mentions prescribers and future medical professionals. Education is crucial to minimize the role of doctor-prescribed narcotics abuse. In Massachusetts, every medical student will receive education on how to balance pain management with the ongoing opioid crisis.
- Intervention
Intervention is keeping the problem from further affecting future generations. Dr. Bharel speaks about a prescription medication monitoring program that has already been implemented in Massachusetts. Other precautionary measures that have been taken in Massachusetts is putting a 7-day limit on first time narcotic prescriptions.
Another facet of intervention would be to bring naloxone to every household in America. More commonly known as Narcan, a drug Dr. Bharel stresses the importance of increased availability for, is naloxone. Later in Part III of this event, when a discussion is moderated between Dr. Bharel and Dr. Jerome Adams, they go into much further detail for why naloxone availability is a top priority.
- Treatment
The fact of the matter is that there is a huge population already addicted to drugs. Of them, most users need some sort of opiate detox. While Dr. Adams went into thorough detail about what makes a “good” opiate detox, and why they play such a vital role in curbing this epidemic, Dr. Bharel stayed at the high level and discussed supply and demand issues.
Currently, there are hundreds of drug and alcohol rehab centers across the country. The majority of which, are full or have not instituted a proper program in place to help those in need. She outlines two important and very necessary actions that must be taken: more beds to be added, and involving Medication Assisted Treatment (MAT) to opiate detox centers.
- Recovery
“Substance abuse disorder is a life long disease,” Dr. Bharel explains. Recovery is a life long commitment to those seeking a better way of life. In the early stages of recovery, Dr. Bharel says a few points are vital:
- Safe and structured housing
Many come from troubled homes, have been recently incarcerated, or are just homeless. Providing safe and structured housing is meeting a basic human need and absolutely necessary to give those suffering a shot at long-term recovery.
- Help with reintegration into society
This can include help finding employment, learning how to communicate efficiently with others, coping skills, etc. These are all topics covered in drug and alcohol rehab group therapy sessions. At GateHouse Treatment, one of our main goals are to help our clients reintegrate into society in a safe place with many resources at their disposal.
- Ongoing medication
As stressed many times through her speech, Dr. Bharel is a strong advocate for medication assisted treatment (MAT). Drugs like Vivitrol are a great deterrent from relapse, which is common in opioid users.
Are we seeing results?
With Massachusetts acting quickly, and an action plan as aforementioned since 2015, they have already seen results. The state has come to the foreground as a leader in taking positive strides towards finding a solution to this growing problem. Statistics show they are working. In 2017, compared to 2016, Massachusetts saw a 10% decrease in overdoses. While every other state’s numbers regarding deaths from substance abuse are increasing, we are seeing a decrease in Massachusetts under the leadership of Dr. Bharel. Also outlined in her plan, there has been a 29% decrease in narcotic prescription medications being prescribed to patients. These tighter restrictions have made narcotic prescriptions harder to find on the street, and allow prevention and intervention plans to have a chance to work.
Click to watch the entire broadcast event.
If you have any questions, please reach out to GateHouse Treatment at (855) 448-3588.
If you missed our coverage, check out the Discussion on the Opioid Crisis: Part I.
Check back in for our Part III coverage on the discussion between Dr. Monica Bharel and Dr. Jerome Adams, the US Secretary General.
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