Locals cool on federal opioid report

Recorder Staff
Friday, July 07, 2017

GREENFIELD — While a sweeping report released by the Centers for Disease Control and Prevention on Thursday reminded health professionals across the country about the issues with prescribing opioids, local players fighting the epidemic in Franklin County found the report less than useful.

In Massachusetts, similarly to the rest of the country, the epidemic stemmed from the over-prescription of opioids, like percocet, but in the last three to four years, the issues here have turned to illicit drugs like heroin, Opioid Task Force co-founder John Merrigan said.

“I think it’s interesting when public officials want to celebrate the reduction of selling (legal prescription) opioids,” task force member and leading expert Dr. Ruth Potee said. “It’s not what people die from. People die from heroin and carfentanil.”

Nonetheless, national focus shifted at least for a day to the CDC report that examined opioid prescription rates from 2006 to 2015, noting that the rate peaked in 2010 and since has been declining — although the rates remain three times higher than in 1999 nationally.

Statistics released to the Greenfield Recorder by the CDC show the breakdown of prescription rates by county, with Franklin 6th out of 14 counties in Massachusetts and below the state average.

In a concurrently released article in the Journal of American Medical Association, a collection of doctors reflected on the opioid epidemic, pointing to when there are decreases in prescription opioids it has helped to solve the epidemic.

“Too many individuals in the United States are adversely affected by the opioid crisis, either from misuse of prescription opioids or use of illicit opioids,” the July 6 JAMA article concluded. “Physicians and other health professionals can help prevent many individuals from becoming addicted to opioids or overdosing by improving opioid prescribing practices as part of a coordinated public health approach.”

The article, written by Anne Schuchat and three other doctors, acknowledges what is known as fact locally: cutting off prescription opioids has led to the increase in illicit opioid-drugs.

“The increase in illicit opioids and high levels of prescription opioid use are related,” Schuchat writes. “Reducing inappropriate opioid prescribing will likely have an important role in addressing illicit opioid use.”

Yet the JAMA article doesn’t fall in line with how local experts view the epidemic. For example, Schuchat writes, “There is no evidence that state policies designed to reduce inappropriate opioid prescribing are leading to increases in heroin use and deaths from illicit opioid use. In fact, such policies have been shown to reduce the amount of opioids prescribed, prescription opioid–involved overdose deaths, and all opioid-involved deaths.”

But Potee and Merrigan say the issues they have seen in Franklin County center around heroin and its more potent, synthetic counterparts, fentanyl and carfentanil, rather than prescription pain medication.

“The availability has been something that has skyrocketed all over the country. In this area it’s heroin, not percocets,” Merrigan said.

In talking about having to treat chronic pain in her work, Potee said that it has become more difficult to prescribe opioid, pain-management medications to her patients.

“In a real way there are people who suffer tremendously and the only thing that works for them is opioids,” Potee said. “You can’t yank that drug away and leave a group of people suffering tremendously.”

Merrigan did reiterate that Franklin County was one of two counties in the state that saw a dip in opioid-related deaths, according to the most recent released statistics by the state Department of Public Health.

While fentanyl and the extremely deadly carfentanil continue to stump health care professionals, Merrigan said that it’s important to continue to try to adapt with the epidemic. He pointed to making sure the courts and the correction offices stay up to date on how the issues evolve to best be able to serve the community.

“I’ve always said this. Franklin County, yeah, we have our struggles and issues, rural kind of poverty in some of the outlining areas, but we’re not in a war zone,” Merrigan said. “There’s not a big infiltration of gangs, guns and shootings. If we continue to promote the work of the Task Force, we will have a positive impact on the quality of life in this county.”

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