Editorial: Massachusetts a leader in innovative treatment programs for opioids

Published: 8/22/2018 8:59:47 AM

Innovative programs in the state — including one at a jail and another in a hospital, both in Pioneer Valley — are providing effective treatment in response to the nation’s opioid epidemic.

The Franklin County House of Correction in Greenfield is among the estimated 300 jails and prisons nationwide that are offering opioid addiction medications to some inmates, according to the U.S. Department of Justice.

George Ballentine was among those who received a daily dose of buprenorphine — also known by its brand name Suboxone — before he was released from the Greenfield jail this summer. “Suboxone for me is literally a Band-Aid,” he said. “When you get a cut, what do you do? You put a Band-Aid on until it heals enough to take it off.”

After being hospitalized for three overdoses in three months, Ballentine was arrested for violating a restraining order and sentenced to jail for nine months. When he was released to a halfway house, Ballentine visited a pharmacy to get his buprenorphine prescription, rather than returning to heroin use as he had intended.

The Franklin County House of Correction, where about 40 percent of the 220 inmates reported having used heroin, is the only jail or prison in Massachusetts now administering buprenorphine. Since the program started two years ago, about 240 inmates have received the medication, at an annual cost of about $12,500 per person. Most of the expense is for staff who screen inmates when they arrive, provide behavioral health counseling and manage their post-release plans, according to Ed Hayes, an assistant superintendent for the Franklin County sheriff’s office.

“Jails are really America’s ground zero for the opioid crisis,” Hayes said. “It’s the perfect opportunity to make a public health intervention.”

Sheriff Christopher Donelan, co-chairman of the five-year-old Opioid Task Force of Franklin County and the North Quabbin Region, credits the jail’s medication program with contributing to a 35 percent drop in opioid overdose deaths in the county from 2016 to 2017.

Legislation signed this week by Gov. Charlie Baker requires the state Department of Public Health during the next year to start medication-assisted treatment programs at other jails, including the Hampshire County House of Correction in Northampton.

In Springfield, Baystate Medical Center on Aug. 7 showed off its rooming-in program that keeps newborns together with their mothers who are dependent on opioids. Since the program started in January 2017, fewer of those babies require medication treatment and their hospital stay has been cut almost in half.

“Increasing focus on skin-to-skin and non-pharmacological care from the moment these babies are born has helped decrease the amount of treatment necessary,” said Karen Ricci, who coordinates the rooming-in program. “When you keep the mom and baby together in a quiet environment with a single caregiver or low number of caregivers, they don’t need as much treatment and they don’t need to be here as long.”

The babies have neonatal abstinence syndrome, or withdrawal symptoms, resulting in poor sleep, tremors, sweating and eating problems or excessive hunger. More than 170 newborns at Baystate have had those symptoms since the program began. When those babies were treated in the neonatal intensive care unit, they stayed an average of 17.8 days. Now, in one of four private rooms with their mother at the hospital’s Wesson Women’s Clinic, they stay just 9.8 days, on average.

Babies that don’t show improvement from the bonding with their mother are given morphine in small does. “Babies of mothers with opioid use disorder are not born addicted — they are born dependent,” said Dr. Rachana Singh, medical director of the intensive care unit nurseries.

A $250,000 grant from the Massachusetts Health Policy Commission paid for the program. “The innovation here is a really human one — personal, compassionate care,” said David Selt, the commission’s executive director. “It’s something we should be proud of. The program is a model not only for the state, but the country.”

We agree. These programs at the Franklin County House of Correction and Baystate Medical Center show that a modest investment of money, combined with a healthy dose of smart, compassionate care, helps improve the lives of people touched by the opioid crisis.


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