Heroin still has grip on Greater Taunton, all of Eastern Mass.

Editor’s note:  First in a two-part  series on heroin addiction and the vise-like grip it has had on the region for more than a decade.

The scourge of heroin abuse continues unabated in the greater Brockton and Taunton region, according to two recent federal reports on substance abuse.
And the problem, as first reported by The Enterprise in its ongoing series “Wasted Youth,” now extends to all of Eastern Massachusetts, which outpaces much of the nation in heroin-fueled emergency room visits and admissions to state treatment programs for painkiller addictions, the studies say.

During the fiscal year that ended on June 30, 2010, Brockton residents accounted for 2,140 admissions to state-funded substance abuse programs. Forty-five percent of the people admitted to programs said they had used heroin during the previous year.

Taunton had 1,318 admissions during the same period and 42 percent of those patients said they had used heroin within the previous 12 months.

The data does not include information on the many treatment programs funded by sources other than the state.

The new studies re-enforce the findings of The Brockton Enterprise series which was first published in 2007.

   For example, Abington, a town of fewer than 16,000 people, had 616 admissions to state-funded drug or alcohol treatment programs during the year. More than 54 percent – 332 – of those people said they had used heroin in the past year, while about 48 percent – 298 – said they had used alcohol.

One of the reports said Massachusetts is one of only four states where an illegal drug – in the Bay State’s case, heroin – outpaces alcohol as the most common reason for admission to state-funded substance abuse programs. That report said state-funded treatment programs had 38,594 admissions for heroin alone in 2009, compared to 34,844 involving alcohol.

State hospitalization data from fiscal year 2010 show the problem is not limited to any single part of eastern Massachusetts. South of the city, Brockton, Taunton, Plymouth, Stoughton, Quincy, Weymouth, Norwood, Fall River and New Bedford, each saw more than 208 people suffer non-fatal overdoses during the year.

The findings from the U.S. Substance Abuse and Mental Health Services Administration highlight the state’s ongoing struggle to reduce overdoses and deaths from heroin and prescription drugs such as OxyContin.

 “We know and we’ve been saying for years we have an epidemic here in Massachusetts around heroin,” said Vic DiGravio, president and CEO of the Association of Behavioral Healthcare, which represents drug and alcohol treatment providers. “That’s in part being fed by the whole OxyContin epidemic.”

   One report found Boston and surrounding counties had a higher rate of emergency room visits involving illegal drugs in 2009 than 10 other major metropolitan areas, including New York City, Detroit and Chicago.

 This region also ranked first for emergency room visits involving heroin. The analysis looked at hospital statistics from Norfolk, Plymouth, Middlesex, Essex and Suffolk counties, as well as Rockingham and Strafford counties in New Hampshire.

 The report echoes the state’s own statistics, which show non-fatal emergency room visits involving heroin or other opiates rose 18 percent statewide from fiscal 2002 to 2007, though the number dipped slightly in that final year.

 Most of these visits involve a non-fatal overdose or some other serious emergency, said Michael Botticelli, director of the Bureau of Substance Abuse Services at the state Department of Public Health.

 “Those kinds of acute visits can serve as an opportunity for folks to think about and access treatment,” he said.

  The second federal report said that treatment admission rates for opiates other than heroin, such as OxyContin, were twice as high in New England than any other region of the U.S. in 2009. In Massachusetts, there were 4,734 of these types of state treatment admissions that year, outpacing cocaine.

 Nationally, admissions for people struggling with opiates other than heroin spiked 430 percent from 1999 to 2009, the report said.

 In Massachusetts, many people first get hooked on prescription painkillers such as OxyContin, then move on to heroin, which is cheaper and more accessible, DiGravio said.

 “I’m unfortunately not surprised,” he said of the federal report.

 The first federal report said Greater Boston saw 571 emergency room visits involving illegal drugs per 100,000 people in 2009, well above the national rate of 317 per 100,000.

 The rate of heroin-related emergency room visits in this region was 251 per 100,000 people, more than three times the national rate, the report said.

   The Bureau of Substance Abuse Services also is expanding programs that use the medication Suboxone to treat opiate addiction in community health centers, where young people typically prefer to undergo treatment, Botticelli said.Most people visiting emergency rooms with drugs problems are under 35, Botticelli said.

   Just last month, the state opened Independence Academy in Brockton, a recovery high school. The school has the staff and the room to serve as many as 50 drug- or alcohol-addicted students from southeastern Massachusetts.

 The state is also expanding training in the use of Narcan, a drug used to counter the effects of an opiate overdose, among addicts and their friends and family. A pilot program also is under way in five communities, including Falmouth, Cambridge and Fall River, to help families stage interventions to get relatives into treatment, Botticelli said.
 These efforts pay off, Botticelli said. “Engagement and retention and care significantly reduces emergency department use,” he said.

 While Massachusetts fares better than other states, there is still room for improvement, DiGravio said.

 There are waiting lists to get into so-called recovery homes, or facilities where people who have completed detox can stay for another six to nine months and get their lives back on track while undergoing continued counseling and treatment, he said.

 Treatment providers often see people without access to such services end up in detox over and over again, DiGravio said.

 “They’re not getting the services farther down the spectrum that they really need to help prevent them from cycling through,” he said.

 The Association for Behavioral Healthcare and other advocates also recently called on the state to add $5 million to the Bureau of Substance Abuse Services budget to fund 83 case managers to work with 9,600 young adults.

 “There’s still a ton of unmet need out there at all stages,” DiGravio said.

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