Island forum focused on prescription drug abuse

On Wednesday, March 21, the Mental Health and Substance Abuse Network, an offshoot of the Dukes County Health Council, held a public forum at the Martha’s Vineyard Regional High School to discuss prescription drug abuse, an increasing problem across the country and on Martha’s Vineyard.

More than 70 people attended, including people in fields that address or are affected by the fast-growing problem, and those who have intimate, personal knowledge of the disease of addiction.

The panel included an addiction expert from Minnesota, a local police officer, the director of a detox facility in Falmouth, a doctor, a representative from the local YMCA’s teen center, and a pharmacist. Many others in the audience — including doctors, nurses and mental health professionals, added substantially to the conversation. Two local men shared their own struggles with addiction.

The 15-member Mental Health and Substance Abuse Network chose this time to reach out to the public given the recent focus on the problem. Paddy Moore, network head, said in an interview after the forum, “We’ve been hearing from all parts of the system that prescription drug abuse has gone off the charts, both nationally and here on the Island.”

Ms. Moore said that the goal of the Network is to “map the delivery system of resources on the Island, identify the holes in the system and figure out ways to fill them.” She noted that the network helped Martha’s Vineyard Community Services launch its New Paths Recovery addiction outpatient service two years ago.

Island psychiatrist Dr. Charles Silberstein, who includes addiction psychiatry among his areas of specialization, moderated the forum. He opened the discussion with an overview on opioids, a class which includes both naturally occurring drugs such as heroin and morphine and synthetic prescription painkillers including oxycodone and Vicodin. Dr. Charles Reznikoff, an expert on addiction medicine from the University of Michigan, provided a national perspective on the growing problem of prescription drug abuse.

Dr. Reznikoff presented some alarming statistics on the rapid increase in opioid use. Among other things, he noted that the total amount of opioids prescribed has grown sevenfold in the last five years. He added that in 2010 opioid overdose accounted for more deaths than car accidents or suicides and that opioid-related emergency room visits have doubled in the last five years.

Dr. Reznikoff attributed the rise in opioid use to the popularization of the concept of chronic pain in the 1990s and a financially motivated pharmaceutical industry initiative to generate an “opioids for life” approach for pain sufferers.

Ray Tomasi, president and CEO of Gosnold on Cape Cod, a drug and alcohol rehabilitation center that treats the majority of the Vineyarders who seek inpatient treatment for addiction, said that his facility receives 800 to 1,000 calls a week for help. He said he has seen a dramatic shift in the last ten years from 10 to 12 percent of those admitted battling opioid addiction to almost 50 percent today.

Mr. Tomasi said that the Cape and Islands have been affected more than the rest of the state by the rise in prescription drug abuse. He stated that 10 percent of those admitted to acute services in Massachusetts are treated for prescription drug abuse while the same population accounts for 29 percent of Gosnold’s patients.

Mr. Tomasi said, “Up to two-thirds of people who get introduced to painkillers get introduced by a friend or by a medicine cabinet.” However, he said he is hopeful about pending legislation intended to eliminate “doctor shopping,” where people obtain prescriptions from multiple doctors. A bill passed by the Senate last month would require physicians to enter into a nationwide database whenever they prescribe an opiate drug. Mr. Tomasi said, “Limiting access is one way in which naïve experimenters may be discouraged.”

Mr. Tomasi stressed the importance of viewing addiction as a disease and as a chronic condition. “The best you can hope to achieve is longer periods of remission and shorter periods of acuity.” he said. “We strive to help people manage addiction over a lifetime.”

Officer Michael Snowden of the Edgartown Police and the Martha’s Vineyard Drug Task Force spoke on the growing problem of prescription drug-related crime on the Island. “The pill issue right now is off the charts,” he said. “Every single crime we’ve had in the last few years I think is related to drugs.” He added that of 60 housebreaks in Edgartown last year, 50 involved rifling of medicine cabinets.

According to Officer Snowden, housebreaks in Edgartown are down this year from last, thanks to the department’s recognition of the problem and Chief Tony Bettencourt’s allocation of more resources. “It’s still a major problem,” he said.

Curtis Chandler of the YMCA’s teen center informed the crowd that the center has just launched a young people in recovery meeting to be held on Monday nights from 6 to 7 pm. Dr. Jeffrey Zack, Martha’s Vineyard Hospital emergency department director, provided a local perspective. He spoke on the growing number of ER visits related to prescription drug abuse.

Pharmacist Warren Holmberg of Leslie’s Pharmacy in Vineyard Haven called prescription drug abuse a substantial problem at the store. “There’s a lot of doctor shopping,” he said. “They’ll give you any excuse in the book to get pills.” He noted that one of the problems he and his colleagues face is that the pharmacies cannot share information about who’s getting what.

Dr. Gerald Yukevich referred to the physicians’ dilemma of “walking the razor’s edge” between helping and enabling pain sufferers.

The discussion turned to the need of an inpatient detox facility on the Island. Diede Wieler, chief quality control officer for the Martha’s Vineyard Hospital said, “We don’t have the clinicians and the license to deal with this issue at this time. Detox requires a specific license. We have problems getting specialists in a lot of areas.”

Hazel Teagan, senior addictions counselor for the hospital said, “The one missing piece of the puzzle is a detox on Island. Sometimes people can’t detox at home. They need the medical supervision.” She put forth a suggestion, saying, “I see that the community has to work together. Agencies need to work together. If we could come up with an endowment as a group and if someone could donate a house, I’d be glad to share my knowledge.”

Both she and Jill De La Hunt, director of New Paths Recovery, addressed the lack of available space at off-Island detoxes. Mr. De La Hunt said, “There is a window where we may lose people because we’re waiting for a bed. It’s not possible for us to provide that medical piece.”

Although the dream of providing an on-Island inpatient facility is not likely to be fulfilled in the near future, Dr. Silberstein provided a positive outlook for the Vineyard following the forum. “We have enormous resources on this Island,” he said. And community concern.

Mr. Tomasi noted in his talk that no one showed up for a similar forum held earlier this year on the Cape.