Congressman, clinicians, and clergy congregate to discuss addiction crisis

Rep. William Keating called for new tactics to battle the spreading opiate scourge.

Rep. Bill Keating spoke about opiate addiction to members of the clergy and Island recovery community on Thursday morning at the Federated Church in Edgartown. — Photo by Michael Cummo

Congressman Bill Keating painted a sobering picture of the opiate addiction crisis when he addressed Island clergymen and members of the Island recovery community last Thursday morning at the Federated Church in Edgartown, at a roundtable discussion on substance abuse sponsored by the Martha’s Vineyard Youth Task Force (YTF). The event was less a discussion with clergy and more of an update from Rep. Keating, who’d just returned the night before from the fourth annual National Prescription Drug Abuse Summit.

“The good news is we’ve made a lot of progress on this issue,” Rep. Keating told the gathering of about 40 people in his opening remarks. “The bad news is we’re falling farther behind, because the problem is escalating so quickly.”

Mr. Keating said the cost of the crisis is escalating in human and financial terms. “Addiction has become one of the leading causes of workers’ comp claims,” he said. “It’s costing businesses billions of dollars, and that’s not even taking in the human terms, the divorces and the family breakups. For anyone to argue the cost factors, it’s ridiculous. When someone overdoses, they go to the emergency room, the most expensive care there is. Addicted babies go into intensive care for three weeks. Treating a 16-year-old with hepatitis C from intravenous drug use is extremely expensive.”

Over the course of his talk, Mr. Keating gave a barrage of bleak statistics, nationwide and statewide. “In the past two decades, prescription drugs have gone up eightfold in our country,” he said. “In 2013, 260 million [painkiller] prescriptions were written in our country.”

Citing a recent survey, Mr. Keating said 17.5 out of every thousand babies born in Massachusetts are born addicted. “Massachusetts is three times the national average,” he said. “In the past 10 months in Massachusetts, over 1,700 babies were born addicted.”

Destigmatizing addiction
Mr. Keating said the problem has been mounting for years, and that even 17 years ago, when he was a district attorney, he was “absolutely stunned” at the number of addiction-related arrests and overdoses, adding that the vast majority of people arrested for possession, then and now, had no prior criminal record, which led to them being doubly stigmatized as addicts and criminals.

“It became very clear to me that our country is dealing with this issue using the criminal justice system as a safety net, but it’s a public health problem,” he said. “There’s the stigma that exists, that they brought it on themselves. It’s a health problem; it’s not a moral weakness.”

A particularly insidious aspect of opiate addiction is that many people had no addiction issues until they took legally prescribed, post-op painkillers. “There is a state police officer who had back problems as the result of an on-duty car crash. He became addicted [to opiates], and went on to use his weapon to rob banks in two counties.”

No silver bullet
Given the complexity of the crisis, Mr. Keating said, there has to be an across-the-board paradigm shift, and that responsibility lies at the federal and state level, with the medical community, and with individuals.

A member of the congressional Prescription Drug Abuse Caucus (PDAC) and the Addiction, Treatment and Recovery Caucus (ATRC), Rep. Keating expressed frustration with progress at the federal level — case in point, with Zohydro, a recently FDA-approved time-release opiate, now the most powerful pain medication on the market. “Eleven of the 13 experts that reviewed it before approval said it’s unsafe for the marketplace,” he said. “They said, no need for it, and it’s too dangerous and too addictive. Yet they approved it.”

The PDAC had better luck fighting approval of generic oxycontin. “It was going to come out cheaper and less protected than the prescription oxy, and it was going to flood the markets,” he said to audible gasps in the room. “Canada went ahead and did it, but we at least stopped it.”

Doctor shopping, addicts getting multiple prescriptions from different doctors, has been particularly problematic with Veteran’s Administration (VA) patients. “I’ve heard story after story where the veterans will be prescribed drugs and more drugs, and then the person will go to a private doctor and get double the drugs,” he said.

At the state level, Mr. Keating said the Massachusetts Prescription Monitoring Program (PMP) has been effective in cutting down on doctor shopping, but it needs to be done in real time to be effective.

The congressman also asked people to consider if they need painkillers in the first place, and in a personal aside, spoke about his painful recovery from three ruptured discs in his back. “I was always having drugs thrown at me,” he said. “I didn’t want them, because they don’t help the pain, and I was afraid, as people should be.” He showed the group a neurostimulator, a small device that once implanted, sends pulsing electrical signals that short-circuit chronic pain, as an effective alternative to opiates. “Neurostimulators are one example. You can control the pulse of the electricity by a small remote control.”

Prevention begins at home
In a newly released Massachusetts poll, 56 percent of respondents said they have leftover opiate drugs in their medicine cabinet, and only five percent thought their children had access to the drugs, but when children were polled, three and a half times that amount said they took them. “In fact, a third of the people from 12 years old to adulthood said the first time they had prescription drugs, it wasn’t prescribed,” Mr. Keating said. “They were given it by parents, or they took it from the medicine cabinet.”

Theresa Manning from Martha’s Vineyard Youth Task Force said there are “take-back days” for leftover prescription medication, and there are drop boxes at Edgartown, Tisbury, Oak Bluffs, and West Tisbury police departments.

Faith community fills a void
“The faith community and the atmosphere of trust and nonjudgment that it can provide is a major asset in the fight against addiction,” Rep. Keating said. “I think the faith community is underutilized in this area, and that’s part of why we’re here today.”

While the faith community is known a major provider for meeting space for recovery programs, it has also quietly helped recovering addicts find homes, according to Dawn Bellante Holland, managing director of Vineyard House. “The Island faith community has been instrumental in helping people find their way into our sober housing project, even helping with their first month’s rent and security deposit,” she told the gathering. “We have five residents that wouldn’t be there otherwise, due to the faith community. The local faith community has really been instrumental in helping our program help people find their sobriety.”
“It may be useful for clergy to remind them that we are here for them,”
the Rev. Chip Seadale, from St. Andrew’s Episcopal Church in Edgartown, said. “I’ve learned from my six years here that we’re a small Island, but it’s hard to get information to everybody.”

Resources and peer support for parents and family members with a loved one addicted to opioids or other drugs are available at Learn to Cope,