Mass. Hospitals Seeing Surge In Heroin-Related Visits

Opioid-related hospital visits are "skyrocketing" in Massachusetts, with heroin-related visits jumping by 201 percent between 2007 and 2014, according to Health Policy Commission figures discussed Wednesday.

Opioid-related hospital visits have increased from around 30,000 in 2007 to more than 55,000 in 2014, with non-heroin opioids accounting for the bulk of the trips, an analysis by the commission found.

"These are not deaths," said Katherine Record, the commission's deputy director of Behavioral Health Integration and Accountable Care. "These are patients who had successful health care intervention....and the rate of those patients, is skyrocketing, as you can see."

Record said there has been "huge growth" in heroin-related hospital visits. "Heroin has gotten cheaper and more accessible, and as we clamp down on the availability of pills, which is a good thing, it does force patients to turn to heroin, so we need to be thinking about that as well as prescription control," she said.

Preliminary findings from the analysis, presented at a meeting of the commission's Quality Improvement and Patient Protection Committee, showed the rate of hospital visits varies significantly across the state, with Pittsfield, Holyoke, Springfield, Worcester, Boston, Lynn and Leeds, a village in Northampton, representing "hot spots" with higher rates of opioid-related inpatient admissions.

"It is everywhere," Health Policy Commission executive director David Seltz said. "It's just a particular problem in some of the communities, and I think that lines up with what we know."

According to the Department of Public Health, the 1,099 confirmed cases of unintentional opioid overdose deaths in 2014 represented a 65 percent increase over the 668 overdoses in 2012 and a 21 percent increase over the 911 overdose cases in 2013.

Curbing the rising rates of opioid addiction and overdose throughout the state has been a focus of policymakers, with the signing of an addiction prevention and education law on March 14 coming as the latest step. The bill, which Gov. Charlie Baker called "the most comprehensive measure in the country to combat opioid addiction," includes measures that limit new opiate prescriptions to seven days, allow a patient to receive a lesser-than-prescribed amount of a drug, and require evaluations of emergency room patients presenting with overdose symptoms.

Earlier this week, Baker said he wanted to see the federal government invest in researching and supporting the best way to treat addiction and support people in recovery.

The commission's analysis found that access to medication-assisted addiction treatment, which combines behavioral therapy with the drugs methadone, buprenorphine or naltrexone to address a substance use disorder, varies widely throughout the state with "no clear relationship to the burden of the epidemic."

According to the analysis, the Berkshires region had the highest rate of opioid-related hospital visits — 70 percent above state average — but patients there have "comparatively long" travel times for treatment. Thirty-three percent of Berkshire patients must travel more than five miles to a buprenorphine provider, and 39 percent travel more than five miles to a methadone clinic. The region has no naltrexone providers.

The upper North Shore has the lowest availability of medically assisted treatment, the report found, with no methadone clinics or naltrexone providers and the fewest buprenorphine providers per capita of any region in the state.

The commission found that in 2012, less than half of opioid-addicted adults and adolescents received medication-assisted treatment.

The number of additional medication-assisted treatment providers the state would need remains an unknown, Record said.

"Clearly, this is not the right supply, but how much more do we need is an unknown that the state needs to continue working out," she said.



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