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Governor Patrick Delivers Remarks on the Opiate Crisis

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I have read account after account of the impact of heroin and other opiate abuse on our communities. Over the years, I have received letters and e-mail messages, talked with those in recovery, visited recovery centers, and asked countless questions of our public health and public safety experts. Yesterday, I met with a number of people in recovery as well as family members who have been impacted by their loved one's addiction. They shared powerful stories of loss, heartache and in some cases triumph. Above all, they asked for renewed action.

Heroin today is cheap and highly potent. The use of oxycodone and other narcotic painkillers -- often as a route to heroin addiction -- has been on the rise for some years now. At least 140 people died from suspected heroin overdoses in Massachusetts in the last several months, levels previously unseen. From 2000 to 2012, the number of unintentional opiate overdoses increased by 90 percent -- affecting all kinds of people from all kinds of neighborhoods from all around the Commonwealth. For most of those who received services from the Bureau of Substance Abuse Services in 2013, opiates were their drug of choice.

What we have is an opiate epidemic. So, we will treat it like the public health crisis it is.

This morning, I formally declared a public health emergency. Based on my authority under such a declaration, I have directed DPH to take the following immediate steps:

1. DPH will significantly expand access to naloxone -- commonly known as Narcan -- for first responders and for family and friends who may find themselves present at the overdose of a loved one. Narcan, when timely administered, can reverse an overdose and save a life.
2. DPH will ban hydrocodone-only medication -- a narcotic painkiller otherwise known as Zohydro. Zohydro is a dangerously addictive pharmaceutical painkiller, approved by the FDA recently over the objection of their scientific advisory council, and is not available in an abuse-deterrent form. Until it is available in an abuse-deterrent form, or better, until the Secretary of HHS or the Congress has acted on the requests to overturn the FDA, Zohydro will not be available in Massachusetts.
3. DHP will mandate the use of prescription monitoring by physicians and pharmacies to better safeguard against over-prescribing to patients. This is currently a voluntary program. But we must have more rigor around the over-prescribing of pain medications that so often lead to addiction.
4. DPH will issue a public health advisory that provides guidance on how to recognize opiate abuse and addiction and what steps family and loved ones can take. There is a kind of trial and error quality about the way many families find and use recovery services, and we need better information out there for those affected, such as the range of treatment options, from methadone to buprenorphine (or suboxone) to injectable Vivitrol.
5. And finally, DPH will dedicate an additional $20 million to expand the use and availability of prevention, intervention and treatment services to the general public, to the Department of Corrections and to Sheriffs' Departments.

Earlier today, I convened the Public Health Council on an emergency basis to put these initial directives into effect.

In response to the many requests I have received to create a special Task Force, I am re-tasking the Governor's Interagency Council on Substance Abuse and Prevention to give us a comprehensive plan to address this epidemic. We will supplement the membership of the executive committee to include representatives from the legislature, local public health agencies, provider organizations, law enforcement, municipalities, individuals in recovery and families impacted by the opiate epidemic. That team will make recommendations in 60 days on further actions we can take, including how to better coordinate services, to align private insurance with public insurance to pay for needed recovery services, and, importantly, to divert non-violent criminal defendants struggling with addiction into treatment programs.

In addition, I intend to confer with other governors and federal stakeholders to develop a regional action plan to bring an end to this epidemic.

As a first step, I have sent letters to Congress and the federal HHS to express my concern related to the FDA approval of Zohydro, and have joined other governors in expressing concern for the large volume of oxycodone entering New England.

I know that many members of our legislature, as well as our partners on both the local and the federal level, are committed to appropriately and swiftly addressing this problem. I look forward to working together with them and all stakeholders to reduce opiate addiction and help our residents recover.

Thank you.

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