Combating the Opioid Epidemic
The opioid epidemic is a public health crisis here in our district and across the country. We must fight it with the urgency it deserves. Close to 2.6 million Americans suffer from opioid addiction. The epidemic is particularly pressing in Massachusetts: in 2017, an estimated 1,977 people lost their lives due to an opioid-related overdose, up from 560 deaths in 2010. The latest statistics in the Third District underscore an especially tragic reality: between 2012 and 2016, opioid-related overdose deaths increased by 271% in the district. Opioid abuse is tearing apart families and devastating our neighborhoods. Addiction does not care if you are on the left or the right—we all know someone impacted by this epidemic. We have to fight back, now.
In the face of this crisis, the federal government has fallen far short. We can, and must, do better for our families and communities. We need to push forward a proactive agenda and invest the necessary resources on the ground to tackle the opioid epidemic head on. My plan contains 5 key elements:
- Destigmatizing addiction and increasing awareness of the devastating consequences of opioid misuse in our communities
- Investing in policies to prevent the overprescription of opioids and crack down on fentanyl trafficking
- Expanding access to Narcan and addiction treatment
- Supporting public health programs focused on recovery and rehabilitation
- Using data-driven approaches to create targeted, long-term solutions
1. Destigmatizing Addiction and Increasing Awareness
To combat opioid addiction, our communities must first understand the real scope and threat of the epidemic. That’s why I will invest in educational programs that highlight the risks of opioid use and teach about prevention. We must empower people with the knowledge and resources to make a difference in their own homes and neighborhoods. I support:
- Expanding youth education programs. Young people are particularly at risk in the opioid epidemic: as of 2015, almost two-thirds of people in Massachusetts who died from opioids were under age 45. One life lost is one too many. As a congressman, I will collaborate with local schools, businesses, substance abuse treatment centers, and other key stakeholders to raise awareness about the dangers of opioid misuse by young people.
- Increasing public education about addiction through advertising. We need to destigmatize addiction, and recognize opioid misuse for what it is: a preventable and treatable medical condition. In Massachusetts, more people now get treatment for opioid abuse than for alcohol abuse. Although President Trump previously pledged to launch a large-scale advertising campaign about addiction, this has not materialized. I will advocate for federal funding for educational advertising focusing on opioid addiction.
2. Investing in Prevention
Along with raising awareness, we also must curb the supply of dangerous, addictive opioids. I will champion policies that encourage doctors to reduce opioid prescriptions and crack down on the trafficking of fentanyl. In particular, I support:
- Improving prescriber training. Since 1999, the prescription rate for opioids in the U.S has tripled, and it is now significantly higher than in other developed countries. Massachusetts has had success investing in prescription drug training resources for dental and nursing schools, as well as physician assistant programs. The percentage of overdose deaths with prescription drugs present has gradually declined over the past four years, and since 2015, opioid prescriptions have fallen 29% statewide. We need to build on this progress, and I will fight for federal funding to expand these programs. I will urge the Food and Drug Administration to enact a measure currently under consideration that would require doctors to be trained in pain management before prescribing opioids for an extended period of time. Likewise, I support measures that have been proposed in Massachusetts that require prescribers to complete continuing education on opioid misuse.
- Reducing the number of opioids in circulation. Massachusetts was the first state to limit the length of first-time opioid prescriptions to 7 days, and our data-driven prescription monitoring program has become a model for other states. At a federal level, we need to work with state and local leaders, as well as pharmacies, insurers, physicians, and nurses to improve and scale these programs nationwide. I also support Congresswoman Katherine Clark’s bill to reduce overprescription by requiring electronic prescription of prescription drugs under Medicare. To complement this approach, I support advertising drug take-back days to reduce the supply of unused dangerous prescription opioids in our neighborhoods.
- Cracking down on the trafficking of fentanyl. I strongly support Congresswoman Tsongas’s successful efforts to provide additional funding to screen for fentanyl trafficking. Between 2012 and 2015, deaths from synthetic opioids like fentanyl rose by 264%, and fentanyl is now responsible for approximately 70-80% of opioid deaths in Massachusetts. Indeed, while Massachusetts has begun to slow the number of deaths related to prescription opioids, heroin and fentanyl have become the primary drivers of the epidemic in our neighborhoods. According to the CDC, the primary cause for this increase is illicitly manufactured fentanyl, which often is combined with heroin or cocaine without a user’s knowledge. I endorse the DEA’s effort to make it easier to prosecute traffickers of illicit fentanyl.
3. Expanding Access to Narcan and Addiction Treatment
To save lives, we must invest additional resources at a federal level to increase the availability of overdose reversal drugs like Narcan and expand access to addiction treatment. I support:
- Increasing the availability of Narcan for law enforcement and first-responders. Given the deadliness of fentanyl, multiple doses of Narcan are sometimes needed to prevent overdose deaths. Congresswoman Katherine Clark and Congresswoman Tsongas have been crucial advocates for increasing access to Narcan. I support supplementing federal funding for distributing and training first-responders on Narcan use.
- Increasing access to Narcan for individuals at risk and family members. We have to make sure that Narcan is quickly administered to people who have suffered an overdose. That’s why I support increasing Narcan access and training not only for EMTs and law enforcement, but also for the family members and friends who interact most frequently with those suffering from opioid addiction.
- Expanding access to medication-assisted treatment. Beyond life-saving measures such as Narcan, I will advocate for expanding access to medications that are the foundations of treatment for addiction. Medications such as methadone and buprenorphine have been shown to be effective at treating opioid dependence and provide a road to recovery for people battling addiction. I support the expansion of medication access within addiction treatment programs in which individuals can receive both treatment and counseling from qualified providers.
- Increasing access to quality, affordable healthcare. In order to combat the opioid epidemic, we need to make sure that people can actually afford treatment. Expanding access to health insurance is critical for improving health outcomes and combating the opioid epidemic. In its 2019 proposed budget, the Trump Administration plans to cut Medicaid—a crucial safety net for vulnerable people with opioid addiction. I will resist attempts to dismantle the ACA and defund Medicaid.
4. Supporting Public Health Programs Focused on Recovery and Rehabilitation
Despite promises on the campaign trail, President Trump has actually proposed slashing funding for agencies on the frontlines of the fight against opioids. We need to continue to invest in our public health programs. Federal grants have played a crucial role in strengthening substance abuse programs at places like the Lowell Community Health Center and Fitchburg’s Community Health Connections. Moreover, the opioid epidemic has shown that we need to improve our healthcare system to tackle addiction and substance abuse. To provide effective recovery and rehabilitative services, we have to better integrate mental and behavioral health care. I support:
- Simultaneously addressing both opioid misuse and mental illness: Massachusetts has succeeded in increasing the number of treatment beds to address opioid abuse and behavioral health. I support the expansion of programs like this nation-wide. I also endorse the recommendations of the Governor’s Opioid Addiction Working Group to improve access to recovery coaches in emergency rooms and increase funding for patient follow-up after overdoses.
- Supporting local rehabilitation centers. Rehabilitation centers and emergency shelters, like the Daybreak Shelter in Lawrence or the Lowell House, play a crucial role in helping people recover from addiction. We need to make sure those suffering from addiction have the resources they need to succeed on the road to recovery. I support efforts to create an easily accessible database of local treatment services so people know where they or a loved one can go to for help.
- Treating formerly incarcerated addicts effectively. Formerly incarcerated people suffering from opioid addiction are particularly at risk during the first six months out of prison. As public health experts have recommended, we can reduce the risk of relapse by providing addiction treatment in prisons. I also support increased coordination between correctional facilities and substance abuse treatment centers to make sure that formerly incarcerated addicts get the care they need.
5. Using Data Analytics to Target Solutions to Communities in Need
During my tenure as Chief of Staff to Boston Mayor Marty Walsh, I saw first-hand how data-driven technology can help policymakers enact effective public health interventions. For example, I introduced a data analytics initiative that tracked key metrics like EMS response times. When we saw EMS response times rise in 2015, we discovered that the EMS budget was not keeping up with the growth in Boston’s population, and we decided to devote additional resources to training new EMTs and purchasing new ambulances. Similarly, in 2017, we implemented a data-driven pilot program to send a team of EMTs in a marked SUV equipped with Narcan to areas where overdoses were concentrated. This also helped free up ambulance units to respond to emergencies in other parts of the city. Federally, we need to invest in data-driven approaches to create targeted solutions to the opioid epidemic. I support:
- Improving data availability. In 2015, Massachusetts launched a groundbreaking project to share data on the opioid crisis between government agencies, academic institutions, and the private sector. This innovative collaboration gave public health officials and policymakers crucial insight into combating opioid misuse and overdoses. We should support efforts to expand initiatives like this to incorporate data analysis at a federal level.
- Improving data sharing between states. As the Governor’s Working Group has recommended, states should collaborate to monitor data on opioid prescriptions. By using data effectively, we can identify at-risk populations, tailor responses to overdose outbreaks, and develop long-term preventative measures.
Opioid addiction is treatable, and opioid-related deaths are preventable. We have an opportunity and obligation to protect our families and communities. The federal government must work with state and local agencies to commit resources on the ground for education, prevention, intervention, treatment, rehabilitation, and recovery services. It’s time to come together and treat the opioid epidemic as the public health emergency that it is.