Paul Mendis, M.D.

Guest Editorial by Paul Mendis, M.D., Neighborhood Health Plan Chief Medical Officer

The heroin and opioid epidemic has touched every community in the Commonwealth and transcended boundaries of income, education, age, and racial/ethnic identities.  While once labelled with the stigma of a crime, the medical community—and now the Commonwealth of Massachusetts – has come to understand that opioid addiction is more properly labeled a chronic disease. Understanding its origins and treating it like a chronic disease (similar to asthma or diabetes) is critical to better outcomes for individuals, families, and communities.

Research by the National Institute of Drug Abuse notes that 80% of those addicted to heroin began by using prescription opiates – those prescribed to themselves, family members, or friends. Often, this addiction begins with those who look to intensify their experience by taking prescription drugs in ways, quantities, and frequencies other than prescribed. 

Recent national data shows that those who misuse opioids may be more likely to use heroin.  Heroin is easily available, cheap on the street, and can have drastic immediate and long-term harmful effects on the brain and body, including serious medical complications, addiction, brain damage, overdose, and death.  Once addicted, many people experience permanent brain changes, which makes opioid addiction a relapsing and unremitting, chronic illness.

Medication Assisted Treatment (MAT) is an evidence-based practice that involves the use of medications along with counseling and recovery support services to treat opioid dependence. Methadone, buprenorphine, and naltrexone are medications currently approved by the FDA for treatment of opioid dependence. Methadone is dispensed only at specially licensed treatment centers. Buprenorphine and naltrexone are dispensed at treatment centers or prescribed by doctors.

Studies have shown that the mortality rate for those receiving MAT is similar to that of the general population, while the mortality rate of untreated individuals using heroin was more than 15 times higher. MAT has been shown to stabilize physical cravings, improve retention in treatment, as well as control behaviors that may lead to relapse. Those who are admitted to treatment facilities with abstinence-only policies face 40% higher risk of relapse and overdose when discharged to the community than those connected to and receiving long term MAT. It is important to remember that medications should not be used as a stand-alone treatment choice. A combination of therapy, recovery supports, and medication provide the best chance for long term recovery.

Tips for Parents from Governor Charlie Baker’s Opioid Addiction Working Group

If you are a parent, start when your child is young to help prevent opioid misuse. 

  • Talk with your teen about the potential dangers of taking medications that are not prescribed for them.
  • Be clear about your expectations. Support healthy decision making.
  • Keep prescriptions in a secure location. 
  • Dispose of unused prescription drugs. To find a secure medication dropbox in your area, visit Mass Drug Drop Box

For additional information, visit Stop Addiction.

 

For Help: If a loved one does have an opioid addiction…

  • If you or someone you know is affected by opioid addiction, visit Stop Addiction to access information and resources.
  • Refer to your health plan’s behavioral health benefits to understand your coverage and options. To find out if a service is covered, and for additional benefit details, contact your plan.

Dr. Paul Mendis is Chief Medical Officer at Neighborhood Health plan and has practiced primary care for more than 20 years in urban health center environments as well as serving in health care leadership roles. He was appointed by Governor Charlie Baker to the Special Commission to Examine the Feasibility of Establishing a Pain Management Access Program and to Governor Baker’s Prevention and Wellness Trust Fund Advisory Board


This information provided by the Group Insurance Commission .