PHOTOS BY KEIKO HIROMI
Dozens of activists marched to the State House last week demanding action for the city’s addiction epicenter.
The area often referred to as Methadone Mile, roughly encompassing the intersection of Melnea Cass Boulevard and Mass Ave, has long had a reputation for its abundance of homeless people and those suffering from addiction.
That reputation only grew under former Mayor Marty Walsh; over the past seven years, the city’s largest methadone clinic and homeless shelter were relocated to the vicinity, further concentrating the city’s addiction and homelessness services into an area that is frequently targeted by drug dealers.
At the heart of the area is Boston Medical Center, which as the state’s safety net hospital receives a disproportionate share of low-income and homeless patients and those with addiction.
The South End Roxbury Community Partnership organized the march in partnership with In Memory of Damien Hughes, the Mass Ave Project, Bridge Kids Give Back, Chris’s Project, Moms on the Mile, Charlestown Coalition, Ricky’s Inc., and Little Liberty.
“We continue to ask our elected officials to be held accountable for their responsibility to the communities they serve,” said the joint statement from the group that organized the march. “We have reached out countless times through emails, petitions, town halls, community meetings and numerous protests.”
The marchers on Wednesday called on Boston mayoral candidates to make the situation in the area a key campaign focus, declaring “No Plan = No Vote.”
The fact that mayoral candidate and current Mattapan/Dorchester City Councilor Andrea Campbell made Methadone Mile a key campaign issue back in January reflects the bare minimum of what could be expected from would-be leaders in the city.
At the time of this reporting, other mayoral candidates have yet to release a concrete plan for the area, though it’s likely some are in the works.
While the services at Melnea Cass and Mass attract people in need from across the state, the Bay State’s opioid problem is not exclusive to the City of Boston.
Massachusetts as a whole saw a 5% increase in opioid deaths in 2020 over the previous year, according to a new report from the state. That spike reflects a shift away from the previous three years that saw a downward trend in fatal overdoses.
There were 2,104 confirmed and estimated opioid-related overdose deaths in 2020, reflecting a 102-death increase over the previous year, and a slight increase above the 2,102 deaths that made 2016 a record-breaking year for tragic drug deaths. Most of that increase was among Black people, who experienced a 69% increase in overdose deaths in 2020.
“Both the COVID-19 pandemic and the opioid epidemic have underscored the importance of supporting disproportionately impacted communities, and as we address both issues, our Administration has continued to focus on equity as a core component of our response,” Gov. Charlie Baker said in a statement.
Although opioid deaths were bad in Mass, Baker is hanging his hat on the low-bar standard that the Bay State is at least not as bad as other states in the country.
“While Massachusetts experienced a smaller increase in drug-related deaths compared to the rest of the country, these trends make clear we have to redouble our efforts,” he said.
When he was running for president, Joe Biden pledged to combat the opioid crisis by increasing access to addiction treatment and cracking down on pharmaceutical companies that push opioids.
Now that he is in office, Biden recently issued new guidelines for the Department of Health and Human Services, easing restrictions for prescribing buprenorphine, which is used to treat opioid addiction.
“The alarming increase in overdose deaths underscores the need for more accessible treatment services, and studies have shown that medication-based treatment promotes long-term recovery from opioid use disorder,” said a HHS press release announcing the move.
The new rule allows health care providers to prescribe Buprenorphine to a limited number of patients without having to first federal training and approval.
Even with the relaxed regulations, there is no guarantee that patients would have increased access to the drug. A recent study published in medical journal Drug and Alcohol Dependence found that 1 in 5 pharmacies across the country refuse to dispense buprenorphine.
While the move was applauded by medical experts in the field of substance use disorder, many were quick to point out that much more extensive reform is needed.
“We will only change the course of this epidemic when all clinicians are able to screen for and diagnose Substance Use Disorder, and be able to initiate therapy,” wrote University of New Mexico Hospital MEdicine Chief Dr. Kendall Rogers in a series of social media posts in response to the Biden move. “To be fair, this HHS Guideline is likely the most the Biden Admin could within their power to increase access as an elimination of this requirement requires legislation.”
For better or worse, probably worse, it’s also worth noting that this is another major money grab for recovery drug manufacturers, many of whom are the same companies that got us in this mess. As we reported in the past:
Drug companies were just getting started in late 2002 when buprenorphine was approved by the FDA for use in the treatment of opioid dependence. As Suboxone (a drug with buprenorphine) was introduced to the United States market in 2003, lobbyists hired by its maker, Reckitt Benckiser Pharmaceuticals, were already fighting restrictions, arguing against caps on “the number of addicted patients a physician can treat at any one time.
So far, Big Pharma has got what it wanted. Initially, physicians could only prescribe buprenorphine to up to 10 patients. Soon after, the Substance Abuse and Mental Health Services Administration (SAMHSA) introduced a waiver for up to 30 patients, followed by another that allows up to 100 patients.
As of 2016, after prescribing to up to 100 people for a year, physicians can then apply to increase their limit to 275 patients.
Past successful lobbying considered; it’s likely that trend will continue. Whether more buprenorphine prescriptions will change things for the better, however, is another story.