HEROIN A CONTINUING CRISIS IN ARLINGTON, REGION

Arlington - Eastern Massachusetts outpaces much of the nation in
heroin-fueled emergency room visits and admissions to state treatment
programs for painkiller addictions, according to two recent federal
reports on substance abuse.

And while overdoses haven't necessarily spiked in Arlington, those
findings came as no surprise to local paramedics, police and medical
professionals, who say that abuse of heroin and prescription drugs
such as OxyContin continues to be elevated and problematic in the community.

"I think that [the rate of drug overdoses in Arlington] remains
steady," Police Captain Richard Flynn said this week. "People out
there are, whether it be OxyCodone, whether it be heroin, it seems
there's always that market out there for whatever the drug of choice
may very well be."

The recent findings released by the U.S. Substance Abuse and Mental
Health Services Administration (SAMHSA) highlight the state's ongoing
struggle to reduce overdoses and deaths from heroin and prescription
drugs such as OxyContin.

"We know and we've been saying for years we have an epidemic here in
Massachusetts around heroin," said Vic DiGravio, president and CEO of
the Association of Behavioral Healthcare, which represents drug and
alcohol treatment providers. "That's in part being fed by the whole
OxyContin epidemic."

One report found Greater Boston had a higher rate of emergency room
visits involving illegal drugs in 2009 than 10 other major
metropolitan areas, including New York City, Detroit and Chicago.

This region also ranked first for emergency room visits involving
heroin. The analysis looked at hospital statistics from Middlesex,
Essex, Norfolk, Plymouth and Suffolk counties, as well as Rockingham
and Strafford counties in New Hampshire.

The report echoes the state's own statistics, which show non-fatal
emergency room visits involving heroin or other opiates rose 18
percent statewide from fiscal 2002 to 2007, though the number dipped
slightly in that final year.

For those suffering a drug overdose, treatment often begins when
paramedics arrive on scene with a dose of the drug naloxone, which
can reverse the immediate effects of an overdose, according to Gary
Setnik, chairman of the Department of Emergency Room Medicine at
Mount Auburn Hospital in Cambridge.

The drug can be administered intravenously, or through a nasal mist,
referred to as Narcan.

A typical hospital stay following a non-fatal overdose lasts eight to
10 hours, Setnik said. Doctors first ensure the patient isn't at
immediate risk, then monitor them until the effects of the medication
have worn off. Treatment includes a psychological evaluation, and
patients can be referred to a detox unit.

For doctors, Setnik said, the biggest challenge posed by the level of
heroin and painkiller abuse in the area is convincing addicts that
"there is a life beyond addiction, and that there's some hope for them..."

"It's frustrating for everybody," he said, "because most of these
individuals, in my now 35-year experience, really haven't accepted
that, and they're not interested in pursuing it, and so we know we're
going to see them again."

Heroin tops treatment list

The second federal report said Massachusetts is one of only four
states where an illegal drug - in the Bay State's case, heroin -
outpaces alcohol as the most common reason for admission to
state-funded substance abuse programs.

In Arlington, 212 people were admitted to such programs during fiscal
2010, according to statistics released by state health officials.
Nearly half of them - 43 percent - had used heroin in the past year.

The federal report also found that treatment admission rates for
opiates other than heroin, such as OxyContin, were twice as high in
New England than any other region of the U.S. in 2009. In
Massachusetts, there were 4,734 of these types of state treatment
admissions that year, outpacing cocaine.

Nationally, admissions for people struggling with opiates other than
heroin spiked 430 percent from 1999 to 2009, the report said.

In Massachusetts, many people first get hooked on prescription drugs
such as OxyContin, then move on to heroin, which is sometimes cheaper
and more accessible, DiGravio said.

"I'm unfortunately not surprised," Setnik said of the federal report.

The first federal report said Greater Boston saw 571 emergency room
visits involving illegal drugs per 100,000 people in 2009, well above
the national rate of 317 per 100,000.

The rate of heroin-related emergency room visits in this region was
251 per 100,000 people, more than three times the national rate, the
report said.

State hospitalization data from 2009 show the problem is not limited
to any single part of eastern Massachusetts. South of the city,
Brockton, Fall River, Taunton, Plymouth, New Bedford, Weymouth,
Norwood, Stoughton and Quincy each saw more than 200 people suffer
non-fatal overdoses in 2009.

In MetroWest, only Framingham saw a rate that high. Cities just north
of Boston, such as Cambridge, Somerville and Medford, also saw among
the state's highest rates of non-fatal overdoses. Similarly high
rates continue up the North Shore to Saugus, Beverly, Salem, Danvers
and Gloucester.

The Bureau of Substance Abuse Services is expanding programs that use
the medication Suboxone to treat opiate addiction in community health
centers, where young people typically prefer to undergo treatment.
The state is also expanding training in the use of Narcan with pilot
programs in five communities.

One such pilot program is taking place in Cambridge, where the local
chapter of AIDS Action Committee offers a Narcan training and
distribution program, according to Emily Bhargva, director of Mount
Auburn's Regional Center for Healthy Communities, located in Cambridge.

The organization also runs a needle exchange program for area
residents, which allows injecting drug users to exchange used needles
for clean needles, along with education about how to reduce risk of infection.

Although the state outpaces some others in offering treatment
options, challenges remain for those seeking help. There are waiting
lists to get into so-called recovery homes, or facilities where
people who have completed detox can stay for another six to nine
months and get their lives back on track while undergoing continued
counseling and treatment.

Treatment providers often see people without access to such services
end up in detox over and over again, DiGravio said.

"They're not getting the services farther down the spectrum that they
really need to help prevent them from cycling through," he said.

The Association for Behavioral Healthcare and other advocates also
recently called on the state to add $5 million to the Bureau of
Substance Abuse Services budget to fund 83 case managers to work with
9,600 young adults.

"There's still a ton of unmet need out there at all stages," DiGravio said.