3 Ways to Combat CT’s Opioid Crisis

More than 720 Connecticut residents died of drug overdoses last year, according to a report released by the state Office of the Chief Medical Examiner.   Over half of the reported deaths were heroin-related.

So when I sat down with a clean-cut, 57-year-old private practice lawyer from Orange, Connecticut, I never expected him to introduce himself as “the man who wants to decriminalize heroin.”

Sylvester Salcedo is a former Naval officer who served in Colombia in the early 80s, so he is no stranger to the drug trade.

He advocates for rehabilitation, in April he told the Register Citizen,”you want to promote health and key people’s safety until they chose to change their behavior, you wouldn’t deny the diabetic insulin. So why deny someone who has a disease that involves injection drug use clean equipment or a clean place? A lot of people are injecting quickly, in cars, in abandoned buildings, in places that are not hygienic.”

Salcedo points to a successful clinic in Vancouver that was the first safe-injection site in North America as proof that his approach will be effective.  Since the clinic’s inception in 2003, they hadn’t suffered a single overdose death.  With the number of deaths from heroin rising so rapidly, alternative measures like Vancouver’s clinic should be considered.

 US_timeline._Heroin_deaths

Connecticut Senator Richard Blumenthal detailed a five-point plan last month he released on his website, which can be read in more detail here.

  1. Prescribing Practices: We must change prescribing practices through mandatory training and increased use of alternative pain management methods.
  2. Treatment: We must expand access to quality substance abuse programs and behavioral health services.
  3. Emergency Medical Response: We must strengthen emergency response and coordination in crisis situations through expanded access to affordable Naloxone.
  4.  Law Enforcement: We must provide federal, state and local law enforcement resources to fight drug trafficking and to address addiction that leads to criminal acts.
  5. Veterans Administration Treatment, Research, And Education: We must enhance VA leadership in education, research, and treatment of opioid misuse and abuse.

According to his plan, he wants to mandate training to reduce opioid overprescribing and encourage alternatives and start encouraging compliance with opioid prescribing guidelines. He also hopes to establish FDA risk evaluation and mitigation strategy for immediate release opioids.

The state wants to begin requiring annual reports by insurers on mental health parity implementation and institute federal audits of insurers’ compliance with mental health parity.  They will facilitate the relationship by reimbursing pharmacists for providing naloxone and eliminate insurer copays and other restrictions on take-home naloxone kits.  These will all help the miracle drug land in the right hands.

Additionally,  increased funding for the federal High-Intensity Drug Trafficking Areas Program and for alternatives to incarceration for drug-addicted criminals will go a long way, according to Blumenthal.  

Sixty-seven people will die today in America because of heroin or narcotic painkillers, according to RAND reports.   They believe that Buprenorphine could be the ticket to combating addiction at the source.  “When it was approved in 2002 for widespread use against heroin and other opioid drugs, experts predicted it would change the face of addiction medicine.”

Pharmacists can now play a role in opiate addiction treatment. According to the FDA, Suboxone and Subutex are the first medications approved for office-based treatment of opioid dependence. Before the Drug Addiction Treatment act in 2000, it was illegal for a doctor to prescribe narcotic drugs for the treatment of narcotic dependence.

Buprenorphine functions by blocking the receptors in the brain that opioids target.  It trumps methadone in that buprenorphine can be taken at home, without a stigmatized trip to a clinic.  Steadily, more and more doctors are taking a clinic that allows them to write prescriptions for the drug, according to RAND.