The city of Worcester in Massachusetts has no shortage of American history. The Worcester Regional Chamber of Commerce estimates that the current population of the city is 185,000. Worcester is a 45-minute drive to Boston and to Providence, RI. When you stay in the city, there is plenty to do, too, with 70 cultural venues that include museums, concert halls and theaters, as well as countless eateries.
Worcester is the second largest city in the New England region with 5,000 businesses calling it home. This is a city that prides itself on being a leader of innovation in the fields of education, health care and biotechnology, among others. While it is true that there are several accomplishments to celebrate, the city also has its share of problems. Worcester is one of the hardest-hit cities in New England and the United States when it comes to overdose deaths as well as addiction and substance use disorders.
In the current overdose epidemic, Worcester is not alone. Massachusetts has numbers that are alarming.
For the year 2018, the National Institute on Drug Abuse found that there were 67,367 drug overdose deaths in the country. This represented a 4.1% drop from 2017, which was good news. Before 2018, the overdose deaths had steadily risen. Overdose deaths that involved prescription opioids and heroin dropped. Deaths involving a synthetic opioid were the only category that rose.
In Boston, 88% of drug overdose deaths in 2018, or 1,991 deaths, involved at least one opioid. In addition:
• 475 overdose deaths involved heroin or prescription opioids in 2017.
• 331 overdose deaths involved heroin or prescription opioids in 2018.
• 1,806 overdose deaths involved synthetic opioids other than methadone in 2018, which was an increase from 2017.
• 90% of overdose deaths in Massachusetts in 2018 involved synthetic opioids.
• 35.3 opioid prescriptions were written for every 100 people in Massachusetts.
There are several reasons why all of those statistics among others are important. Children born to women who use opioids during their pregnancy may develop Neonatal Abstinence Syndrome or Neonatal Opioid Withdrawal Syndrome, which are fairly new and have not been steadily tracked by the medical field. Since there is no reporting standard, each state has its own criteria.
In 2016, the following information was found:
• Seven cases per 1,000 hospital births was the national incidence rate of NAS/NOWS.
• 15.9 per 1,000 births were among American Indian/Alaska Native individuals.
• 10.5 per 1,000 births were among White Non-Hispanic individuals.
• $572.7 million is the estimated hospital costs for NAS/NOWS births nationwide.
• 13.7 cases per 1,000 hospital births was the NAS/NOWS incidence rate for Massachusetts in 2017.
Substance use disorder rates are important, too, because it helps the medical field forecast other things such as potential new HIV diagnoses due to injection drug use (IDU). For Massachusetts in 2017, 20,374 individuals were living with a diagnosed HIV infection. 25.5% of male cases and 30.2% of female cases were attributed to IDU. Hepatitis C is another concern for the medical field. It is estimated that 38,100 individuals are living with the condition in Massachusetts.
The Boston Indicators, the research wing of the Boston Foundation, also researched the opioid epidemic. Specifically, they took a look at the impact on Massachusetts. They found that:
• Fentanyl has become more common in Massachusetts.
• Massachusetts may be impacted because key Northeast drug trafficking routes run through it.
• Economic hardship plays a role in the epidemic, but it is not the reason for the increase.
• Massachusetts had an opioid-related death rate twice the national average.
• The rate of doctor prescriptions plays a role.
The state of Massachusetts has taken action to curb these troubling statistics. The leadership of the state as well as the leadership of Worcester have recognized that their residents needed help, so those who struggle with substance misuse have resources available to them.
If you are someone who is living with a substance use disorder, you can get professional assistance to recover. Worcester and Massachusetts have enlisted help on several fronts that are funded through the public, grants and federal funds. There are also private options. One example of a private option is Green Mountain Treatment Center in New Hampshire. Each option has its own set of benefits. Sometimes you do not have time to leave work or family responsibilities, so a local and immediately available option is the best course. When you do have the opportunity to leave a potentially triggering environment, a private rehabilitation center is a great choice.
The city of Worcester has the following options available to residents to help reduce substance misuse:
• Detox services
• Methadone treatment
• Narcan distributors
• Suboxone treatment
• Emergency services
• Rehab treatment and helplines
• Outpatient services
• Syringe and sharps disposal
• Support groups
• Medication disposal
• Youth services
• Smartphone apps
In 2019, a report showed that there was still a call for more public resources. Police reports revealed a 9% increase in Worcester overdose deaths from 2017-2018 and 202% increase from 2013. April 2018 saw 112 overdoses, so first responders were busy. In 2018, 288 doses of Narcan were administered by the local fire department, and 92 doses were administered by the police department.
The Massachusetts Overdose Prevention Collaborative Grant Program is funded by the Substance Abuse and Mental Health Services Administration.
Its purpose is to implement local policies, practices and systems in order to force environmental change. The change is necessary so that opioids will not be misused. This should lead to the prevention or at least the reduction of overdoses across municipalities in the state.
More attention has also been placed on youth services. It is believed that due to the way the brain develops, if a youth gets hooked on a substance, his or her brain will not develop fully. Plus, overcoming an addiction is likely to be more difficult when it has started early in life.
The National Institute on Drug Abuse for Teens has explored the subject of teens, the brain and drugs. The brain is a system of neurons, neurotransmitters and receptors that communicate with the rest of the body. Drugs are chemicals. Opioids, for example, are 50-100 times more potent than a drugstore painkiller. An opioid’s purpose is to send a message to the opioid receptors in the body. They attach and deliver a message of relaxation, which is why someone who is given this prescription is able to get through the healing process with more ease.
Drugs change the brain, however. Messages are no longer sent throughout the body in default mode. The chemicals that are consumed cause a sense of euphoria or state of sleepiness. Either way, it is an engineered state that was not achieved through natural means. Drugs either imitate the brain’s natural messengers or overstimulate the reward circuit. Neither are good because the brain likes it, and this is how an addiction begins. The longer the substance use goes on, the more difficult it is to get over it.
The U.S. Department of Health & Human Services found the following information about youth in Massachusetts in 2017:
• 6% of high school students reported that they had smoked at least once in the last 30 days.
• 20% of high school students reported that they had used electronic vapor products in the last 30 days.
• 31% of high school students reported that they had at least one drink in the last 30 days.
• 16% of high school students reported that they had engaged in binge drinking in the last 30 days.
• 38% of high school students reported that they had used marijuana at least once in their lifetime.
• 4% of high school students reported that they had used cocaine at least once in their lifetime.
• 3% of youth 12-17 years old reported that they had abused prescription drugs in the last year.
What Is Next?
Once you realize that you are indeed experiencing an addiction or substance use disorder, the next step is get help. There are several ways to begin recovery that range from publicly funded to private facilities as well as outpatient to inpatient.
The treatment that you enroll in should be recommended for your situation. Someone who has been misusing their prescription opioids for two months is more likely to get over this condition quickly than someone who has been misusing them for at least a year, for example. A consultation with a medical professional allows them to assess your situation. Your medical history and circumstances are also taken into consideration.
Why Get Help?
Getting help is good for you, your family and society. Once you acknowledge your condition, you are on your way to learning how to live in a sober manner again. When you are sober, you are more likely to keep up with your responsibilities like showing up to your job on time, paying your bills and keeping a roof over your head.
There is also the societal component. Addiction is a negative weight on society. The NIDA estimates that the misuse of tobacco, alcohol and illicit drugs costs at least $740 billion annually due to crime, lost work productivity and health care. By getting back to a sober life, you are contributing to yourself and society.
Once you have decided that it is time to get help, you will be seen by a medical professional to receive a diagnosis. Sometimes, a decision is made for you about how to treat your condition. If you are overdosing and a first responder can get to you in a timely manner, medicine that reverses the overdose will be administered to you. Then, the first responders follow the protocol outlined to them based on your signs and symptoms. You may be dropped off at the local hospital, or you might be told to go home and research rehab options.
If you can make a choice of treatment method, you can pick from:
• Inpatient treatment
• Outpatient treatment
• Medical detox
• Relapse prevention programs
• Anonymous meetings
• Co-occurring treatment
An outpatient program is great for someone who has only a mild substance use disorder. This treatment takes place at a clinic, doctor’s office or hospital. You attend a few sessions a week where you receive therapy. It is often coupled with medication, so the person attending to you keeps track of your progress. If the plan is working, nothing changes; you simply complete it until the end.
Someone who qualifies for an outpatient program will receive therapy during the day and return home to a stable environment. This means that even if triggers exist there, you can cope. The triggers are not going to knock you into relapse.
On the other hand, a private rehab program at an inpatient center is beneficial for most cases. If you opt for Green Mountain Treatment Center, for example, you are going to have helpful amenities, programs and support staff available to you. Recovering away from your home environment may help prevent relapse.
The first step you might have to complete after a consultation is a medical detox. This is important and necessary. The detox step gets the substance out of your system and bloodstream. You cannot go into a 30-day program while you are still using because it simply negates the point of treatment. When you detox, you will go through withdrawal. Some people experience withdrawal more intensely than others, but it is hard for everyone. This is why professional support staff is necessary.
After the detox process, you may be scheduled to attend an individual therapy session a few times a week as well as group therapy sessions. At Green Mountain Treatment Center, men and women stay and sleep in separate quarters. Plus, the therapy programs are separated by gender, too.
It is not uncommon for an individual to have a substance use disorder and a mental health disorder at the same time. Whether one led to another or not, they can be treated at the same time with therapy. Some patients need anger management while others need cognitive behavioral therapy. The goal of a private rehab center is to help each patient recover from their addiction in a soothing environment that has a therapeutic backdrop. At Green Mountain Treatment Center, our staff is trained to help each individual build a solid foundation that is going to set the stage for lasting recovery.