Framingham Panel: Destigmatize Opioid Misuse

FRAMINGHAM, MA — Four panelists provided different perspectives on opioid misuse at a forum Tuesday about the state of the opioid epidemic, but one theme transcended — the stigma around substance use disorders needs to change. The event was hosted by Framingham's League of Women Voters and held in the McAuliffe Branch Library. The event chronicled the history of the opioid epidemic, how treatment options are changing in the region and the effect the epidemic has had on families.

Cathy Miles was a featured panelist and told her story of how opioid misuse touched her family's life. Through her daughter's struggle with opioid misuse and journey through recovery, Miles and her family have educated themselves on the topic. Miles founded the group Framingham FORCE (Fostering Opioid Recovery Compassion & Education) and works to end the stigma associated with substance use disorders and opioid misuse.

Miles said her daughter struggled with anxiety but was an honor roll student and champion athlete. Miles and her husband were involved in her school activities and did their part to support her emotionally, academically and socially. Miles' daughter came to her for help about her opiate use when she was a sophomore in college. She eventually dropping out.

Miles went into detail about how her and her husband were not prepared for the challenges they faced but educated themselves on the topic to face it head-on. Finding the right treatment options was hard enough since many didn't accept health insurance, but the negative stigma associated with addiction made it hard for the family to get support from friends and loved ones.

"I had to find my own support groups where I learned I was not alone," Miles said.

Her daughter tried several different treatment options and relapses occurred along the way. Miles pointed out that during the process she realized that recovery is not linear. An outpatient treatment program proved to be the best fit for Miles daughter, who entered the program three years ago and has stayed since. This wasn't the first outpatient program she had tried and Miles said her daughter was reluctant. The difference with this program, Miles said, was they were nice.

"She was so used to being treated like a loser, that simply being respected and treated nicely was what turned the corner for her," Miles said.

Putting numbers to the issue, Dr. Sharon Reif, senior scientist at the Heller School for Social Policy and Management at Brandeis University and deputy director of its Institute for Behavioral Health, said 81,000 people used heroin for the first time in the past year. She added that 2 million people misused prescription opioids for the first time in the past year as well. Reif said that opioid misuse has been an issue since the 1990's but the epidemic has changed from focusing on prescription pills to synthetic opioids such as fentanyl. Reif said substances like fentanyl are "so much more efficient at killing people."

Reif said treatments are not just about medications but should incorporate counseling and peer and family support. Destigmatizing substance use disorder is a crucial step in helping patients recover, she said.

"This is not about a choice, this is not about — you're a bad person," she said.

Pulling that stigma out of the minds of hospital workers and nurses is another battle that has made some progress, according to Justin Looser, executive director for behavioral health at MetroWest Medical Center and St. Vincent’s Hospital. Looser talked about his experience working in hospitals in New Hampshire. He said opioid users were met with dismissive and cold attitudes from ER staff who classified them as junkies, discouraging them from returning or seeking more help in recovery.

He said the average wait time to be placed in treatment in Massachusetts was 18 hours — a systemic issue that is isolated to psychiatric medicine and addiction, he said. Now, instead of pushing patients along, doctors are moving toward a continuum of care model that looks for further treatment options to guide patients through their recovery.

That model is being perpetuated by recovery coaches like Bill Parks, who spoke on the panel about his work with Advocates Inc., Framingham and Marlborough hospitals and his own experience with substance use. Parks said listening to the patient is key to finding a program or recovery method that suits them.

"People who are battling addiction are always told what to do," he said, giving them the option to shape treatment to their needs instead of the reverse yields better outcomes, he said. "We understand where you're at — I've been there. What do you wanna do about it?"