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Jimmy Duran, a recovering pain pill addict, speaks at a Statehouse press conference on Dec. 8, 2016.
(SHIRA SCHOENBERG / THE REPUBLICAN)
BOSTON -- In 2004, Jimmy Duran was working for a moving company when he was hit by the swinging door of a truck. A back specialist prescribed him six weeks of Oxycontin for his injury. His life went downhill from there.
"I never thought you could be addicted to pain pills," Duran said.
For five years, Duran's doctor prescribed him monthly doses of methadone, morphine, Valium and Oxycontin. He bummed pills off friends. Facing addiction, he left his job and stayed home. He spent all his money on drugs until his electricity and cable were shut off, then he was evicted and moved in with his mother.
In 2011, Duran was arrested for selling cocaine, which he did to feed his habit. In jail at age 52, Duran finally asked for help from a nephew, who worked for the Gavin House, a substance abuse treatment center in Boston. The treatment turned his life around, and Duran is now a licensed drug and alcohol counselor working for the Gavin House.
"I owe them everything," Duran said.
Duran told his story Thursday at a press conference where Gov. Charlie Baker announced a pilot program to provide alternative treatments to opioids for workers injured on the job. The program will shorten the process of appeals for workers' compensation cases where opioids are an issue, and coordinate workers' care through a specialized nurse who is familiar with pain management techniques other than opioids.
"We hope this will encourage participation and mediation, leading to better care, alternative treatment and reduced risk of addiction," Baker said.
Currently, if a worker is injured on the job and receives opioids for pain treatment, insurance companies often move to discontinue the painkillers in order to stop paying for them. Workers can appeal, and often continue taking opioids while the appeal process drags on for months.
Secretary of Labor and Workforce Development Ronald Walker, whose office oversees workers' compensation, said the new program will ensure that any worker whose case involves opioids can go before a judge within 45 days. The worker will be assigned a care coordinator -- a nurse specializing in chronic pain care -- who will try to find viable treatment options for chronic pain that do not involve opioids. The worker or insurer can withdraw at any time and return to the traditional dispute mediation process.
The insurer will cover the cost of the care coordinator, and no additional state money is being used for the program. Massachusetts is the second state to pilot this type of program, after Ohio. New York will launch a similar program in January.
Department of Industrial Accidents Senior Judge Omar Hernandez, who is on a committee overseeing the pilot program, estimated that 50 to 75 injured workers will participate in the program during the first year.
Hernandez said in the court cases he handles, he has had people die of drug overdoses while their appeal is ongoing. When someone is taking opioids, Hernandez said, "Every day matters."
Steve Tolman is president of the Massachusetts AFL-CIO, a strong supporter of addressing opioid addiction and will sit on the oversight committee. He said no one knows if the pilot will work, but it is an innovative step toward addressing addiction.
"We're willing to take a gamble to try to figure out how we can change the tide of this treacherous, deadly epidemic created by the pharmaceutical industry," Tolman said.
Budget cuts
Baker's announcement came days after he made midyear budget cuts, which included $1.9 million from the Bureau of Substance Abuse Services. The bureau still has a $123.7 million budget.
State Sen. Karen Spilka, D-Ashland, chairwoman of the Senate Committee on Ways and Means Committee, criticized Baker's cut to the bureau as one example of a cut that has "real consequences" for communities. Legislative leaders have said they believe Baker's budget cuts were premature.
Baker said as he went through the budget to try to keep it in balance, and many of the cuts were made to programs that had alternatives or that he believed were already adequately funded. Many cuts were to earmarks.
"On the margins, these are difficult choices, but I still believe we are going to continue to invest more significantly than the commonwealth ever has in battling this substance abuse issue," Baker said.
Secretary of Health and Human Services Marylou Sudders said the substance abuse cuts did not affect any continuing programs, only earmarks for new programs. Some of the money was for public awareness coordinators in towns, which the administration believes could be adequately funded with existing local aid dollars. Many of the cuts were relatively small dollar amounts for local earmarks, such as $75,000 for the George Crane Memorial Center in Pittsfield, which offers support for addicts. Baker also eliminated funding for a pilot program to have recovery coaches in Western Massachusetts hospitals.
"We saw this as over and above what we believe we needed for treatment and access," Sudders said.
Baker administration officials point out that, in fiscal 2017, spending on substance abuse services increased by $15.5 million over fiscal 2016.
The administration previously spent money moving women civilly committed for substance abuse disorders from prison to new treatment beds at Taunton State Hospital. The state has paid for new treatment beds and revamped its prescription monitoring program to make it easier for doctors to check a patients' prescription history before prescribing opioids. Officials have worked with medical, dental and nursing schools to craft curricula around opioid abuse and pain management.
Joanne Peterson, founder and executive director of Learn to Cope, a nonprofit that helps family members deal with addiction, said in a statement that in 15 years of working with addiction, "I've never seen government do more to try to address opioid misuse" than under Baker's administration.
Roger Brunelle, who lost his 26-year-old son to an overdose in 2014, attended Baker's announcement. Brunelle's son was an assistant harbormaster in Wareham. He was first prescribed drugs for a back injury on the job, which ultimately led him to become addicted to heroin. Brunelle said he hopes the new program will help deter others from similar addictions.
"Any other alternative to taking these very powerful and addictive narcotics is a good thing," Brunelle said.
This story was updated after additional information became available about specific line item cuts.