1

Maura Healeys Plan to Combat Prescription Drug Abuse, the Heroin Epidemic
& Drug Addiction

Prescription drug and heroin abuse is a major health epidemic in Massachusetts and across the
United States. Nationally, prescription painkillers alone cause 16,000 deaths per year, and 475,000
emergency room visits. Painkiller addiction is also increasingly a path to heroin use and addiction.
Massachusetts heroin overdose fatalities have surged by more than 45% since 2006.

Today, more than 6.1 million Americans abuse or misuse prescription drugs and overdose deaths
involving painkillers have quadrupled in the past 15 years, outnumbering overdoses from heroin and
cocaine combined.

Nearly 1 in 5 young people in Massachusetts have misused a prescription drug. Prescription drug use
also harms newborns. Other particularly high-risk groups include rural populations, teens and young
adults, soldiers and veterans.

Prescription drug abuse is also exerting a huge cost on the U.S. economy, estimated at $53.4 billion
per year, including $42 billion in lost productivity, $8.2 billion in increased criminal justice costs, and
$2.2 billion in additional drug abuse treatment.

Massachusetts must lead the nation in addressing the public health epidemic of prescription drug
abuse, surging heroin use, and drug addiction.

My plan to combat drug addiction, the opioid and heroin epidemic, and prescription drug
abuse calls for:
1. Strengthening the Massachusetts Prescription Drug Monitoring Program by focusing on
interstate coordination, real-time reporting, integration with electronic health records, and
sustainable funding.
2. Deploying new resources to opioid abuse and drug trafficking hotpots.
3. Adopting a pharmacy lock-in program, like 46 other states have done.
4. Improving prescriber education.
5. Expanding our Good Samaritan law & access to Narcan.
6. Ensuring access to substance abuse and mental health treatment.
7. Reforming our criminal justice system to focus on substance abuse and mental health
treatment and not incarceration.
8. Educating the public on prescription drug misuse, safe storage and disposal.
9. Partnering with schools on stronger education initiatives for young people, focused on
heroin and other opioid abuse and addiction.

1. Strengthen the Massachusetts Prescription Drug Monitoring Program:
Prescription drug monitoring programs (PDMPs) are state-run databases used to track prescribing
and dispensing of controlled drugs to patients. The National Drug Control Strategy and Centers for
Disease Control conclude that PDMPs are a key strategy in reducing prescription drug misuse.
PDMPs can identify problem prescribers, stop doctor shopping by individuals misusing drugs,
identify inadvertent misuse, and allow for better treatment.

A 2010 study found that an increase in PDMP utilization in Virginia led to a 44 percent drop in
prescriptions to individuals identified as doctor shopping. A 2008, Ohio study found that 41
2
percent of prescribers accessing the database altered their prescriptions to certain patients and 61
percent of emergency rooms decreased opioid prescriptions.

As Attorney General, I will lead the effort to improve our states Prescription Drug Monitoring
Program, focusing on:

Interstate operability: Prescription drug abuse and trafficking does not recognize state
boundaries. Particularly in New England, our PDMP systems need to communicate with
each other so that a trip across state lines does not allow for doctor shopping and further
abuse. Current interstate communication is often complicated and slow.
As Attorney General, I will work with other regional state attorneys general and partners
to jointly decide on the best methods of state data sharing, focusing on allowing real-
time access to information.
Massachusetts should immediately join the NABP PMP Interconnect System, which
currently facilitates PDMP communication amongst 24 states.
Real-time reporting: The effectiveness of our PDMP hinges on the availability of data.
Massachusetts must push for real-time access, which is working on other states, to stop
abusers and traffickers from fooling the system by operating inside the reporting window.
Real time reporting will stop abusers and dealers from hitting up the pharmacies on opposite
sides of the street.
Integration with electronic health records: As Attorney General, I will argue for
integration of PDMP data across electronic health record systems in Massachusetts. The
effectiveness of such integration has been demonstrated in several successful pilot programs,
including a 58 percent drop in prescriptions by Indiana physicians, and should be
championed in Massachusetts.
Adequate funding: We need to guarantee resources for prescription drug monitoring. As
Attorney General, I will convene a working group comprised public health, public safety,
and law enforcement representatives to develop sustainable funding models to ensure that
our Massachusetts PDMP leads the nation.

2. Deploy resources to heroin, opioid abuse, and drug trafficking hotspots:
The Attorney Generals Office can actively take on drug trafficking by placing investigators,
prosecutors, and State Police into opiate-abuse hot spots, providing local communities with
additional resources to address the scourge.
The state must be a strong partner for local communities and ready to deploy resources to
increase on-the-ground presence and prosecutions to shut down drug rings and trafficking.

3. Adopt a pharmacy lock-in program:
Forty-six states, including every other state in New England, have a pharmacy lock-in
program for individuals suspected of misusing controlled substances must use a single
prescriber or pharmacy. Lock-ins are credited with reducing doctor-shopping while ensuring
quality of care. States that adopt lock-in programs also see significant cost savings in
reducing over-prescriptions. Massachusetts should adopt a lock-in program as soon as
possible.
3
As Attorney General, I will advocate for Massachusetts to adopt a lock-in program to
provide better assistance to pharmacies, health care professional and substance abusers in
curtailing use, overdose, and illegal distribution of prescription drugs.

4. Improve education and training for prescribers and practitioners:
Outside of addiction treatment programs, most health care providers receive only minimal
training on substance abuse and identification of patients with addictions. Studies have
shown that medical students receive only 11 hours of training on pain management.
As Attorney General, I will partner with Massachusetts health care providers, medical
schools, community groups, and fellow law enforcement to develop improved substance
abuse and pain management trainings for students and in continuing medical education.
Educating prescribers on appropriate prescribing practices is a critical step in stemming the
epidemic.
I will also demand that hospitals and other medical facilities report regularly on prescriptions
of narcotic painkillers and other drugs that can lead to abuse to better detect trends and
outliers, and provide better data to law enforcement and the health care community.

5. Expand the Good Samaritan Law, access to Narcan and public awareness:
Massachusetts law prohibits an individual who seeks medical attention for someone
experiencing a drug-related overdose from being charged or prosecuted for possession of a
controlled substance. I support expanding the Good Samaritan law to further protect
individuals from arrest on any drug offenses, and to prohibit revocation of parole or
probation.
As Attorney General, I will also support public awareness campaigns to promote the Good
Samaritan Law so that individuals know their rights and protections and can confidently
assist those in need.
I strongly agree with Governor Patrick that Naloxone (commonly known as Narcan) should
be made broadly available to first responders to prevent overdoses.
As Attorney General, I will support expanded trainings for drug users, family members,
friends, and community bystanders on the proper administration of this life-saving drug.

6. Ensure access to substance abuse treatment:
Nearly 8 percent of our population has a substance dependency. We are not doing enough to
provide needed treatment. The National Center on Addiction and Substance Abuse (CASA)
reports than only one in every ten Americans with an addiction to drugs or alcohol receives
treatment.
Massachusetts must ensure that quality, affordable treatment is available to those in need of
substance abuse treatment, including evidence-based treatments like medication-assisted
treatment.
As Attorney General, I will direct settlement funds obtained through enforcement actions as
well as community benefit services delivered through our not-for-profit hospitals and
insurance providers to increase beds, services, and programs for those struggling with
addiction. Our office must also fight to deliver on the promise of real parity between mental
health treatment and services for physical health.

7. Reforming our criminal justice system to focus on treatment and not detention
4
I support ending mandatory minimums for non-violent drug offenses.
I support the use of drug courts to better serve those dealing with drug addiction.
Expand community corrections programs.
We need to shift resources and focus on making treatment available, instead of relying on
our jails to be detox facilities.
That means more treatment for those suffering from substance abuse addiction and in need
of mental health treatment.
As Attorney General, I will direct settlement funds obtained through enforcement actions as
well as community benefit services delivered through our not-for-profit hospitals and
insurance providers to increase beds, services, and programs for those struggling with
addiction and mental illness.
We must focus our criminal justice resources onto shutting down drug traffickers and
manufacturers, who are channeling opioids into our communities.

8. Educate the public on prescription drug misuse, safe storage and safe disposal
As Attorney General, I will join with community groups and colleagues in law enforcements
to actively support evidence-based public education campaigns on appropriate use, safe
storage, and safe disposal of prescription drugs, with particular attention to the education
and support of parents with at-risk children, education professionals, and other at-risk
populations throughout Massachusetts.
As the chief enforcer of the states consumer protection laws, I will make sure that, as new
drugs come onto the market, the risks of addiction and abuse are well known and that drug
companies are held accountable for unsafe, addictive, and dangerous products.

9. Partnering with schools and communities on stronger education for young people on
prescription drug and opioid abuse, and the risks of addiction.
Young people across our state need access to strong, evidence-based education on the
dangers of prescription drug abuse and the significant risks of addiction.
As Attorney General, I will convene state and local education officials, school and municipal
leaders, public health and law enforcement officials to discuss ways to improve the education
and outreach to middle school and high school students on the risks of prescription drug
misuse, and the dangers of opioids and addiction.