By Robert Israel
Vital Signs Editor
For nearly two years, the MMS has been a leading force in the battle
against opioid abuse. Prescribing guidelines, public awareness, and
prescriber education have been hallmarks of the effort.
From Boston to Worcester to Greenfield and beyond, physician efforts continue the fight.
“We encourage physicians to use safer ways to prescribe opioids for
patients suffering from chronic pain,” said Dennis M. Dimitri, M.D.,
chair of the MMS Task Force on Opioid Therapy and Physician
Communication and immediate past president, “and to protect patients
through the enforcement of safe prescribing. We educate physicians and
medical students to understand opioid substance use disorder as a
chronic brain disease to be treated through therapy and support
Current task force efforts follow a well-attended MMS leadership summit last fall, Medication Assisted Treatment: Improving Access to Evidence-Based Care,
where strategies for increasing the availability and access to
evidence-based treatments were explored as weapons against the influx of
heroin, fentanyl, and illicit prescription drugs.
Another effective weapon is physician and patient education. Since
May 2015, when the MMS began offering free pain management and safe
opioid instruction, more than 8,000 individuals have completed over
23,000 course modules through the end of 2016. Physicians/prescribers
enroll to learn best practices and then share their knowledge with
patients. Their efforts, as seen in this report, can be felt in
Massachusetts communities state-wide.
Activism in Franklin County
Ruth Potee, M.D., is a family physician in Western Massachusetts.
She was honored in 2015 as Community Clinician of the Year by her MMS
peers of the Franklin District Medical Society and has been a voice for
change in erasing the stigma associated with substance use disorder,
advocating for treating it as a disease.
To that end, Dr. Potee urges all physicians to join the fight
against the opioid epidemic. “Physicians need to get the training they
need and to dig deep and to talk to patients about opioid use, to ask
the tough questions, to work in their communities, and to view this
epidemic as a major public health crisis,” she said.
Franklin County’s opioid task force, which unites medical, law
enforcement, civic and educational groups, and Baystate Franklin Medical
Center, is doing just that.
“All our prescribers are in full compliance with the Massachusetts
Prescription Awareness Tool (MassPAT),” said Thomas Higgins, M.D., chief
medical officer at Baystate Franklin, referring to the state’s
prescription monitoring program. “This has resulted in huge changes in
prescribing behavior. Our nurses and emergency room personnel are
trained in screening and intervention. Six newly-hired mental health
counselors provide around-the-clock coverage to those patients
presenting with opioid or other substance abuse. We monitor our efforts,
and there has been a slight decrease to the substance abuse problem
Educating Physicians/Prescribers in Worcester
At UMass Medical School in Worcester, Michele Pugnaire, M.D., senior
associate dean, and Jennifer A. Reidy, M.D., co-chief of palliative
care, train medical students who will take their place at the front
lines in the opioid battle. This training program emphasizes a
collaborative approach toward understanding, treating, and preventing
“At UMass, graduate-level nursing students study alongside pharmacy
and general medicine students,” Dr. Pugnaire said. “This
mixed-professional approach is a model for our communities: a united
force of medical professionals battling the epidemic.”
UMass Medical’s “holistic teaching” model, Dr. Reidy noted, includes
panels of patients who are invited to classrooms to share personal
testimonies of their struggles with addiction and chronic pain.
“Patient panels are the heart and soul of medical training,” Dr.
Reidy said. “Learning about health is knowing your community. Students
learn how patients struggle with addiction and how these patients have
become stigmatized. Unless we crack the stigma, we can’t advance against
Treatment and Recovery in Boston
An example of how to “crack
the stigma” of addiction, said Barbara Herbert, M.D., a task force
member, can be found at Boston Medical Center. She cited the work of
Alexander Y. Walley, M.D., who presented at the MMS leadership summit
last fall, as indicative of helping patients who are “suffering from
addiction to gain access to treatment that can lead to recovery,” she
“As this crisis we’re facing continues, there is a silver lining,”
Dr. Walley said, “and that is that evidence-based treatments work.
Fortunately, in Massachusetts, treatment is accessible. What is
rewarding to me is that every day I see my patients get better. This is
MMS President James Gessner, M.D., who was the first chair of the
Opioid Task Force that developed MMS prescribing guidelines, sees the
physician’s role as critical in the fight against addiction.
“Prescriber education is working, as opioid prescriptions are
declining,” Dr. Gessner said. “We have advocated for partial-fill
prescriptions and stressed proper storage and disposal to reduce the
amount of drugs available for diversion. We are focusing on eliminating
the stigma of addiction, recognizing it as a chronic medical disease,
and are now moving to expand treatment options. State officials,
legislators, policymakers and patients have now recognized that
physicians are part of the solution to this epidemic.”