As Gov. Charlie Baker makes his case for re-election, he speaks frequently about his efforts to combat the opioid epidemic — saying that while there’s more work to be done, Massachusetts is now on the right track. But Baker’s challenger, Democrat Jay Gonzalez, is making a very different argument: Baker's record on opioids, he contends, isn't nearly as impressive as voters may think.
Baker's optimism was on full display during a recent visit to Lynn Community Health Center. Officially, he was there to announce new funding for community health centers across the state, but the actual focus was the state of the opioid epidemic in Massachusetts.
The problem has particular resonance in Lynn, which saw 60 fatal overdoses in 2017. But when the health center's CEO, Kiame Mahaniah, introduced Baker, he accentuated the positive, speaking glowingly about the governor’s efforts ... which got an ovation from the cloud.
"It’s been great having an administration at the state level that’s been so supportive," Mahaniah said. "I don’t think we could have wished for a better partnership."
Afterward, Baker gave his take on the state of the epidemic now.
"When I first started talking about this issue with people in 2014, there was literally, like, no good news anywhere coming from anybody," Baker said. "It was the most depressing, desperate, and hopeless set of conversations I've ever had. And when I talk to people about it now, while there is still tremendous work to be done, people do talk about things that have been working. They talk about things that have made a difference. They talk about the fact that in many cases, they have seen progress."
For one thing, Baker said afterward, fatal overdoses are down in Massachusetts.
"We’re one of a small number of states that have actually seen a decline in deaths since 2016, and that was after seven or eight years of double-digit increases in deaths," Baker said. "Tremendous momentum in the wrong direction. And I do believe we’ve had sustained progress on that one for the past 18 months."
That progress is almost certainly linked to the increased availability of the anti-overdose drug Naloxone, which Baker has made a priority.
In addition, Baker said, there are two other areas where progress has been both tangible and valuable.
"The prescription-monitoring system, and the limitation on first prescriptions [of opioids] to a seven-day supply have had an impact on prescribing generally, which is down about 30 percent since 2015," he said.
"I also take some satisfaction in the fact that we have managed to add about 1,200 treatment beds," Baker added. "And while we still hear issues about access to treatment, they're nowhere near as broad-based and distributed as they were when we first got started with this."
That's actually where Gonzalez began his critique of Baker's record at a recent fundraiser in Lexington.
"Two of my campaign volunteers lost sons in the last seven or eight months." Gonzalez said. "One of the sons I got to know a little bit before he died, and there was a point at which he wanted to get into treatment. And he was told he had to wait 15 days. Which is unacceptable."
Gonzalez didn’t say how many more treatment beds Massachusetts needs. Instead, he shifted to other solutions he’d pursue if elected — like increasing the use of medical marijuana in lieu of traditional painkillers, and another highly controversial option.
"Safe-injection sites ... have been proven to work in other parts of the world, not only to help keep people alive, but also to help get them into the treatment they need," Gonzalez said.
"We've got to try new and bold things," Gonzalez said. "We're not being aggressive enough."
Andrew Lelling, the U.S. Attorney for Massachusetts, has said that anyone using or staffing a supervised injection site could face federal prosecution.
In one case, though, Gonzalez faulted Baker for being too aggressive. If elected, he said, he'd end a Baker Administration initiative that allows some individuals struggling with addiction to be civilly committed for detox at a Department of Corrections facility in Plymouth.
It’s hard to say that Baker’s narrative is right and Gonzalez is wrong, or vice versa. Different clinicians have different perspectives; so do different people struggling with addiction, whether it’s their own or a loved one’s.
But Dr. Barbara Herbert — a past president Massachusetts Society of Addiction Medicine — thinks the truth lies somewhere in the middle.
On the one hand, Herbert says, "Charlie Baker has done a great job at trying to diminish stigma. He created a commission of real experts, and laid out a plan for how we could take on severe opioid-use disorder ... in this state."
But Herbert faults Baker for his disinterest in supervised injection sites, which she said would be a lifeline for the most vulnerable victims of addiction.
"Twenty percent of people who come into supervised injection facilities go into treatment," she said. "They’re people we can never get into treatment."
Herbert also argues that past time for Massachusetts to providing medications like methadone and buprenorphine to addicted prisoners, who fatally overdose at a high rate after they’re released.
"Rhode Island, our neighboring state, has brought the full range of medication-assisted therapy into the jails, and has dramatically reduced the number of people who die," she said. "And one of the major reasons the department of corrections says they can’t do that is they don’t have the money. Baker could make that happen."
Perhaps he will. In Lynn, Baker told me he'd like to expand medication-assisted treatment in a second term, though he didn't specifically mention prisons. He also spoke of increased use of “recovery coaches,” who’ve grappled with their own addiction and then help others.
But whether Baker redoubles his efforts in a second term, or Gonzalez begins tackling it in his first, the opioid epidemic won’t be solved any time soon. While fatal overdoses dropped in 2017, they still took the lives of more than 2000 Massachusetts residents.
This piece has been edited to note the US Attorney's position on the legality, or lack thereof, of supervised injection sites.
