More than half of the adults entering state-licensed, residential addiction treatment centers in Massachusetts do not complete their treatment programs and one in eight are readmitted within a month of being discharged, according to a new state report.
The findings from a special commission created to study the state's network of treatment centers point to some of the many challenges facing policymakers trying to control a persistent and deadly opioid addiction scourge.
The state Department of Public Health reported 1,005 confirmed opioid-related overdose deaths through Sept. 30, with estimates bringing the total as high as 1,475 deaths. If trends continue, deaths in 2016 are likely to exceed the estimated 1,747 in 2015.
The 11-member commission, chaired by Health and Human Services Secretary Marylou Sudders, makes a number of recommendations including increased access to "recovery coaches," who provide personalized service to guide patients through the difficult process. The report notes that too few coaches are available and the ones that are need more supervision, training and support.
Recovery coaches "can be helpful in many different stages of the process," said panel member Joanne Peterson, founder and executive director of Learn to Cope, a state-funded group that supports families dealing with addiction.
In addition to helping people get into treatment, coaches can provide important follow-up throughout recovery.
"Sometimes people give up and a relapse can happen," Peterson said.
According to the report, only 49 percent of those admitted state-licensed adult residential treatment centers successfully complete their treatment program, with many simply dropping out or leaving treatment against medical or clinical advice. More than 12 percent relapsed within a month.
Completion rates are slightly higher at other types of treatment facilities: 64 percent for acute treatment, 68 percent of clinical stabilization and 58 percent at those which offer transitional support services.
The report also pointed to significant obstacles for patients struggling with both substance abuse and mental health issues, recommending among other things expanded on-site mental health care at residential treatment centers.
Staff at hospital emergency rooms, often the first stop following overdose, "lack the appropriate training and protocols that enable a patient to obtain appropriate addiction treatment," the report stated, adding to the "stigma" that people with substance abuse disorders often endure. One suggestion: Create within ERs the equivalent of a trauma team that is specially trained to respond to overdose incidents.
The commission was created under a landmark opioid abuse law signed in March by Republican Gov. Charlie Baker to fight what he called a "deadly, merciless epidemic." The law established a seven-day limit for first-time prescriptions for opiate painkillers and a rule that people treated for overdoses in hospital emergency rooms undergo an evaluation and be given further treatment options with 24 hours.
The administration "remains committed to fighting the opioid epidemic and in evaluating these recommendations has continued to invest in prevention, education, treatment, and recovery programming to curb this public health crisis impacting citizens across the Commonwealth," said Michelle Hillman, a spokeswoman for Sudders.
Since taking office, administration officials say they have invested significantly in substance abuse prevention and treatment, including an $18 million spending increase in 2016.