There is no simple explanation for why so many people in Massachusetts are hooked on opioids: drugs that include heroin and its list of derivatives like the painkillers Vicodin and OxyContin.

Experts and advocates have identified so many root causes (access to prescription drugs, too few treatment beds) and side effects (a spike in overdoses, which killed more than 1,200 in the state last year alone, overburdened emergency rooms) that it can be hard to keep track of it all.

In light of Gov. Charlie Baker’s new plan to tackle the opioid abuse crisis announced Thursday, Metro asked those who work on tackling the issue every day to weigh in.

Pat Cronin, program coordinator for the Massachusetts Organization for Addiction Recovery

Pat Cronin

Pat Cronin

Pat Cronin


Cronin, an opioid addict who’s been in recovery for 10 years, applauded Gov. Charlie Baker’s legislation announced today, calling it “a long time coming” for a multifaceted problem.

“It’s coming at so many different angles,” he said. “It’s a laundry list of items that have to be addressed to actually combat this crisis.”

Cronin said he now testifies in favor of drug and addiction treatment reform about twice a month, joining many organizations and families doing the same.

“[Parents] are knocking on legislators' doors saying, ‘My kids are dying. You’ve got to do something about it.’”

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Dr. Sharon Levy, director of the Adolescent Substance Abuse Program at Boston Children’s Hospital

Amid all the attention being given to opioid abuse in the state, Levy said she wanted to reinforce the benefits that pain-killing opioids have for patients.

“It’s important for legislators to understand that pain can be treated safely without causing a patient to develop an addiction,” Levy said. “We need to put out guidelines that avoid over-prescribing … but eliminating opioids entirely is not the appropriate solution.”

Dr. Barbarajean Magnani, chairwoman of the Department of Pathology and Laboratory Medicine at Tufts Medical Center

Dr. Barbarajean Magnani

Dr. Barbarajean Magnani

Tufts Medical Center


Magnani said she leads training for doctors to address the balancing act pain management and opioid prescribing presents.

“Over-prescribing for minor things is really part of the problem,” Magnani said, adding, “You want to make the patient comfortable, but - and this is my personal opinion - I think to live in a pain-free world is not possible. Patients should be able to tolerate a little bit of pain.”

She said Baker’s plan to add new training requirements could help health practitioners “pay attention and prescribe what’s really needed and look for alternatives to all these opioid drugs.”

RELATED: State officials wrestle with growing heroin crisis

Dr. Peter Smulowitz, associate chief of emergency medicine at Beth Israel Deaconess Hospital in Plymouth

Smulowitz, who said he has seen countless opioid addicts come through his emergency room, said the state needs to increase the number of treatment beds available to patients.

A law that would make it easier to commit addicts to treatment against their will, as Baker has proposed, Smulowitz said, could burden hospitals.

On Thursday alone, Smulowitz said, there were 19 patients in his emergency room with a variety of behavioral health and substance abuse needs facing long waits for care.

“There is nowhere for us to put them,” he said.