>> genetic disparities linked to breast cancer in black women and the governor' s new plan to tackle the opiate crisis. today here on cityline. karen: hlo. i' m karen holmes ward. governor charlie baker along with the column and wealth -- the commonwealth is facing a public health emergency. >> the days of people walking out of a dentist office or doctor' s office with 30 or 60 or 90 days worth of this pain medication need to come to an

and i appreciate the fact that this is a controversial idea. but it' s one that needs to be part of the larger conversation. karen: a wide-ranging bill would include limits on medical practitioners prescribing excessive amounts of opiate medicine to first-time patients. the effort has been met with both positive and negative response. joining us now is the clinical director of the women' s renewal program academic center. welcome. guest: thanks for having me. karen: give us your initial thoughts on the governor' s builder guest: ill. guest: we definitely need more awareness in the community and amongst prescribers for unnecessary prescriptions. it' s really where the addiction for opiates begins. having this as a place to cut this off is crucial. karen: and prescription

monitoring seems to be a key part of this. guest: having everyone on the same page. making sure everyone knows that if an individual has received an opiate prescription that they don' t get additional prescriptions or if they are struggling with abuse or dependency that they are not given a script. karen: is a 72 hour prescription enough? guest: it' s definitely a start. i know there' s going to be pushed back among prescribers. -- i know there is going to be pushed back among prescribers. right step. karen: as the epidemic widens, tell us about what the center is doing. lines.

we are doing our best to make sure that we are tackling this opiate crisis head-on. we have our upcoming stepping out event. it is our biggest fundraiser of the year. we raise awareness for this issue and other issues that we take care of. karen: and you are only one of two inpatient detox facilities in the state. and you serve individuals from 212 different zip codes. 2 guest: it' s not just dorchester or roxbury. it' s all over the state of massachusetts and other states as well. karen: tell us why your model of care is unique. guest: it' s unique because everything is in-house. an individual who struggles with dependency can come to the detox center and continue their

such as our residential programs so everything stays in house. karen: it' shopping situation. how does that impact patients? guest: it' s great for the receive care. they see the same practitioners. the same specialists. the same counselors. it' themselves back into the community. karen: and there' s consistency. are there enough detox beds in the state? guest: we do need more. we are looking to expand from 30 beds to 40 beds. there is definitely a need for more beds across the state. karen: so many people who want detox services aren' t able to get into programs right away. guest: that'

s correct. it' s a huge crisis. think goodness for governor baker' s bill and what he can do to curb the second this epidemic. karen: tell me about the women' s renewal program. guest: they go from detox to the css. we have 20 beds there. they participate in group counseling. we really focus on not only the opiate pi ece but also the trauma piece. karen: what is one of the key pieces about the women' s renewal program in terms of helping them step away from the opiates?

program is just one step in the recovery process. we have aftercare coordinators who work with our individuals and help them get into other programs, halfway house is. -- halfway house s. karen: what' s the philosophy on narcan or other substitute methods? guest: officially i am unsure actually of their position on narcan. personally as a mental health provider in the state and my own private practice, i believe in narcan. i think it saves lives. so many individuals are overdosing. the numbers tripled in the past year. the need for narcan is

karen: it is not a perfect solution but it is a solution. stepping out of his coming up. it is the big fundraiser. you guys are about to launch a major capital campaign and this is a way to raise unrestricted funds for these ancillary programs. guest: that' s right. unrestricted is the key word. we want to be able to raise over $1 million. last year we raised just under that mark. karen: it' s going to be a nice evening. chaka khan is going to be there. guest: if tom brady wants to show up, i' m ok with that. karen: i' m looking forward to being there, too. i' m going to be the mc for the evening. thank you for being here. guest: thank you.

karen:. forget, the stepping out gala is november 7 at the sheraton boston hotel. chaka khan is the special guest. up next, how african-american breast cancer. mammograms.

karen: just this past week, the american cancer society changed their long-standing tradition on what they continue to be appropriate breast cancer screening. as we enter the tail end of breast cancer awareness month, women are being advised to get mammograms less often and at a later age. janet will has this report.

the american cancer society' s new guidelines for mammogram testing is already meeting resistance. the group is now suggesting annual screenings started age 45 instead of 40 and that screenings after 55 can be done every other year. one cancer survivor called the new guidelines terrible. >> people who have had breast cancer in their families are terrified. >> dr. jim michelson who served on the american cancer society subcommittee that suggested the new numbers insisted they are just minimum recommendations. >> y 45 instead of 40? >> it' recommendation. it' also good at 45. i don' other. we say that both give women benefit. >> but feinstein said these new guidelines are dangerous. >> insurance companies are going to start not covering this. my concern is that people are

going to say, no worries and stop going. and that' s going to be a huge problem. >> there is flexibility in using screening, but we very much feel that we want women to have screening from age 40 if they choose. >> but there may be some wiggle room for insurance companies when they see this >> i hope not. karen: african-american women are yet again at a higher risk than their caucasian female counterparts. a new study finds that genetic differences among lichen wightman -- black and white women make black women more susceptible to fatal tumors. the lead author of the study of the massachusetts general hospital cancer center joins us now to speak more on the study.

it is so important that you are here today. tell us about the study and what the results were. guest: our study found that african-american breast cancers behave more aggressively than their caucasian counterparts. and we think this gives good reason for clinicians and researchers to pay more attention to developing better treatment for the types of cancers that disproportionately affects african american women. karen: can you go into why? guest: we found that breast cancers in african-american women had more markers of aggressive disease. two of those markers are one triple negative breast cancer. breast cancers lack the three most common receptors used by

treatments to kill the cancer. and two, the breast cancers had more mutations in the t 53 gene and it is very important in producing a protein that prevents the growth of cells out of control into cancer. karen: so some of this is genetic. rsa environmental -- or is it environmental? guest: our study just shows that genetics could contribute, but not that it' s the only thing contributing. certainly there could be environmental reasons as well and there is good data showing that. karen: so there is real research about what makes african-american women have a higher prevalence to drive the mutation. guest: that is the next step. i think that kind of rings us to one of the key findings of our

that more african-americans need to be involved in breast cancer research to develop better treatment. karen: let' s go back to janet wu' s package. the new recommendations are that women not have mammograms as often. what is your view on the recent edict from the american cancer association? guest: as a practicing physician, i think that in some ways it' s a good thing. because it brings all the different recommending bodies closer in alignment and agreement. and it is supported by a lot of evidence and research and studies. to patients. and the key part of the recommendation that everyone needs to remember is that this can be tailored to each patient' s preference. and it can still start earlier and insurance companies are still covering. karen: but as an african-american woman, if you

just explained to me at a study had come out that i' m more would feel that i would need to have mammograms more often. guest: it wasn' african-americans are more susceptible. as much as the disease often behaves more aggressively in african-americans. -- if it progressive more aggressively -- if it progresses more aggressively, i would want it caught earlier. guest: so the idea is that patients like african-americans who are at higher risk could still get the more frequent and earlier screening. it is just important to seek high-quality care and talk about this with your doctor. karen: the study that you and your colleagues have put forth is very interesting. what is the next step that you research? guest:

develop treatments that help the affect african-americans. that by finding more of the biological reasons for this -- family history. those things i assume. s really going on. guest: yes. and the most exciting part is that maybe if biology is contributing, treatment could help reduce cancer outcome disparities. if we develop treatments for those cancers that are more aggressive and found more often in african-americans, maybe some of the disparities in the cancer outcomes -- the fact that more african-americans die from breast cancer and that it recovers faster in african-americans can be alleviated a little bit by

some of the key risk factors. that kind of education can help guest: that' s correct. karen: this is all very important information. thank you for coming by to share it with a. guest: thank you. karen: don' t let the seasons open enrollment of health care pass you by. breaking down the basics and the not so basics right after the.

period is right around the corner,

massachusetts comprehensive health care reform law laid the affordable care act and has insured 250,000 commonwealth residents since 2006. if you are interested in enrolling in health care through the health connector, co vicki coates joins us now. they call it managed care yourself. s what i always say. it' s so daunting trying to figure all this out. you are here to give us some advice. we have the enrollment dates correct. and how do you enroll? guest: the best way is to go to our website. there is some information to get started about income, citizenship. it should be pretty

if not, we have a ssistors who can help you in person. karen: and do it early. don' t wait until the last minute. that' s when the lines get long and the website starts to crash. guest: that' s not going to happen this year. we have made a lot of improvements to our website. people can make sure the provider they want is in the plan they choose. they also have the ability to make changes online about their account. karen: what are some of the options for individuals and families? guest: connector care is our primary one. that' s where you are able to get state and federal assistance and it keeps premiums low. we want people to be covered with health insurance. and we have 14 different plans that participate and offer

products through our website so people can pick the one that suits them in terms of coverage, location. there' s a lot of options. karen: what' s the difference between an hmo and a ppo. ? guest: for an hmo you have to pick a primary care provider. a ppo means you have a little more freedom in terms of choosing the various things you want in your deductibles may be a little higher grade . the real thing is to go online. we call it the one front door. verify your eligibility and your income. you could qualify through our connector website or the health connector. there is a variety of assistance options for federal assistance that help people keep premiums low. karen: i' ve heard about the fsa

? guest: they are offered by our carrier. account. that' bit of money away. over. there are all sorts of options partners offer through the health connector. we are the front door that says and someone can pick. they can go to whichever health plan they pick and they get various options. karen: and the health care spending account takes money out of your check pretax? guest: i' m not a next and expert. we offer the ability that if you have questions, they would be

with a representative what choice of plan is best for somebody. karen: that' s another tool in the toolkit. because it offers you additional options enters of paying for your health care and unexpected health expenses. guest: our goal is to really make sure everybody is insured. that they have health insurance. then they can start to go to the doctor, have their children covered, be able to get the care they need, and then depending on what kind of cost or were they may pick a different plan. you may pick one that is more preventive or whatever. try to offer a full suite of products. karen: there are ways to save money based on the plan you choose. -- but that'

guest: it is. n' t. our mission is to help people get access to state and federal subsidies or assistance that they might not have access to unless they come through the connector in order to keep premiums low and affordable for families. karen: what types of average are you doing in communities that have the most uninsured? guest: we are doing a ton of local media if you will. an emphasis on media in cultures. we also have a bunch of navigators. they are organizations already outreach and then we have six walk-in centers. s a lot of information. you just have to look on the website or go to one of the

guest: or you can call. our number is also on the website. i would recommend that everybody start there. of opportunities for people to be helped. we have also added a lot of hours. we starting on november 1. karen: thanks for being here vicki. open enrollment season begins november 1 and continues through january 31 2016. thanks for watching. have a great rest of your day