Yes, human trafficking right here in Connecticut.

Those entities include agencies such as the Department of Children and Families, which you might imagine would work against trafficking, as well as groups such as the Motor Transport Association of Connecticut and the Connecticut Lodging Association. Truck drivers and motel workers see trafficking firsthand, and they need training to recognize it and act appropriately.

The National Human Trafficking Resource Center, an anti-trafficking hotline, has received some 730 calls since 2007 that referenced Connecticut. Recent numbers from DCF show that last year the state received the highest number of referrals—133—since Connecticut began focusing on human trafficking in 2008, and it looks like the numbers are increasing. In the first quarter of this year, the state received 53 referrals.

The majority of reported cases in the state are for sex trafficking, though that may be misleading. Researchers say the number of people forced into labor trafficking is probably higher, but those people are more difficult to count, said Jillian Gilchrest, chair of the state’s Trafficking in Persons Council.

iStock Photo.

Getting a conviction for trafficking has been difficult in CT.

Top venues for sex trafficking include commercial-front brothels and escort services. Large sporting events such as the Olympics and the Super Bowl tend to be venues for sex trafficking as well. Top venues for labor trafficking include health and beauty services, such as nail salons, and agriculture.

In Connecticut, trafficking includes compelling a person to engage in sexual contact or work or services. That can involve force, or threats, fraud, or coercion. If someone is younger than 18 and involved in commercial sexual exploitation then force, threat, fraud or coercion need not be present, the law states. The majority of victims are women and children, though DCF says the number of boys and men involved is “vastly” underreported.

Connecticut passed a law in 2006 that requires training programs about human trafficking for local police departments and prosecutors. Legislation passed in May—which goes into effect in October—expands required training for people such as hotel and motel staff to recognize trafficking. Hotels, motels, and rest stops now must post information on trafficking as well as a hotline number.

Other states are following suit. A bill is winding its way through the Massachusetts House of Representatives that strengthens that state’s anti-trafficking laws. Gilchrest said Connecticut is the first state to legislatively address the role of motels and hotels in human trafficking.

But there’s still work to do. Getting a conviction is difficult. There have been just two convictions of a trafficker in the state, ever, and a March forum sponsored by DCF in Hartford explored why. Formerly the law required more than one occurrence of sexual contact before there could be a conviction; Gilchrest said the law was changed in May and should help the state pursue more convictions. As Gilchrest said, in the last 10 years in the state, 1,847 people—most of whom are women and many of whom aged out of the DCF system—were convicted of prostitution. Meanwhile, just 267 men were convicted for buying sex from them.

Before Gilchrest started working as Connecticut Coalition Against Domestic Violence director of health professional outreach, she worked on human trafficking issues for the former Permanent Commission on the Status of Women. When that commission was folded into the larger Commission on Women, Children and Seniors, one of the first conversations revolved around continuing the anti-trafficking work.

“One of the first things we thought about in our reorganization was how to ensure there was a level of continuity with the experts we have, but also with the work we were doing,” said Steven Hernández, the new commission’s executive director. So Gilchrest has continued in her role working against trafficking in people, and trying to figure out some key questions.

“Why are men buying sex with women and children?” Gilchrest said. “Why do we, as a society, still accept and tolerate that men buy sex with women and children?”

Susan Campbell is a distinguished lecturer at the University of New Haven. She can be reached at slcampbell417@gmail.com.

Researchers from Vanderbilt University who analyzed states’ prescription drug monitoring programs – central databases that log controlled substances dispensed to patients — found that programs that were “updated with greater frequency” and that reported data for a broad range of drugs were associated with greater declines in opioid-related deaths.

The study in the journal Health Affairs comes as Connecticut prepares to put a policy in place requiring that pharmacies report controlled substance (Schedule II to V) prescriptions “immediately,” or at least within 24 hours after they are dispensed, into the central database, known as the Connecticut Prescription Monitoring and Reporting System (CPMRS).

iStock Photo.

In CT, 729 drug overdoses were reported in 2015.

The CPMRS, maintained by the Department of Consumer Protection, can be accessed by doctors and pharmacists to give them a complete picture of a patient’s medication use, including prescriptions by other providers. It also can be used by law enforcement officials to investigate physician prescribing.

Under current law, pharmacies have been required to report to the CPMRS at least weekly, meaning there is often a one-week lag between a prescription being filled and reporting. The change, which takes effect July 1, was among a package of opioid-related reforms proposed by Gov. Dannel P. Malloy and approved by the legislature this year.

Susan Campion, president of the Connecticut Association of Addiction Professionals, called the change “a good step.” But she said she worries that the fiscally strapped state lacks the resources to ensure that irregularities in prescribing will be followed up by enforcement action. She had more praise for other reforms, including one that encourages providers to call in addiction specialists for consultation on opioid prescribing.

The Health Affairs study shows that every state except Missouri now has a monitoring program in place to detect high-risk prescribing. The researchers found that implementation of such programs was associated with a decrease of 1.12 opioid-related overdose deaths per 100,000 population annually, and that states with more “robust” programs had greater reductions in deaths.

The authors estimated that if Missouri implemented a monitoring program, and other states enhanced existing programs with more robust features, there would be at least 600 fewer overdose deaths nationwide in 2016.

A recent report by the National Alliance for Model State Drug Laws shows that Connecticut will become one of 26 states that require daily reporting of prescriptions. Connecticut’s program lacks some of the features of other states’ programs, however, such as provisions that specifically allow the data to be shared with prosecutors and other judicial officials or with Medicaid and Medicare officials, or that require annual reports to the legislature on the program’s effectiveness, according to the report.

Also, Connecticut’s program is one of only two in the country housed in the consumer protection department; most are overseen by state health departments, which license and discipline doctors.

Connecticut, like other states, has seen a spike in drug overdose deaths in recent years – from 357 deaths in 2012, to 729 in 2015, many from heroin, fentanyl and other opioid medications. The Office of the Chief State Medical Examiner projects that accidental overdose deaths could surpass 830 this year.

In addition to the change in the reporting requirement, reforms effective in July include a provision that limits initial prescriptions for opioids to a seven-day supply in most cases.

Campion called the package of reforms a “strong start,” but added that some doctors already were “pushing back” because of the new restrictions and were dropping some patients who genuinely need pain relief.

“There have been too many prescriptions floating around,” she said. “Now, we’re seeing the opposite in some cases– doctors who are saying, ‘I don’t want to take the risk. I don’t want to get caught up in this morass.’”

She said providers “need to set uniform standards of practice for prescribing opioids” that are cautious, reasonable and compassionate. Unlike many other states, Connecticut has not adopted opioid prescribing guidelines and does not have specific laws regulating pain clinics or pain management.

Last year, the state enacted requirements that health care providers check a patient’s history in the database before prescribing more than a 72-hour supply of any controlled substance, and that a prescriber who dispenses the drugs for “continuous or prolonged treatment” review the patient’s records at least every 90 days.

The Vanderbilt study shows Connecticut’s rate of opioid-related deaths was in the range of 4.7-6.9 per 100,000 population in 2013 – 20^th highest in the country.

This week, the National Institutes of Health released a study showing that rates of nonmedical prescription opioid use and opioid use disorder more than doubled in the decade from 2002 to 2013.

Nearly 10 million U.S. adults, or 4.1 percent of the population, used opioid medications in 2012-13 without a prescription or in excess of the prescribed amount or length of time — up from 1.8 percent of the adult population in 2001-02.