Rep. Peter Welch met with a group of first responders, public servants, caseworkers, medical professionals and others working on solutions to the opioid epidemic at the Nolin Murray Center in Springfield Monday. The forum was the latest of several to bring together people in Vermont addressing the heroin and prescription drug epidemic.
“What I do isn’t hard,” said Welch, expressing his appreciation for the work of the others in the room. “What you all are doing is hard.
“This incredible challenge of the opioid epidemic is something that can only be addressed on the granular level, one person at a time,” said Welch, adding that he saw his role in Washington D.C. as working to provide support for people on the ground. Although Welch’s “Marshall Plan” – Comprehensive Addiction Resources Emergency Act of 2018 (H.R. 5545)-- to combat the opioid crisis by providing $100 billion in funding over 10 years to states and communities failed to gain Congressional approval in June, three other measures co-sponsored by Welch did succeed.
Lt. Mark Fountain of the Springfield Police Department described the current situation. “Heroin is abundant. The heroin epidemic is creating great strains on our town.”
Fountain said after some success in combatting “bath salts” – a misnomer for unregulated chemical hallucinogens – “We are once again seeing bath salts in our town. We can’t arrest our way out of this. On the enforcement side, we are at every crossroads trying to target the suppliers, to try as best we can to stem the flow.”
Fire Chief Russell Thompson said although the EMTs are saving lives with Narcan, a drug that can stop an overdose in progress, “We see an abundance of people who then choose not to go into the hospital. When we go out and help somebody who is clinically dead, the idea of their signing off and not going to the hospital is ludicrous.”
Thompson said paramedics will administer Narcan, miraculously reviving the user, but then get a call from the same location or the same person a few days or a week later, “and now it’s a dead person.”
James Downe, a drug intelligence officer for New England HIDTA (High Intensity Drug Enforcement Area) said some states have passed legislation to require people in that situation to go to the hospital. “They’ve identified these situations as ones in which an individual is not capable of giving informed consent.”
Thompson added, “Even with treatment, where do they go? Recovery is a lifelong process.”
Support services short
Several of those present said the more times addicts can meet with people who want to help them recover, the better their chances. Director of Workforce Planning and Development Rose Gowdy at Vermont Department of Human Resources said syringe exchange services provide a good opportunity to do this.
“We need more syringe services inside the state,” said Laura Byrne, executive director of the HIV/HCV Resource Center in Lebanon, New Hampshire, “including inside Springfield. Sometimes Brattleboro and Bellows Falls are too far away for somebody who doesn’t have transportation.”
Housing, mental health, employment, and medical care were all identified as necessary parts of the solution. Some people said that there’s no housing available for people moving out of rehab; that not having transportation to clinics and recovery centers is a problem, and still others said that when people hit the moment they’re ready to quit, there aren’t beds available.
“We account for 99 of the 130 beds [for detox] in the state,” said one forum attendee. “It keeps coming back to funding. Sometimes a person can’t get in because their insurance company is mandating they do outpatient treatment services first.
“Listening to the fire chief,” he continued, “if we start overburdening our system with people who aren’t ready to quit, what happens to people who do want it?”
EMT Mike Johnson said, “There’s a difference from our point of view between mental health and substance abuse. By law, we have to take them in for treatment if an individual says they’re going to hurt themselves. We give Narcan, CPR to somebody who’s overdosing, they come back to life, and they walk.”
Johnson said even if 8 of every 10 people mandated to the hospital for overdosing refused drug addiction treatment, “What if only two of those ten stay for treatment? Maybe next time they won’t be dead.”
Joe Sampsell from the Springfield probation office said the drugs prescribed to get people off heroin – suboxone, methadone – as well as Narcan have unintended consequences. Sampsell said drug users feel safe if they have a friend with Narcan to save them from overdosing. “It’s almost like a designated driver.”
Dr. Rick Masara, who works in emergency medicine, said although addiction is understood to be a disease, addicts don’t act like patients with other diseases. “Most people with cancer was to get better. Most people with addiction want to stay addicted, because they’ve found a solution to their problems.
“I’m a medical person, I’m practical,” said Masara. “I think things change if they change. The rate of death is going up.”
Masara criticized the widespread use of both Narcan and suboxone. “If you’re on suboxone and you relapse, you’re more likely to die. One little known fact: people that are not addicted get high from suboxone. It’s worth more on the street than heroin. The state is funding suboxone; the state is funding addiction.”
What needs to be done
Improvements to the treatment system were called for: one man sitting in the audience said discharge planning for people coming out of rehab or the hospital is inadequate. “In my experience they get a list of phone numbers. There ought to be a coordinated entry to for treatment. I’d like to see a connection with anybody who’s getting paid by Medicaid to have a requirement for discharge planning.”
“What we are doing is costing a fortune in government money,” he said. “The money is there, if we can spend it more smartly.”
Christine Chapman, of the Springfield Supportive Housing Program said her agency has not seen a funding increase in eight years, although the cost of housing continues to rise. Chapman asked for more training for her workers.
Welch discussed federal measures that could address the root problems of addiction: poverty and hopelessness. Noting that it’s getting more and more difficult to participate in the economy without internet access, he said, “A lot of rural America is being excluded from the economic vitality of this country. We’ve been seeing this two-tiered economy accelerate. We don’t have an infrastructure bill ... it would be a simple matter for the government to do with the internet what it did with electricity in the 1920s.”
Zach McLaughlin, superintendent of Springfield schools, sounded a warning for the future. Children of substance abusers are not meeting developmental milestones because their families are in chaos: “We’re sending more children to Brattleboro [Retreat] because we need help to help them. Money that would have gone to our core mission, education, is now going to other issues because of this crisis. We’re seeing families destroyed and the impact of trauma on kids.
“They’re not using now,” said someone in the audience, “but it’s coming.”
-- GLYNIS HART