Opioid crisis worsens, with no end in sight
It was standing room only at the Central Fire Station in Brattleboro on June 20 for a community forum on the opioid crisis.

Opioid crisis worsens, with no end in sight

Panelists agree: County must deal with scourge of opiate addiction within a framework of compassion, restorative justice, and community involvement

BRATTLEBORO — By the time the community forum on opiates was fully started, the room in the Central Fire Station was overflowing - perhaps in violation of fire code laws, as Fire Chief Michael Bucossi wryly noted in his opening remarks.

But what he had to say was serious: When it comes to statistics regarding drug overdoses and deaths, Brattleboro and Windham County face a deep challenge.

In 2018, 110 people died from opiate overdose in Vermont, with 21 of them in Windham County and seven of those in Brattleboro. There were 109 overdose calls for emergency responders in Brattleboro.

Already this year, there have been 73 overdose calls in Brattleboro and two overdose deaths.

“The numbers seem to be rising in every year, and there is no end in sight,” said Bucossi, gesturing to the numbers projected on a slide.

The forum that followed took place against the backdrop of that cold reality, with panelists representing a broad array of community leaders focused on the local and regional opioid crisis.

All 10 panelists presented their respective organizations' work on the challenge along with a brief take on their perspective on the crisis of addiction that faces Brattleboro, as it faces so many small cities and towns across America.

The message through all of the presentations by panelists and the following discussion was simple: Brattleboro and Windham County must deal with the scourge of opiate addiction within a framework of compassion, restorative justice, and community involvement.

Law enforcement takes turn toward reducing harm

One key point made throughout the two-hour forum was the importance of harm reduction.

One such measure: providing access to naloxone, a drug that counteracts the effects of opiate overdoses and is essential in preventing drug overdoses.

Taylor Wellington, the director of emergency services at Brattleboro Memorial Hospital and a co-creator of the event, noted that there are standing orders to local pharmacies to provide naloxone (known as its brand name, Narcan) without a prescription.

Narcan costs $100 a dose if someone does not have a prescription. Wellington said that people can receive the drug free through BMH's emergency department.

Brattleboro Police Lt. Adam Petlock, who is responsible for Project CARE (Community Approach to Recovery and Engagement), said that all police officers now carry Narcan. He emphasized the police department's harm-reduction approach, which includes the option for individuals arrested for minor drug offenses to go into treatment rather than the criminal justice system.

Windham County State's Attorney Tracy Shriver emphasized that Vermont has a “good Samaritan” law in which anyone who seeks help for one's self or another person because of a drug overdose will not be held liable for any criminal violation, even if they are already on probation or parole.

Petlock made clear that the police department's efforts had intensified on drug interdiction.

Such efforts include cutting off the supply of drugs to the local community using a variety of techniques, including directed patrols and confidential informants, “to cut off those victimizing the vulnerable population” of people with substance use disorders.

At the same time, Petlock underscored the reality that a criminal-justice approach can only go so far, and that prevention and harm reduction are essential elements to confronting the challenge of opiate addiction.

“We're not going to arrest our way out of this problem,” said Petlock, emphasizing the importance of “thinking outside the box” in a community policing model.

Shriver echoed Petlock's points, agreeing that jailing addicts is not the way the reduce the opioid epidemic.

“The criminal justice system is strained, bulging at the seams, and a little outdated,” she said. “We need more tools, and jail won't help us.”

A medical problem, not a moral issue

Of the 13 people involved in the forum, five were medical professionals, underscoring the importance of seeing addiction as a medical problem, not a moral one.

There is a big difference between talking about people as “junkies” or “addicts” and talking about them as people with a substance-use disorder, the current medical term.

For medical personnel, another hopeful element is the evidence that medicine-based treatments can be an important element in helping someone trying to kick an opiate habit.

Two such options: methadone, or the combination of buprenorphine and naloxone, also known as Suboxone.

Both Geoffrey P. Kane, M.D., the chief of addiction services at the Brattleboro Retreat, and Mathew Dove, an advanced-practice registered nurse and psychiatric provider for BMH's emergency department, emphasized this point.

“Medication for someone addicted is like putting something on ice to give them traction,” said Kane, as he asked the audience to imagine what the Flat Street area would have been like after the flooding of Tropical Storm Irene if all of the water had frozen and people were stuck on it, unable to move.

Dove echoed that point, noting that one of the first steps for someone who has been saved from an overdose in the hospital's emergency department is to make sure they are treated with medicine as well as with support and counseling.

Moving the needle

Other participants in the forum included Rhianna Kendrick, operations director for Groundworks Collaborative; and Suzie Walker, the executive director of Turning Point of Windham County, which provides direct services for people in recovery from addiction.

After the panelists were done presenting their perspectives, the session was opened to comments and questions from the participants who had flooded the room to overflowing.

Many people took the opportunity to share their own experience with addiction within their families. The question of how ordinary individuals in Brattleboro can help came up several times.

Toward the end, questions arose about the problem of Brattleboro's street life, and the way that panhandling can affect the town, came up.

It was clear that there still are real concerns, and that as Brattleboro addresses the challenge of addiction it also must address the problems that ordinary citizens of Brattleboro face as they live in town and try to cope with people on sidewalks and petty theft in their cars and garages.

Toward the end of the forum, Peter “Fish” Case recalled that he had moderated a similar meeting five years before, and that if anything, the problem had grown far worse since then.

At the same time, he also observed how essential it is that people come together in forums like this one, and how important it is that the community is involved.

“If we continue to show up,” Case said, “we will continue to move the needle.”

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