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Vt. opioid forum: good news and bad By GLYNIS HART reporter@eagletimes.com 5 hrs ago 0 Facebook Twitter Email Opioid forum Maryann Morris was one of a large group of health and human services professional who met with Rep. Peter Welch at the Nolin Murray Center in Springfield, Vt. to discuss the opioid crisis. GLYNIS HART Facebook Twitter Email Print Save SPRINGFIELD, Vt. – 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. Police frustrations 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.” Consequences 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.” Vt. Forum Focuses On Opioid Policy By Nora Doyle-Burr Valley News Staff Writer Tuesday, July 10, 2018 Health Care Springfield VT opioid epidemic Peter Welch Nora Doyle-Burr Related stories Officials Credit Reversal Drug With Leveling of Overdose Deaths Springfield, Vt. — Challenges persist as community members work to address the opioid crisis, first responders and service providers said in a forum about the opioid epidemic with U.S. Rep. Peter Welch, D-Vt., on Monday. First responders are frustrated that they often respond to calls for overdoses for the same people several times. Those providing treatment services say their ability to provide services is limited by funding. Law enforcement officials say they know the problem will not be solved through the criminal justice system. The approximately 50 people gathered at the Nolin-Murray Center on Pleasant Street had some ideas of policy changes that might help. Requiring those who just suffered an overdose to take a trip to the hospital, expanding treatment programs to rural parts of the state and improving transportation were among the suggestions. “We see an abundance of people that we go out and help,” Springfield Fire Chief Russ Thompson said. It’s a lost opportunity when people choose not to enter into treatment after they revive from an overdose, he said. Unlike when paramedics respond to someone experiencing a mental health crisis, however, there is no law that requires that people revived from an overdose take a trip to the hospital for further assistance, he said. “I think that we have a huge opportunity when we go and interact with people,” Thompson said. It is hard on first responders for them to revive someone only for them to overdose again, he said. Instead, Thompson said he would rather take the opportunity to give the person who just suffered an overdose information about resources that could help them to recover from their addiction. “I find it futile for these efforts to continue,” he said. But John Caceres, the marketing director of Valley Vista, which offers inpatient treatment, said he worried that requiring people who don’t want to be in treatment to get it could make it harder for those who want treatment to get it. His organization already has a two-week waiting period before patients can get a bed. “In order to get it you have to want it,” he said. Needle exchange programs, which offer clean needles and health information to people who use intravenous drugs, can be a way for service providers to build a relationship with those using the drugs that can lead them into treatment, said Laura Byrne, executive director of the HIV/HCV Resource Center, which operates a needle exchange in Springfield. Byrne said she would like to see needle exchange programs expand around the state. “Transportation is a huge issue,” she said. Similarly, Jennifer Parker Williams, an employment consultant for the Vermont Association of Business Industry and Rehabilitation, said the community needs more medication-assisted treatment programs. It is difficult for the people she is trying to help find employment to get to Brattleboro and back to their workplace in a reasonable amount of time, she said. Some, including Dr. Richard Marasa, director of Springfield Hospital’s Emergency Department, questioned the use of medication-assisted treatment, saying that some patients are distributing suboxone, which is used to curb opioid cravings, to others and then continuing to use heroin or other illicit drugs themselves. Marasa also said that the use of the overdose reversal drug naloxone makes people who are addicted to drugs feel as though they can continue using without fearing for their lives. “What we’re doing now doesn’t work,” he said. Despite Vermont’s hub-and-spoke model, Marasa said people are still dying. The model relies on regional treatment centers, or hubs, and a network of clinicians throughout the state who treat addiction — the spokes. “People that have addictions want to stay addicted if they can,” Marasa said. In that way substance use disorders are different than other diseases such as cancer or heart disease in which patients usually want to get better, he said. Amanda Schoff, who is in recovery and works as an administrative assistant at Turning Point Recovery Center in Springfield, said she has found buprenorphine effective in treating her addiction. Two years into her recovery, she said she has not suffered a relapse. But, she said it’s important for those in recovery to be active in seeking work and attending meetings. “You have to want it,” she said. On the law enforcement front, Windsor County State’s Attorney David Cahill said he aims not to incarcerate people because of their addiction. It can sometimes be difficult to differentiate between those who are using drugs and those who are selling drugs. Oftentimes, he said, people begin selling drugs to support their own habit. He prioritizes cases where people are selling drugs near schools or neighborhoods. Even so, he said, “I’m not going to pretend for a second that we’re eroding the supply problem.” Others at the forum spoke about the importance of prevention in addressing the crisis. Maryann Morris, executive of the Londonderry, Vt.-based prevention organization The Collaborative, noted that Springfield lags behind the rest of the state in the connectedness of youth to their community, according to the Youth Risk Behavior Survey. “Something’s off here and our young people are feeling it and they’re feeing it pretty early on,” she said. Welch said that he hopes to work with his colleagues in Washington to address the difficulties facing rural economies. He said he remembered a time when Springfield boasted several thousand jobs in machine-tool factories. “One of the real challenges we have as a country is reinvesting in rural America,” said Welch. This was the eighth of eight opioid discussions that Welch has held around the state. He faces a primary challenge from Dr. Daniel Freilich, a Brownsville resident who works as a staff physician at the VA Medical Center in White River Junction, next month.
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