Stemming the tide of the opioid crisis in Northampton

  • A chart showing the number of nonfatal opioid overdoses between 2011 and 2015. Courtesy of the 2017 Massachusetts Department of Health Chapter 55 Overdose Report. — Massachusetts Department of Public Health

  • A chart showing fatal opioid-related overdoses from 2000 to 2015. Courtesy of the 2016 Massachusetts Department of Health Chapter 55 Overdose Report. — Massachusetts Department of Public Health

  • A sign at Tapestry Health needle exchange center in Northampton reads “Do you need Narcan today? It’s free and could save someone’s life.” — M.J. TIDWELL

  • Naloxone, brand name Narcan, a nasal spray that can reverse an opioid overdose, along with administration instructions in Spanish at Tapestry Health needle exchange center in Northampton. — M.J. TIDWELL

  • A display at the Tapestry Health needle exchange program in Northampton shows the number of fatal overdose deaths from heroin in the U.S. from 2001 to 2012. — M.J. TIDWELL

  • A board at the Tapestry Health needle exchange center in Northampton where active drug users write notes and warnings of fentanyl and overdoses for different bags of heroin. — M.J. TIDWELL

  • Materials provided at a public forum discussion “The Opioid Crisis: What Works?” at Baystate Medical Center in Springfield. —M.J. Tidwell

  • A sign outside the Tapestry Health needle exchange center in Northampton reads “Bring your I.D. for age verification.” People must be 18 to possess syringes legally in Massachusetts. —M.J. TIDWELL

  • Cherry Sullivan, the program coordinator at Hampshire HOPE, works with intern Michele Farry on creating a data base to track information when police respond to a overdose. —GAZETTE STAFF/CAROL LOLLIS

  • Cherry Sullivan, the program coordinator at Hampshire HOPE, works on creating a data base to track information when police respond to a overdose. —GAZETTE STAFF/CAROL LOLLIS

  • A billboard on Route 5 on the way to Easthampton warns that “Prescription opioids can be addictive and dangerous.” GAZETTE STAFF/CAROL LOLLIS

  • GAZETTE STAFF/CAROL LOLLIS

  • Dawn Haynes leaves the Interfaith Cot shelter in Northampton which was going to close for an hour but because of the cold weather decided not to. —GAZETTE STAFF/CAROL LOLLIS

  • A bill board on route 5 on the way to Easthampton. —GAZETTE STAFF/CAROL LOLLIS

For the Gazette
Published: 1/3/2018 10:09:59 PM

Editor’s note: This is Part 4 of a four-part series. This story focuses on the steps one community is taking to address the opioid crisis.

NORTHAMPTON — Tucked upstairs in a building just off Northampton’s Main Street, Liz Whynott sits in a tidy office lit by a cold November morning. A soft buzzer rings when the front door opens.

Each person who enters is warmly welcomed to the Tapestry Health needle exchange center, an orderly space with bins of medical supplies, syringes and red biohazard waste cans where counseling and clean needles are offered with no moral judgments.

Just down nearby Center Street, Northampton Police Chief Jody Kasper shakes the hand of a man who recently lost his son to an overdose. She waves goodbye and then walks to her office, where she lets out a long sigh.

“Is it working?” she says quietly when asked about the opioid prevention efforts by her department. “It really depends how you define ‘working.’ There’s some good news out of all the efforts being put in, but we still have this massive epidemic.”

From the police headquarters it is a short walk across Main and Pleasant streets to the Northwestern district attorney’s office, where Cherry Sullivan and Lynn Ferro study a spread of charts and reports.

Sullivan is director of Hampshire HOPE, a regional opioid prevention coalition. Ferro, director for Opioid Research and Recovery Support Services in the DA’s office, coordinates efforts by officials and lawmakers looking for ways to fight the epidemic.

Whynott and Kasper, Sullivan and Ferro are soldiers fighting to blunt the region’s opioid epidemic, which has made the wave of death and addiction all too commonplace.

“This epidemic is so big…” Sullivan says.

“...and all encompassing,” adds Ferro.

“We’re chipping away.”

Northampton’s fight

In Northampton, a team of dedicated women are taking the lead on finding solutions for the opioid problem.

Whynott at Tapestry Health works to help those struggling with addiction to develop solutions, while trying to keep them as safe as possible.

Chief Kasper and Sullivan of Hampshire HOPE look for ways to reduce the dangerous stigma of addiction through programs such as Northampton’s Drug Addiction Response Team and implementing health curriculums to educate students around Hampshire County.

Ferro coordinates the efforts of the DA’s office, lawmakers and constituents to create legislation and programs like MassPAT, the prescription drug monitoring database that provides the detailed information needed to deal with overprescribing clinicians and doctor-shopping patients.

The combined effort has seen recent signs of hope. The 2017 annual Chapter 55 Report, a federally required assessment of opioid overdoses in each state, found that overdose deaths have decreased by 10 percent statewide compared to the same nine months in 2016.

There were over 2,000 confirmed opioid overdoses in Massachusetts in 2016. As of September 2017, there were 1,470, according to the DPH report. And in Hampshire County, Ferro says fatal overdoses are down 44 percent through the first nine months of 2017.

However, Sullivan, Ferro, Kasper and Whynott all caution that fewer fatal overdoses doesn’t necessarily mean less drug use or fewer total overdoses. The data, while a good marker, don’t capture the entire scope of the problem.

The Chapter 55 Report found that nonfatal overdoses in Massachusetts increased by about 200 percent between 2011 and 2015.

But on the whole, the experts say there’s less stigma and more access to treatment. Work is moving ahead to close gaps in the system, such as support for users after treatment, and there’s a new sense of collaboration, one that includes listening to users themselves.

Here is a check-in on some of the various programs and initiatives currently fighting the opioid problem in the Northampton area.

Personal connection

In addition to the needle exchange program, Tapestry provides services such as testing for sexually transmitted infections, providing access to birth control and educating current drug users on overdose prevention and naloxone training — all given without judgment.

“On the first visit, we sit down, talk about the program, and do an assessment of what they are using and their individual risk factors,” Whynott says. “But it’s OK if people don’t want to tell us anything.”

Whynott’s work at Tapestry is part of a new focus on “harm reduction,” the idea that because drugs are here, right now, those using drugs need help to be safe in unsafe situations.

Harm reduction includes training those who use drugs in the use of naloxone, the drug also known as Narcan, which can reverse opioid overdoses, referrals for treatment and clean needle exchanges to lower the risk of HIV and other diseases transmitted by unclean syringes.

“There are people who aren’t ready for treatment and there are an incredible amount of barriers to treatment, so sometimes harm reduction is necessary and important,” Whynott says. “We have to meet them where they are at, not where we want them to be at.”

Less jail, more help

When Kasper joined the Northampton police force in the 1990s, attitudes toward those addicted to drugs were one dimensional.

“We arrested people for using, and threw them in jail,” she says.

Now, as Northampton’s first woman police chief, Kasper sees herself on the other side of that hard line.

“Arresting people, as I’ve been doing for 20 years, it doesn’t work,” Kasper says. “That’s the lesson we’ve learned.”

Although Kasper acknowledges that arresting users and dealers will always be part of her job, she thinks law enforcement needs to get at the roots of the crisis.

What caused a person’s addiction? Overprescription for a sports injury or a wisdom tooth extraction? Should there be a greater attempt to educate doctors, families and schools about the dangers of prescription medication? What can law enforcement do to keep prescription drugs off the street?

She sees solutions that take time, such as prevention, rehabilitation and social support and developing a better relationship between law enforcement and the community her officers are trying to help.

Sullivan of Hampshire HOPE says she has seen a shift in perspective from her time working with law enforcement and in what she hears from others.

“When I listen to people who are in recovery talk about law enforcement, I do see them acknowledge the fear and the bad experiences they’ve had in the past, along with the recognition that police officers and first responders are changing and are responding differently to this crisis,” she says.

One of those changes happened in 2016, when the department created the Drug Addiction Response Team, or DART, composed of four officers (Justin Hooten, Adam Van Buskirk, Monica Czerwinski, and Brad Buzzee) who trained with Hampshire HOPE, Urgent Care, and Tapestry Health to provide information on local resources for people struggling with addiction.

The team responds to overdose calls and other drug related issues, establishing relationships with people known to be at risk and working to connect them with treatment.

“I’ve definitely had people come up to me on the street and say, ‘I know Officer Van Buskirk or Officer Hooten or Buzzy and I’m grateful to have them and I trust them,’” Kasper says. “I do think there’s more trust.”

Although she sees progress in working with those caught up by the system, Kasper talks about the need for better follow through with those who have gone through treatment, rehabilitation or incarceration.

For this, Ferro at the DA’s office is hopeful about the new use of “recovery coaches,” usually people with their own addiction history who work with others to seek treatment, reduce the number of drugs they use and discuss ways of being safer such as carrying Narcan and testing drugs for fentanyl.

The Northampton Recovery Center is working to connect recovery coaches with probation workers, the police department and the DA’s office drug diversion program.

Ferro sees this one-to-one connection as essential to aiding those with drug problems find help and stay safe.

“Down the road, I hope that will have a significant effect in preventing relapse,” she says.

Methods more than meds

Ferro and Sullivan of Hampshire HOPE say they’ve also seen a shift in the community as a whole to focusing on educating and preventing people from misusing or abusing prescription drugs to begin with, before it ever reaches addiction.

Ferro points to the Massachusetts Prescription Monitoring Program, which requires doctors and dentists to register new opioid and benzodiazepine prescriptions, providing more information to monitor who is getting prescriptions and where they are getting them.

She also says new informed consent programs are making a difference.

One example is Amherst’s Valley Medical Group, a private practice that asks patients who use opioids for an extended period of time to read and sign a contract detailing the risks of opioids, sedatives, tranquilizers or benzodiazepines.

“I have been told that this agreement is needed because controlled substances can be risky and even fatal, unless I use them only as my PCP had ordered. I know that if I do not comply with this agreement, my PCP may end my controlled substances therapy for my own well-being,” the contract reads.

For young people, Ferro and Sullivan said there is a new emphasis on teaching emotional resilience and coping to students so they never have to reach for a drug to deal with emotional pain in the first place.

A national program called Life Skills implemented in a number of Hampshire County schools focuses on teaching kids to build self esteem, deal with difficult relationships and manage their emotions in a healthy way.

“If you don’t have resilience and you don’t have coping ability, that’s it, what are you gonna do?” Ferro said. “You need comfort, right now. And that’s going to be alcohol or drugs or smoking… whatever addiction you choose.”

While Sullivan said she is glad to see this shift, she said it’s important to remember that children live in more than just their health classrooms. The community as a whole, she said, needs to promote healthy living skills and consider the kind of places children and young adults grow up in.

There’s a new group in the community joining in efforts to illustrate the dangers of opioid addiction: families who share their own tragedies in an effort to peel away one more layer of stigma.

Those who have lost loved ones, like the family of Danny Werbiskis, 26, of Easthampton, are starting to tell their stories in hopes of helping others struggling with addiction.

His August obituary read, “Addiction does not discriminate, it doesn’t care how you look, how hard you work, how much you are loved or how hard you fight. Danny fought hard, but sadly after a 17-day hospitalization due to a drug overdose, he passed away with his parents by his side on July 31, 2017.”

It is with these personal stories in mind that people like Sullivan, Ferro, Whynott and Kasper continue to do what they can to stem the tide of opioids.

“It’s overwhelming but I still feel more hopeful,” Kasper says, “We have to believe that efforts we make are going to have a positive impact or else why bother making them, right?”

M.J. Tidwell writes for the Gazette from the Boston University Statehouse Program. Her entire four-part series on benzodiazepines and the opioid crisis can be found online at itsnotjustanopioidcrisis.wordpress.com


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