Community leaders at opiate forum learn cooperation key in fight with addiction
MONTPELIER -- A group of Bennington leaders traveled to the State House Monday, along with 11 other delegations from across the state, to begin planning a coordinated effort to attack the addiction crisis in Vermont.
After hearing remarks from Gov. Peter Shumlin and presentations by top state health officials such as Dr. Harry Chen, commissioner of the Vermont Department of Health, the 100 or so gathered for the "Governor's Community Forum on Opiate Addiction" split off into smaller groups to attend panels ranging from law enforcement, school officials, representatives of health and medical centers, and housing experts. Their task at the end was to identify steps to take upon returning to their communities.
Their clearest direction came from Rutland Mayor Chris Louras, whose city, along with Bennington, was singled out in feature articles about opiate addiction in the New York Times. These followed Shumlin's state-of-the-state address at the beginning of the year, in which he made Vermont's opiate problem the central focus.
Rutland, a larger town than Bennington, has taken a number of steps to address addiction and the drug trade.
"You need to, when you go back home at the end of the day today, start your harder work over the next several months," Louras said. "And rest assured you've got to deal with one premise, that you need to have honest conversations. Feelings are going to get hurt, there will be a divergence of opinion."
The problem cannot be looked at from any one angle and be solved. He said it is a community and societal issue, and unless you're willing to accept that you're doomed to failure."
He said many different groups will have to work together within a community.
"Each community is going to have to find their own comprehensive and holistic strategy," Louras said. "We're all a little bit different throughout the state, but you will need to work collaboratively and that's really the takeaway from Rutland's story, frankly."
He said the town has launched an effort called "Viable Initiatives and Solutions Involving Neighborhoods," or VISION, which involves more than 100 groups that meet in Rutland regularly to plan ways of getting into neighborhoods and solving problems.
"When you leave here today with an action plan, you're not done, you are just barely scratching the surface," he said. "It will take months of planning and outreach to disparate groups and partners, and not without some pushback."
What will help, he said, is involvement from academia to study the outcomes of these efforts and provide hard, reliable data on what works and what does not.
"I don't think there's a discussion more central to preserving our quality of life than the one that we're having today," Shumlin said. "We know folks don't want to talk for lots of reasons. Addicts often feel shame, so they won't talk. Family members feel ashamed, so they won't talk. Politicians don't like to talk about it ... because we recognize that we have to change in order to move more people from addiction to a productive life, and when we talk about making change we talk about risks, and we all know people who are elected tend to be risk averse."
Shumlin said he chose to focus on addiction because it was a recurring theme among people who came up to him as he traveled the state -- people saying they had lost their family members to addiction, or their homes and businesses were being stolen from to fuel addictions.
Shumlin said the prevalence of legal, prescribed narcotics such as Oxycontin, has a clear connection to the problems being seen with addiction in Vermont and across the country. He said the Federal Drug Administration approved the drug, "And when we started passing it out with what can only be described as irrational exuberance, a lot of people got addicted."
He said the FDA does not appear to have learned anything since then, and has been approving more powerful narcotics for public use.
"It's not a puzzle how we got into this mess. The FDA sells opiates, heroin in pill form, approves it, we pass it out, it's all 50 states, Vermont is no better or worse than the other 50. The difference is Vermont has a quality of life that binds it together, that holds us together, that defines us, and therefore we feel it more intensely here. We don't have much robbery, we don't have much crime, we don't have people on the streets who will do almost anything to feed a habit."
Chen, of the Vermont Department of Health, said data shows Vermont's problem is no worse than anywhere else in the United States, and in some areas things have improved.
"The percentage of Vermonters who are using prescription painkillers for nonmedical reasons has declined or stayed about the same since 2002-2003," he said.
On the other hand, last year the number of people seeking treatment for opiate addiction surpassed those seeking treatment for alcohol dependence, something Chen, a former emergency room physician, never thought he would see.
Part of the reason may be that those with an opiate addiction seek treatment for it sooner than a person addicted to alcohol. It takes a person with an opiate addiction on average eight years to seek treatment, while a person addicted to alcohol may wait as long as 25 years.
"Research is showing what common sense tells us, that the use of opioid painkillers is related to the use of the opiate heroin," Chen said. "Heroin is now cheaper and easier to get than painkillers. I remember in the emergency department seeing a patient who I didn't want to give opiate painkillers for the tenth time for their tooth, or their back, and them just storming out from the emergency department saying, ‘Well, I'm just going to get some heroin on the street.'"
He said the state has allocated money to set up treatment centers using the "hub and spoke model," the hubs being the centers and the spokes being providers who manage a person's recovery plan.
The model is based on how other chronic diseases such as diabetes and high blood pressure are managed.
On the list of people from Bennington scheduled to attend the forum were Bennington Police Chief Paul Doucette, State's Attorney Erica Marthage, Jennifer Fels of Southwestern Vermont Medical Center, Peg Gregory and Lorna Mattern of United Counseling Service, Patti Komline, Denise Main of the Sunrise Family Resource Center, Brian Maroney, Mary Ellen Mendl or United Way, Kiah Morris of Alliance for Community Transformations, and Melanie Muniz and Joan Walsh of Turning Point Recovery Center.
Contact Keith Whitcomb Jr. at firstname.lastname@example.org or follow him on Twitter @KWhitcombjr.
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