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Vt. Forum Focuses On Opioid Policy



Valley News Staff Writer
Tuesday, July 10, 2018

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.

Valley News Staff Writer Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.