A deeper look at the roots of the opioid crisis needed
Note: This article, written by Michele Farry, originally appeared in a Hampshire Gazette column on May 21, 2018.
Back in early April Hampshire County was feeling a cold lingering spring. In Atlanta, Georgia, however, it was heating up at The National RX Drug Abuse & Heroin Summit and Hampshire HOPE was well represented.
First convened in 2012, this annual summit was created to find solutions to the alarming increases in opioid-related deaths plaguing our nation. It’s become the largest opioid prevention conference in the country, the gold standard for bringing to the fore promising solutions to help communities hardest hit by this crisis. Hampshire HOPE’s goal in sending a team of eight people active in the work of our coalition was to gain information, learn about approaches that are proving effective in other communities and hone skills necessary to develop strategies back home that best fit Hampshire County’s needs.
As a new staff member to Hampshire HOPE, I was excited to join the audience of just over 3,000 people eager to learn more about innovative responses to the opioid crisis as we work to save lives and promote recovery. Our local team also consisted of J. Cherry Sullivan, Hampshire HOPE’s program coordinator, police officers from Northampton, Belchertown and Easthampton who are working on promising post-overdose intervention teams, a representative from Cooley Dickinson Hospital and a recovery coach from Behavioral Health Network based on Springfield.
Throughout the week our group spread out among dozens of workshops and large group sessions led by experts in the fields of public health, grassroots advocacy, law enforcement, harm reduction, prevention, treatment and recovery. Presenters and participants came from all over the country and beyond. In our efforts to try the most effective and up-to-date strategies in our communities, we attended as many of these workshops as we could and then reported the highlights back to each other. Here are just a few:
A program called “Handle with Care,” in which police and other first responders alert schools when an incident occurs involving a child so teachers are aware that a potentially traumatizing event occurred.
A presentation on research into gender differences in substance use and treatment described the obstacles to care and variance in results in women struggling with substance misuse.
A session looking at the real cost of opioids in the workplace, identified ways to incorporate relevant education into substance misuse, prevention and treatments.
Down the road, we plan to incorporate some of the lessons learned in Atlanta into our work here including improving the Northampton Police Department’s post-overdose response DART program, enhancing data reporting, making stronger connections between hospital emergency departments and DART teams, sharing information about gender differences with treatment providers, engaging the business community in our work and grappling with the way illicit fentanyl reshapes our approaches.
The Atlanta Summit always draws influential speakers for keynote talks, including, one year, President Obama.
This year’s roster included former President Bill Clinton; Kellyanne Conway, counselor to President Trump; Tom Price, former U.S. Secretary of Health and Human Services as well as U.S. senators known for their work on this crisis. The conference focuses on improving national and state responses related to the opioid epidemic. U.S. Surgeon General Jerome Adams issued an advisory urging more Americans to carry the opioid overdose reversal antidote naloxone.
It was inspiring for our group to see sessions dominated by our state elected officials, including U.S. Rep. Katherine Clark, D-Melrose; Attorney General Maura Healey and U.S. Sen. Ed Markey, D-Malden, each of whom talked about the pioneering work Massachusetts has done to address this public health crisis. Our local team was pleased to see that our state is ahead of much of the nation in terms of naloxone distribution and integrating other life-saving harm reduction practices into our responses to the opioid crisis.
And yet there’s so much more we must do. The Massachusetts delegation discussed their leadership roles advocating for improved systems of care, better access to medication-assisted treatment and increased funding needs. Markey did not mince words when he noted that there’s a sad reason behind Massachusetts intense work on this crisis.
“Massachusetts is living through a tragic irony. We have some of the lowest rates of all states in the nation for motor vehicle fatalities, gun violence, obesity and infant mortality and we are very proud of our state’s low rankings with these public health issues,” he said. “But when it comes to the opioid crisis, we rank among the states with the highest overdose rates in America.”
Markey took a salt shaker from his pocket and waved it back and forth as he described the biggest threat we face: fentanyl. It is a substance, he noted, that is 50 times more powerful than heroin; Minute amounts of fentanyl are lethal. “Every grain is like a powerful bullet that can kill a human being,” he said. “It is small, it is powerful and it is growing as an epidemic in our country.”
Among opioid-related deaths where toxicology screens were performed in this state last year, Markey noted, 80 percent of those who died tested positive for fentanyl. He noted that at this rate once initial reports are validated, there could be more than 1,700 fentanyl-related opioid deaths last year.
“It is a crisis, it is scourge and a human tragedy that is unfolding every day,” he said. “Of all the forms of inequality, injustice in healthcare is the most shocking and the most inhumane.”
Cherry Sullivan, at the conference for the fourth year, said she’s noticed the Summit evolving to take deeper dives into root causes of addiction, in addition to its focus on prescription drug practices and drug policy. This year, for example, Ann Hazlett, assistant to the Secretary for Rural Development at the United States Department of Agriculture, identified the lack of access to health care, isolation and economic decline as key factors continuing to fuel the crisis.
The solutions must emerge from the communities and be shared widely, and Sullivan said she sees that happening.
“I felt more hopeful this year that some key federal leaders are starting to acknowledge the value of telemedicine, mobile harm reduction units and peer recovery coaches,” Sullivan said. “The conference highlighted that, while we continue to strategize the best ways to save lives in Hampshire County, it’s apparent that we are ahead of the curve with our local response to this major public health issue.”
Michele Farry is assistant program coordinator for Hampshire HOPE, the opioid prevention coalition run out of the city of Northampton’s Health Department. Members of the coalition contribute a monthly column in this space.