Forum to focus on opioids, treatment

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BRATTLEBORO — Hope is the message of a public forum on the opioid epidemic, scheduled for Thursday night from 6 to 8 p.m. at the Brattleboro Fire Department.

The forum is being hosted by the BFD and Brattleboro Memorial Hospital and will feature panelists from the hospital, Project Care, Turning Point, Groundworks, the Brattleboro Retreat and the New England High Intensity Drug Trafficking Area program.

In 2018, 24 residents of Windham County died of opioid overdoses, seven of them in Brattleboro. In 2019, seven people have died through April in the county, two of those deaths in Brattleboro.

"For us to be leading in overdose deaths and overdoses in general is not something to be bragging about," said Taylor Wellington, BMH's director of emergency services.

"Despite all of our efforts, Windham County, had the highest number of opioid-related fatalities of any of Vermont's 14 counties," said Michael Bucossi, chief of the Brattleboro Fire Department. He noted there were three deaths in town in 2016 and 13 in 2017.

"We are aware that Windham County is suffering," said Christina Nolan, the U.S. Attorney for the state of Vermont. "The whole state is suffering, but Windham County has had the most deaths. We need to funnel more resources your way."

In 2018, emergency personnel in Brattleboro responded to 109 overdose calls and so far in 2019, that number has increased, with 66 responses. There have been 37 opioid-related fatalities in the whole state through April of this year. Last year, 110 Vermonters died from opioid overdoses.

Nolan said one way her office can address the issue is to increase law enforcement activity in southern Vermont, but she, like others in the state, knows that Vermont can't arrest its way out of the opioid crisis.

"Our office will enforce the law," she said. "It's an important component. But we want to be part of the prevention efforts as well. Our message is law enforcement is on your side. We stand in solidarity with the prevention, recovery and treatment communities. We want to be part of that work."

Her office, working with Jeremy Leibovitch and Graham Raubvogel, both of Prom Creative, created a public service announcement and documentary, "Face of Recovery," which is screening around the state.

"This drug prevention initiative is an outreach project that carries a message of hope in the midst of the drug crisis," states the press release announcing the release of the film, which can be found at youtube.com/watch?v=l5Q3ojD1fic.

The forum on Thursday is one way local providers are attempting to limit the damage in Windham County.

"Last month we hosted an educational training for first responders," said Bucossi. "We thought bringing the citizens of the community into the discussion would help people to understand how big the problem is and what the community is doing about it."

Folks who attend Thursday night's forum will learn how opioids affect the brain, why some people are more susceptible to addiction than others and what resources are available in the community for those in recovery.

"Not everyone is going to use heroin, drink alcohol or smoke a cigarette and become addicted," said Wellington. "It's part of the makeup of the brain. It's a relapsing chronic brain disease. It's not always about choices. It's about DNA and genetics as well."

Wellington said the opioid crisis won't be solved by one person or one organization. It will take family, friends and neighbors as well as community organizations who are dedicated to helping people kick the habit.

"I hear from patients all the time that they wish there were more treatment options," said Wellington.

And while Vermont has increased its capacity to treat people seeking recovery, availability fluctuates from county to county depending on demand.

"There are more beds in Burlington than in Brattleboro," said Wellington.

She also noted that recovery options can be limited because most insurance companies won't pay for treatment.

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"You have to have a co-occurring issue," said Wellington. "So you have to be suicidal and using substances or have some sort of mental disorder. The medical community recognizes addiction as a chronic relapsing brain disease, but until we can convince the insurance companies, we are going to continue to have this issue."

Vermont implemented a hub and spoke system of care of opioid addiction in 2014, which focuses on medication-assisted treatment with methadone or buprenorphine at one of the state's six regional treatment centers, called hubs, and with buprenorphine in physician offices, called spokes. "This approach has been shown to be the most effective treatment for people with opioid use disorders," states the Vermont Department of Health. "People who are addicted to opioids suffer painful withdrawal when they stop using, and powerful cravings even after withdrawal has ended."

The hub and spoke system has led to dramatic drops in addiction and overdoses. According to a 2017 study conducted by John R. Brooklyn and Stacey C. Sigmon, "Vermont now has the highest capacity for treating (opioid use disorders) in the United States, with 13.8 patients potentially treated per 1,000 people and currently are at 10.56 per 1,000."

The state of Vermont pays for hub and spoke services via Medicaid. The hub programs bill a monthly bundled rate, and the Vermont Blueprint for Health distributes funds to support spoke staffing through its existing Community Health Team payment infrastructure.

While there are resources available, not everyone knows what they are and how to access them, said Bucossi.

"The forum on Thursday will give people the chance to ask questions about what this epidemic is doing to the community, but will also give us a chance to provide them with information," he said. "If someone has an issue with a loved one or friend, or even themselves, we can help them find help."

Wellington said she understands how people feel helpless during this crisis, but the community needs to show compassion for one simple reason: "This person is someone's mother, sister or brother. Someone who holds value for someone else. If this was your loved one, you would want them to be treated. People don't wake up one day and say I'm going to try heroin today. There's a trauma involved, a reason people went searching for opioids as a coping mechanism."

Bucossi said it can be taxing on emergency responders to care for the same people over and over again.

"We are going out every day on overdose calls. These people are very near death if not dead when we get there and we bring them back to life, if we're lucky," he said. "And then we're handing them over to the emergency department, the nurses and doctors, who are doing the same stuff trying to bring this person back to life and offer them services, trying to convince these folks to get into some sort of treatment program."

Wellington urges the community not to throw up its arms in the face of the crisis.

"It's not our job to choose who lives or dies," she said. "It's our job to show up when they come asking for help."

Bucossi said while the public might think opioid addiction is exclusive to one segment of society, emergency responders know different.

"This affects people in all walks of life, from business people, to blue-collar workers to the homeless," he said.

"There's not one person you can point at and say that person is using heroin," agreed Wellington. "It's not that simple."

Bucossi and Wellington said it will take a sustained effort by individuals, care providers, law enforcement and community organizations to reduce, and hopefully eliminate, the effects of the opioid epidemic.

"It's going to be a long haul," said Bucossi.

"As with any health issue, you have to keep trying until that person is ready to meet what you're asking of them," said Wellington. "Not everybody is going to be able to say 'I will stop using because you ask me to.'"

But Wellington said there is hope, as the folks at Turning Point can attest to.

"They are a living example that there can be success. This can be overcome," she said. "They are able to show it's worth it. You don't have to succumb to that level of desperation. You don't have to use to forget. Society is more than happy to welcome you back."

There are a number of resources available to people struggling with addiction. They include: the Brattleboro Retreat at 802-257-7785; Habit OpCo at 802-349-1880; Health Care & Rehabilitation Services at 802-463-3947; Rise in Brattleboro at 844-388-6249 and Bellows Falls at 844-396-5068; Starting Now at 802-258-3700; and Turning Point at 802-257-5600.


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