3 ODs, 2 deaths: two Ryans lay out their approaches to opiate issues

Details: By Bob Sprague; Category: Selectboard summaries; 02 July 2015; Last Updated: 12 December 2018; Hits: 587

"We [police] have been in a silo."
Police Chief Fred Ryan

'You don't need 90 days' of drugs. District Attorney Marian Ryan

UPDATED, July 2: Addiction is not a simple matter. Nab the dealers, and lock 'em away typifies the "war on drugs" attitude of the Reagan era.

Arlington Chief Fred Ryan, while the town's top law enforcer, tends toward community solutions.

He and Marian Ryan, no relation, the Middlesex District attorney, faced a hard topic with a softer-sell approach to selectmen Monday, June 29. A week earlier, three had overdosed in Arlington, and two of them died -- a male, 27, and a female, 21.

"We can’t arrest our way out of the problem," the chief said. "We [police] have been in a silo -- we need to get out of a silo."

Here are some of the steps the chief and the DA spelled out:

-- Under the new contract for town officers, which began July 1, police carry Narcan (Naloxone) and are trained to use the drug that stems the effects of opiates, including heroin;

-- Clean out your medicine cabinets, because leftover drugs invite trouble;

-- Target dealers for help (see more below); and

-- Address addiction through community outreach: Police and the town's department of Health and Human Services plan to open a drop-in night Tuesdays at Highrock Church, where families struggling with opiates can fund support from expert resources.

Deal with stigma

"We need to set aside the stigma of heroin addiction," the chief said. "If you need help, contact us."

As for dealers, the chief referred to recent arrests of those allegedly linked to heroin sales and added, "We know dealers names .... What are we doing? Nothing."

Such a statement from a police chief often follows with arrest rhetoric.

Chief Ryan had a different response. He said that following a criminal investigation, an officer leading a probe needs to team up with community organizations, such as Wicked Sober, a Boston treatment option operated by Mike Duggan, an Arlington High School grad. Police should then bring in those involved, perform training and dispense Narcan to the family of an addict.

His said his department is working with Suburban Middlesex Drug Task Force on a program called Pathway to Recovery and Safety. A memo to selectmen explaining that is below.

"Yes, we are law-enforcement agency," he said, "but we are also in community policing."

District Attorney Ryan sketched the opiate issue with broad outlines and some telling detail.

Training the prescribers

"When I was in my early 30s," she said, "I didn’t know a lot of people who had major surgery" who were then put on an opiate.

"We know where it begins, and we try to attack the source."

That means training for prescribers to be aware of the dangers of choosing drugs for patients.

In many households, opiates build up in medicine cabinets, and when the home owner is out, his children or friends may rifle through them. The missing medicine may go unnoticed for months.

Solution: Clear out those meds you don't need. Arlington police have a place for you to do that at the Community Safety Building.

Further, she said, the cost of heroin is declining -- $4 to $6 a bag now -- and it is increasingly cut with Fentanyl, a powerful opioid.

As state Rep. Sean Garballey, Democrat of Arlington, listened, the DA said proposed legislation would limit purchases of opiates to 72 hours’ worth.

"You don’t need 90 days," she said.

What the numbers say

The numbers she cited speak for themselves:

In 2013, 80 overdose deaths statewide. That rise to 114 the next year. So far this year, with six months to go, there have been 106.

In response to the discussion, Selectmen Kevin Greeley noted he has three surgeries and plans to go through his own medicine cabinet.

Selectmen Diane Mahon said she is talking the athletics director at Arlington High about educating sport teams about the ins and outs of opiate issues.

Selectman Joseph Curro noted the loss of Right Turn, a treatment program that moved from Broadway Plaza to Watertown in June. "He do we fill the void?" he asked.

The chief said Governor Baker has a strategy that calls for paying for 100 more beds. "Our role is filling those beds," he said.

July 2, 2015: DA provides $10,500 for substrance-free events

Suburban Middlesex County Drug Task Force Pathway to Recovery and Safety (PARS)

The Problem

The heroin epidemic has spared no community, family or law enforcement agency. The wide availability of heroin combined with the ever decreasing cost of the drug has resulted in addiction and death of epic proportions in every community, regardless of socio-economic status. Overdose deaths are the number one cause of injury-related death in the U.S., according to the Centers for Disease Control and Prevention, and deaths from both prescription painkillers and heroin quadrupled between 1999/2000 and 2013.

As law enforcement agencies continue to strive to reduce the availability of the drug on the supply side, we have also forged partnerships with social service agencies and health care providers to work collaboratively on treatment and education initiatives. The widely publicized “Angel” program in Gloucester, Massachusetts is a perfect example of such creative collaborations.
The Suburban Middlesex County Drug Task Force (SMCDTF) covers a diverse 8 community region in Massachusetts, including:

• Arlington
• Belmont
• Lexington
• Lincoln
• Newton
• Waltham
• Watertown
• Weston

These communities include densely populated communities such as Arlington (12th most densely populated community in Massachusetts) as well as more rural suburban communities such as Lincoln and Weston. Further, member communities include very diverse communities such as Waltham with 6% of its population being black or African American and almost 14% Hispanic.
The SMCDTF has had wide success at identifying, investigating and successfully prosecuting persons responsible for dealing heroin in the region and beyond. At the conclusion of such investigations we are often left with a list of known heroin users who have purchased their heroin from the target of the investigation. Historically law enforcement has done nothing with the identity of the known users and the users subsequently move onto other suppliers and in some instances, they become victims of a fatal or near fatal overdose. This practice by law enforcement should be seriously reconsidered and as such, the SMCDTF seeks to implement a program called Pathway to Recovery and Safety (PARS).

The Response

The identified population served (heroin users) will likely need to be persuaded to seek out recovery services. The PARS program will bring together law enforcement, health & human services, mental
Suburban Middlesex County Drug Task Force Pathway to Recovery and Safety health professionals, substance abuse health care professionals, social services, treatment centers, and others to bring resources and support to the users and their families. For example, following the arrest of a dealer the case investigator(s) will turn over the identities of the dealer’s customers to the Arlington Police Department Mental Health Clinician who will act as the PARS coordinator. The PARS Coordinator will then schedule a PARS resource meeting of which each identified heroin user will be encouraged to attend along with a family member.

If the user refuses to participate in the PARS resource meeting that particular case will be referred back to law enforcement for consideration for a criminal complaint(s) for their role in the drug distribution operation and for unlawfully possessing drugs. By doing so, it is highly likely that users will feel persuaded to attend the PARS resource meeting to avoid criminal prosecution.
At the PARS resource meeting drug users and their families will be provided with a wide variety of services and/or resources including, but not limited to, the following:

• Direct access to outpatient recovery programs such as Right Turn, Wicked Sober and others.
• Direct access to inpatient recovery programs such as Lahey Clinic, McLean Hospital and others.
• The presence of and access to mental health professionals.
• The presence of and access to health care providers (Mt. Auburn Hospital).
• On-site training of family members on the proper use of Naloxone.
• Issuance of Naloxone to family members.
• The presence of veterans services personnel.

Measures of Success

Law enforcement, social service providers, and communities can no longer stand by silently as known drug abusers risk their lives daily, cause dysfunction in their homes, and panic in their neighborhoods.

Not all identified drug users will attend the structured PARS resource meeting and of those that do, some will continue to use unlawful controlled substances. However, there is no doubt that some will seize the opportunity of having loved ones, law enforcement, and social service agencies, and the community as a whole investing in their safety and recovery.
All pertinent data will be tracked.
• Raw numbers of persons served by the program without identifying person.
• Number of persons trained in the delivery of Naloxone.
• Number of doses of Naloxone issued.
• Number of persons who enroll in outpatient programming.
• Number of persons admitted to inpatient programs.
• Number of referrals to veterans’ services.