OPIOIDS IN OUR MIDST: Understanding precedes enforcement, Town Hall crowd told

UPDATED, Oct. 22: Top law enforcers in town, county and state addressed the sharp rise in opioid use to an estimated 125 people at Town Hall on Tuesday, Oct. 13.

The two-hour conversation toned down enforcement and emphasized less rigid ways to reach out to those haunted by drug use.

A key moment came near the end in a question from the audience: "Can a community forgive?"

Opiate image for forum

Police Chief Fred Ryan, who was moderating in an active way -- not on the stage, but on Town Hall's floor -- turned toward Tom Caccavaro Jr., who rose from his front-row seat. They hugged.

"Of course, we can forgive," Ryan said.

Caccavaro, previously in trouble with local police, was among the addicted who told personal stories at the September vigil at Arlington High

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InsideMedford, Oct. 22: DA hosts opoid forum in Medford

Other moments gave hints of emotion. 

 State Rep. Sean Garballey, Democrat of Arlington-West Medford, who helped bring make the evening possible for the Arlington Youth Health & Safety Coalition, held a moment of silence for families affected by drug use. He referred to a montage shown at the Sept. 1 vigil, showing a montage of death.

"I counted all my friends who lost lives," he said, pausing to remain composure. "We cannot let this list get any longer .... that’s why we're here tonight."

 Duggan lost friends

Later, Mike Duggan, an Arlington High grad who founded the treatment program Wicked Sober, and who has been sober since 2009, said he grew up with some of the same friends as Garballey who had lost their lives. With a hitch in his voice, he said, "This is personal to me."

The public impact of the evening was clear as state Attorney General Maura Healey provided the keynote speech for "The Opioid Crisis: Identifying Community Solutions in Arlington," followed by comments from Middlesex district attorney Marian Ryan, Rebecca Wolfe, Arlington Police Department clinical responder, and Dr. Alex Walley of the Boston Public Health Commission's Opioid Treatment Program.

"What we need is a conversation," Healey said, noting Massachusetts is losing four to five people a day to opioids.

Such numbers don't tell what’s happening in courts or in jails, how the scourge causes families to take time off work, to find bank accounts emptied from drug use, she said.

Anecdotes don't "begin to tell the story," a phrase she repeated numerous times.

Role of painkillers

How did get here? In part, she goes back to 1999, when rules changed for pharmaceutical companies, allowing marketing of painkillers as nonaddictive.

That has led to a significant rise in addiction deaths, which cut across all races. Add to that relatively cheap heroin -- at $2 to $5 a bag -- increasingly cut with Fentanyl, which is 50 to 100 times more powerful.

To make progress, she said, requires education that is preventive. Talk to young people about pills, she said; talks to health-care providers, prescribers

Teach consumers what they need to do to get off painkillers, she said: Push back, ask questions.

Healey called the Arlington Outreach Initiative "such a great program -- exactly where things should be."

Unveiled in July by Chief Ryan, the program aims to get police officers to get directly involved in the demand side of opiate issues by working with a public health clinician to conduct direct outreach to the known addict community and their families, friends and caregivers.

That clinician is Wolfe, a Town Hall panelist. Since July 1, The Globe reports, she has contacted 52 Arlington residents, 18 of whom agreed to be trained in the use of the overdose-reversing drug Narcan. Five others were involuntarily committed to treatment and eight agreed to enter detox.

Narcan demo only the beginning

"We didn’t see this coming," Wolfe said.

She recalled that in May 2014, police held a Narcan demonstration at the Senior Center. following four heroin deaths in town in six months.

She wondered at the time, "Is the crisis over?" It was just building.

In her role since July, she said, she tries to keep people out of jail and emergency wards.

"Did Rebecca say we're breaking law?" Ryan asked, joking, to hearty applause.
Wolfe didn't miss a beat: "People can always call me ... I know all of the officers ... We’re very proactive."

As Ryan moderated, he said that as panelists were commenting that night, pulled out his cellphone and learned that a young man have overdosed. "It looks like another save," he said.

Coaching parents

Later, Ryan offered an anecdote about police "coaching parents" to keep an OD victim alive over the weekend. "Imagine, your police chief involved in that?"

The rhetorical question suggested a theme of the evening -- police that reach out and don't just arrest.

"Our arrests have gone down in Arlington," Ryan said, and that’s a good thing. "We're not arresting those we shouldn't have been."

Middlesex District Attorney Ryan, who appeared with this chief last summer to brief selectmen, is in concert with the approach.

As a prosecutor with 30 years' experience, she recalls the decline in drunken-driver cases and surge in opioids. "The problem will be with us for foreseeable future .... We need to think about recovery and treatment."

And the kind of treatment, including treating those who have overdosed with respect in emergency wards.

Walley, of Boston Public Health Commission, recalled the "grim times" brought by AIDS in the 1980s. "As a country, we came together and fought this," he said, adding we need to do the same with opioids.

He cited documenting more than 5,200 overdose rescues. The number drew strong applause.

Among those in the audience were Juliana Rice, former town counsel who works in Healey's office, as well as Selectmen Joseph Curro Jr. and Steve Byrne and Town Manager Adam Chapdelaine.

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Globe, Oct. 18, 2015: DCF fails to track abuse, opioids

Globe, Oct. 15, 2015: Baker seeks to limit opioid prescriptions

Sept. 1, 2015: First memorial vigil views addiction from those who suffer

Aug. 4, 2015: Police release action plan on addiction

July 10, 2015: Town police begin reaching out to addicts

This report was published Wednesday, Oct. 14, 2015, and updated Oct. 22, to add two links.