BRATTLEBORO — Kurt White of the Brattleboro Retreat described 2009 as a “watershed year” for the treatment field. That was the year the total number of drug-overdose deaths exceeded fatalities from automobile accidents.
Little did treatment providers such as White know that the crisis would get worse and more people would die.
“I think the opioid crisis has forced me to use every ounce of empathy,” White, the hospital's director of ambulatory services, told the audience attending the Windham County Consortium on Substance Use (COSU) launch event at the Latchis Theatre on Sept. 24.
The consortium assembles the specialized knowledge and experience of 15 state agencies, nonprofits, medical facilities, and other entities on the front lines of addressing the opioid epidemic, creating a consistent and coherent approach to a devastating and deadly public health crisis.
For the past year, COSU members have investigated the opioid crisis in Windham County. They wanted to understand how it could reduce and mend the harm created by misuse of opioids and other substances, as well as create stronger and more connected communities.
According to a press release, COSU formed after receiving a federal planning grant from the Rural Community Opioid Response Program (RCORP), administered by the Health Resources & Services Administration (HRSA).
The collaboration's work will continue under a three-year, $1 million federal HRSA implementation grant which started Sept. 1. According to a press release, the purpose of this grant is to decrease the number of deaths and diseases caused by heroin, fentanyl, and other substance use.
COSU was also awarded a Community Action grant through the Vermont Department of Health, as part of a three-year, $9.5 million Centers for Disease Control and Prevention grant. This grant aims to “increase the state's ability to track and respond to overdoses and overdose fatalities and to further build momentum in communities with high rates of opioid-related overdoses.”
By the numbers
White said a public-health crisis like opiate misuse requires new energy every day.
According to COSU, in Windham County last year:
• 2,361 people were screened for substance-use disorder/opioid-use disorder;
• 72 people overdosed on opioids and survived;
• 21 people died from opioid overdoses.
Windham County is one of the 220 counties in the U.S. identified by the Centers for Disease Control and Prevention as having the potential to experience an increase in hepatitis infection or an HIV outbreak due to drug use by injection.
COSU's success will be measured by the numbers, too.
A handout provided at the launch event explained that COSU will gauge the impact of its action strategy based on the decrease in the county's opioid-related deaths, non-fatal overdoses, and new infections related to injection use.
COSU also plans to track what it considered positive increases - for instance, an increase in the percentage of people “who feel they matter in the community,” White said. “An increase in the number of substance-use and opioid use disorder screenings. An increase in the number of peer-recovery coaches.”
The data might track the number of deaths from opioid misuse, White continued. But they don't tell the whole human story.
Trading discrimination for dignity
For Ella Thorne-Thomsen, a recovery coach at Turning Point, her journey from substance misuse to recovery is a story of isolation and of “feeling like a horrible human being.” She said that everyone needs someone to turn to - someone who will always return love.
For Thorne-Thomsen, while she dealt with her substance misuse, that person was her father. She said she could pick up the phone - “No. Matter. What.” - and he would say, “I love you.”
One of the COSU action steps, explained Thorne-Thomsen, includes trading discrimination for dignity.
“Stigma breeds discrimination,” she said - and it can also cause communities to judge individuals rather than focus on systemic issues that contribute to people developing substance-use disorder.
Stigma can become a “barrier to treatment,” she said.
Deb Witkus of Greater Falls Connections in Bellows Falls said, “Addiction does not happen in a vacuum.”
Addiction happens in families, among neighbors, and in communities fractured by many factors such as economic struggles or trauma.
Quoting journalist Johann Harri in his TED Talk, Witkus said, “The opposite of addiction is not sobriety. The opposite of addiction is connection.”
She said that some of the youth she works with in Bellows Falls are breaking the cycle of substance misuse through making “intentional connections.”
Five areas of action
Project Coordinator Chad Simmons, the launch event's moderator, said that from its year of investigative work, COSU developed an action strategy with five categories:
• Trade discrimination for dignity. The group will plan actions that can reduce the stigma around substance misuse. Examples include trainings and professional development, story-driven community events, and advocacy opportunities for people in recovery.
• Expand harm-reduction and safe-use efforts. COSA will expand syringe services, improve distribution of and training in administering the opioid-overdose antidote naloxone, also known as Narcan. The group will enhance and increase safe-use best practices.
• Creating more connections. For example, increasing satellite locations for treatment and recovery programs, increasing the support models for social service providers, first responders, and schools, and increasing public investment in community spaces such as libraries and granges.
• Increase collaboration across the county. This category includes recovery-ready employment opportunities, improving links among services and care coordination, and creating a drug-treatment court in Windham County, as well as enhancing existing restorative-justice options.
• Improve infrastructure and social determinants of health. This category focuses on improving infrastructure and other ways to address health as well as poverty and mental-health issues to help make access to treatment and other services easier - measures like creating more affordable housing, including options for people in recovery, improving public transportation, and supporting a county-wide economic development plan.
Other speakers at the launch event included Becky Burns, Brattleboro Memorial Hospital; Sue Conley, AIDS Project of Southern Vermont; Suzie Walker, Turning Point of Windham County; Rhianna Kendrick, Groundworks Collaborative; Kate Lamphere, HCRS; and Jedediah Popp, HCRS.
COSU includes 15 members from Health Care & Rehabilitation Services, Inc. (the group's fiscal agent), AIDS Project of Southern Vermont, Brattleboro Memorial Hospital, Brattleboro Retreat, Grace Cottage Hospital, Habit Opco, Southern Vermont Area Health Education Center, Turning Point of Windham County, Turning Point of Springfield, Vermont Department of Health (Brattleboro District Office), Vermont State Police, Windham County Prevention Partnership, and Youth Services, Inc.
The consortium is currently seeking a full-time planning director.