Thursday May 18, 2017
South Burlington Police Department’s school resource officer, Cpl. Jeff Favreau spearheaded a community forum on heroin and heroin addiction on Thursday, May 11 at F.H. Tuttle Middle School.
Over the past few years, Favreau has been teaching seventh graders D.A.R.E. (Drug Abuse Resistance Education) lessons around heroin, a type of opiate and one of the state’s most crippling offenders.
Due to student response to the topic and with growing concerns in the city, Favreau decided it was time to bring the conversation to the general public.
The first half of the community forum served as a basic lesson on opiates and the current epidemic, the second half was a question-and-answer format with a panel of professionals.
Heroin has been identified as having the largest impact on South Burlington compared to other opiates, Favreau said.
According to the National Institute on Drug Abuse, heroin deaths have increased six times from 2002 to 2015. As of April 29, there have already been 143 identified non-fatal overdoses and 24 deaths in Vermont this year. This doesn’t count unreported overdoses that have responded to a widely available drug Narcon, which reverses an overdose.
The upward trend started around 2010, when OxyContin, the most commonly prescribed opiate painkiller at the time, was reformulated. The new pills became more difficult to crush and dissolved slower, making them harder to abuse. Unfortunately, this development had unintended consequences: those already addicted to OxyContin ended up turning to heroin to meet their needs, Favreau explained.
At $15 a bag (about 31.5 milligrams on average) or $100 for a bundle (about 10 bags), heroin adds up to be a costly-addiction, often resulting in the need to generate money at whatever the cost, including, but not limited to, stealing from family members or committing retail theft.
SBPD averaged almost 800 calls for service per year from 2013-2016 at the University Mall. Calls classified as retail theft, larceny, and robbery were almost 25 percent of all calls for service.
From 2013 to 2016, SBPD received a 36.8 percent increase in calls classified as drug-related; 2016 was the department’s busiest year in history for calls of service as well as drug-classified calls.
As if the effects of heroin weren’t already alarming, there is an added layer that puts both users, law enforcement, and the community at-large at risk: the use of dangerously-potent synthetic opioids, fentanyl and carfentanil.
“Fentanyl is the most dangerous thing facing law enforcement right now,” Favreau said. Fentanyl is a synthetic opioid that is absorbed through the skin and is intended to help manage chronic pain, including cancer pain. It has a rapid onset and short duration of action, making it a sought after additive to heroin for an increased high.
However, not all buyers or sellers are necessarily aware if fentanyl is added to a heroin product, making it potentially lethal for those who have not developed a tolerance for it; two milligrams of fentanyl (equal to a grain of salt), can trigger an overdose if inhaled or absorbed. When law enforcement encounters it, the product must be sent straight to the lab.
Vermont has not had much exposure to carfentanil, which is 100 times more potent than fentanyl, but there have been cases nearby in New Hampshire.
Every professional on the panel has been on the frontline of the opiate battle. The panel included Dr. Stephen Leffler from UVM Medical Center; Lt. Teresa Randall, commander of the Vermont State Police Drug Task Force; John Caceres from Valley Vista Rehabilitation Facility; Danielle Jatlow from Centerpoint Services; South Burlington School Superintendent David Young; South Burlington Police Chief Trevor Whipple; and Nick Perkov, a senior South Burlington firefighter and paramedic.
“Our whole world has changed. It’s a different business now, and we really have to be careful,” said Randall. After working undercover in 2008 and later supervising the drug unit, Randall has a street view of the scene and its players.
“In 2008, a big seizure for us was about 450 bags of heroin. Now, the biggest seizure we had, back in 2011, was about 9,000 bags.”
Due to supply and demand, the task force has seen more heroin delivered in bulk. There is also a greater presence of fentantyl, which means everyone carries Narcan, a prescription medicine that blocks the effects of opioids and reverses an overdose.
“From an EMS perspective, every member of our department is trained with not just how to give Narcan, but also how to recognize an opioid overdose. We’ve doubled the amount of Narcan we carry on our trucks,” Perkov explained.
Even though heroin use and abuse has been on-the-rise, there have been gradual changes and recommendations made in response.
“Most of what we do is intervention-driven,” Young said. He urged attacking the problem at the root. Since some have turned to drugs as a form of escape, he advocated fostering deeper relationships at an early age.
“We are responded to favorably when we have connections, those deeper relationships. We know there are higher outcomes of positive experiences for us,” he said. “….I think there’s a call-to-action.”
According to Leffler, hub capacity has increased for treating patients, and the waitlist has gone down, but there’s still more work to be done.
“We have to ramp up prevention,” he said, commending Favreau for bringing this to seventh graders’ attention. “Next, we need to get every single Vermonter who needs to be in treatment with methadone or suboxone, in, 100 percent. Finally, we need to be smart about how we prescribe meds. Prescribers definitely play a role in this.”
The state collected 5,500 pounds of drugs during the recent Drug Takeback weekend, Whipple said. “We’ve got too much. We don’t need that much if we’re throwing it away.”
Careres added that they are also starting to see success with Naltrexone/Vivitrol at Valley Vista. Naltrexone is medication being used to prevent opioid substance abuse, and Vivitrol is the injection version of Naltrexone. Conventionally, it would take about 14 days for a patient to be introduced to Naltrexone (the oral version) after ceasing opiate use, but now patients can be given Naltrexone and then ultimately Vivitrol within four days.
“That’s a critical point. Once they get off the opiates, they get sick, they get scared…so having the ability to introduce it within four days has proven to be good. The recommendation is anywhere between six months to a year on Vivitrol.”
There is also a treatment option here in South Burlington at the methadone clinic on San Remo Drive, which is operating at full capacity.
How can you help?
Strengthen the relationships around you, seek education and seek to educate. And try to work against the stigma that is assigned to addiction. Opiate addiction is all around us. It’s easy to think of addiction as something that afflicts a stereotypical ‘them,’ but it can just as easily be ‘us,’ our own family, friends or neighbors whose use of prescription pain medication has led to addiction.
“There’s a place for everyone in this crisis, and you have to find your spot,” Jatlow said. “We need health promotion, we need connection, we need education, we need treatment, we need medication-assisted therapy, we need harm reduction. Pick your passion spot and do something.”
Jane Helmstetter, VT Agency of Human Services field services director for Chittenden County, spoke of the wide variety of resources that are available, and highlighted the recently formed Chittenden County Opioid Alliance. The organization is based on the premise that no single entity can reduce the burden of the opioid crisis in Chittenden County alone. The Alliance is made up of many dedicated people who come from different sectors of the community to partner together, such as local non-profit agencies, state and local government, UVM Medical Center, business leaders and community members.
“No one can do this alone, and there is a place for everyone in the Alliance to make a difference,” said Helmstetter. For more information on the Opioid Alliance go to www.ecosproject.com or contact Cathy Aikman, project director, at 861-0138 or firstname.lastname@example.org.
There will be other community forums planned for the future; the topics are to-be-determined, Favreau said. For more information in addition to these professional resources, visit Vermont Department of Health’s “Vermont’s Most Dangerous Leftovers” campaign around prescription drugs, or ParentUpVT.org to learn strategies and actions to prevent drug abuse among children.
SOURCE: Miranda Jonswold, Correspondent