By Matthew Robare
The North Shore Opiate Addiction Summit meeting at the Kowloon Restaurant on Route 1 last Thursday brought together over 150 people, who shared resources and stories of their own and their families’ struggles with substance abuse. It was a follow-up to a meeting on January 31 that brought together officials from Saugus, Chelsea, Revere, and Winthrop. Those five towns have applied for a regionalization grant that will, with Revere as the mentor community, allow them to develop a comprehensive, regional prevention and treatment strategy. The towns sponsored Thursday’s summit, along with community organizations Saugus We Care, the Saugus Anti-Drug Coalition, Revere CARES, Community Against Substance Abuse, and state-wide programs Massachusetts Organization for Addiction Recovery and the Massachusetts General Hospital Center for Community Health Improvement.
The presence of Robert DeLeo (D-Winthrop), the Speaker of the Massachusetts House of Representatives, was a powerful indicator of support for treating the substance abuse problems.
“Before I was the speaker I was chairman of Way and Means,” DeLeo said, describing how he listened to every representative’s request for money for their districts. “Invariably the top two most requested items were to give money to our cities and towns, and education. The third was and is almost always substance abuse. Things haven’t changed much in many years.”
Greg Nickolas, director of the Saugus Youth and Recreation Department, said afterwards, “It was a success. We need to continue to have the dialogue and keep pointing out the obvious—that drugs and alcohol have a serious impact and secondly, not just be reactionary to it.”
“Sometimes, with certain issues, you can address them with money or changes to the law,” DeLeo said. He reflected, “Despite the attention this issue has gotten, I’m not sure how far we’ve gotten in combating this terrible disease.”
DeLeo, who represents Winthrop, went on to describe how two young people who live on his street died from substance abuse and how he’s been asked more times to help get kids into treatment programs than to write them letters of recommendation. “If everyone here can save one life, then everything I’ve talked about will be worthwhile. To all the folks who are involved in this, God bless you,” DeLeo said.
After the introductory remarks by DeLeo and Representative Donald Wong (R-Saugus), the summit divided in two. Adults stayed in one room while minors went to another to have their own discussions, away from the adults.
Wong thanked the parents: “Without you, the kids wouldn’t be here.”
“The kids’ side was a step in the right direction,” Nickolas said. He explained, “Our objective was to start bringing kids together from the different communities. We want youth at the table to inform those of us making decisions for them that they have a voice.”
On the adult side, there were a series of speakers reviewing the effects and treatment of addiction, as well as opiate overdose-prevention training. One theme that ran through the presentations was that treatment and recovery is very difficult: There are issues with insurance, figuring out the right course of treatment, and obtaining access to programs and detox.
The first speaker, Kim Hanton, the director of addiction services at the North Suffolk Mental Health Association, compared addiction to the Wizard in “The Wizard of Oz,” in the way it preys on the addict’s vulnerabilities and fears.
Hanton said, “Addiction is a chronic brain disorder. When you introduce the substance to the biology, it takes on the psychology. As we continue to fear the disease it continues to grow. It doesn’t go away.”
She explained that there are stages of recovery: precontemplation, contemplation, preparation, action, and relapse, which can happen at any time. “Relapse is part of the disease of the brain,” she said.
She was followed by Janet Calgano and her son Michael. Michael Calgano, who is now 22, began using drugs when he was 13 and quickly progressed from marijuana to heroin.
“He came from a good home and it didn’t make any difference,” Janet Calgano said. “I sit here today very proud of my son, and I tell you that he has made over a year of recovery—I didn’t fix him, he fixed himself.”
Michael Calgano said, “I’ve been through all the insanity. Anything that got in the way of my addiction I cut out. You can stay sober, but if you don’t have a program out of recovery you’re not going to stay sober.”
He said his addiction became so bad that he was Section 35—a provision in Massachusetts law that allows the “courts to involuntarily commit someone whose alcohol or drug use puts themselves or others at risk,” according to the Health and Human Services website.
“That was my first detox,” the younger Calgano said. “It’s not about self-knowledge and self-will. My way—my best thinking—left me in a jail cell or a hospital bed.”
Maryanne Frangules, the executive director of the Massachusetts Organization for Addiction Recovery, led a discussion on the difficulties of getting treatment in Massachusetts. While Massachusetts does have good facilities and programs, finding information about them and tying everything together into a treatment program can be problematic.
“Navigating treatment can be a daunting task,” Nickolas opined.
People have had difficulties getting into detox, because of their insurance or they have clean urine because they were prevented from “using” before going into detox, and so they get rejected. Some drugs, such as cocaine, are not detoxable, and some forms of treatment are underutilized because they’re not very well known.
“We have more residential treatment, but people don’t know [it exists],” Frangules said.
David Coughlin, who said he had a family member struggling with addiction, said that the treatment system was a “conundrum wrapped in a riddle.”
Frangules said that denial of treatment for addiction by insurance companies was leading a group called Health Law Advocates to a point where they would start a class action. “They won’t do whatever they need to do if we don’t tell them,” she said.
“It’s when connections start happening that people can start getting help,” said Katie Sugarman, an assistant director of Revere CARES.
Gary Langis, Community Health Coordinator for the City of Revere, talked about opioid abuse and overdose prevention. Opioid drugs include both traditional opiates—such as heroin, morphine, and methadone—and synthetic drugs available by prescription for treating pain, most notably oxycodone. “This is the drug of choice for our section of the country,” Langis said.
The synthetic opioids, however, have outstripped the natural opiates in popularity. He said that the street price for OxyContin (a brand of oxycodone) has gone as high as $80 a pill while the price of heroin has fallen to as low as $20.
As for overdoses (OD), Langis said that they’re not instantaneous or as portrayed in the film “Pulp Fiction,” where a needle full of adrenaline was jabbed into a woman’s heart to reverse her OD. He said that an overdose usually happens between one and three hours after the drugs have been used and involve the person’s breathing shutting down as the drugs bond to opioid receptors in the brain.
He said a person’s skin will take on a blue tinge; their body will be limp; their face pale and pulse slow or erratic; they’ll be vomiting; they’ll faint or breathe irregularly and can be awake but unresponsive.
Mary Wheeler, the Healthy Streets program director for Northeast Behavioral Health, did trainings on administering Narcan, a drug that reverses an opiate overdose. The Massachusetts Department of Public Health has been distributing Narcan through various programs since 2006. Langis credits the program with halting the rise in overdose deaths since 2007, and the department records that over a thousand lives have been saved.
The Saugus fire department is on the verge of getting into the distribution program, something that they’ve been working on since January.
“Unless something weird happens, it looks really good. This is a no-brainer, giving this Narcan,” said Saugus Fire Chief Don McQuaid.
Langis said of the summit efforts, “I think they are accomplishing a lot in getting the communities mobilized. I know we’ve made a difference in Revere. I think Massachusetts does have one of the better systems around, but right now it’s really hard to navigate.”