By ALYSSA DANDREA Sentinel Staff | Posted: Monday, February 22, 2016 11:45 am
Thirty-six people have overdosed on heroin in Keene in the past 7½ months. Fourteen of them overdosed in January and February. And two of them died.
The city’s first responders, social service professionals and treatment advocates say the heroin crisis is getting worse each month, and more needs to be done to help struggling addicts get clean before it’s too late.
Now, the Keene community is stepping up to try to do something, rather than standing by.
The new Coordinated Access Point Program, also known as CAPP, is focused on addicts who want to start their recovery. The 18-month pilot program depends on the collaboration of multiple groups in the community, and aims to help people on a personal level.
It’s set to launch next month under the direction of Southwestern Community Services and a new administrator, who the nonprofit agency will hire with state funds.
If the program is successful in Cheshire County, it could serve as a model for similar initiatives statewide.
Historically, law enforcement officials have focused on going after the drug supply by apprehending the traffickers who bring heroin here, often across state lines, for sale.
While Keene Police Chief Brian C. Costa and Cheshire County Sheriff Eliezer “Eli” Rivera say they’re not backing down from targeting and investigating those who supply the heroin, they also have a vested interest in helping those who demand it: the addicts.
“This is not a single organization’s problem,” Rivera said during a roundtable interview Wednesday at the Keene Police Department. “All of us have been working hard to come up with some sort of a plan or solution to help our guys on the street.”
Since last fall, Southwestern Community Services has worked closely with N.H. Sen. Molly Kelly, D-Harrisville, to secure funding for the pilot program, Director Laurie J. Tyler said. Now, local officials are waiting for final approval from the N.H. Executive Council, whose members are expected to take up the issue March 9, she said. Until then, Tyler declined to say how much the program will cost.
The goal of CAPP is to provide a single point of contact for people who are serious about their recovery, Costa said. There will be a 24/7 hotline number that first responders can call to get a trained recovery coach dispatched — most regularly to the emergency room at Cheshire Medical Center/Dartmouth-Hitchcock Keene — after an overdose call, he explained.
The recovery coaches, most of whom are local residents, underwent a five-day, 40-hour training program in January and were vetted by local officials for the pilot. They will serve as advocates for drug addicts who want treatment, officials said.
“We’re not going to force the help,” Rivera said. “We’re going to offer the help.”
Many of the 46 newly trained recovery coaches understand firsthand the struggle of addiction; they’re former users in long-term recovery, Rivera said.
What’s missing today is the human link to get people help, and the role of the recovery coach is to fill that gap, Costa said.
Local officials are working to close that gap even further by introducing a companion to the Coordinated Access Point Program. That component, Cheshire Assisted Addiction Recovery Initiative, was formed so the region could link with the Bay State’s vast treatment resources and centers, according to Costa.
The Massachusetts counterpart of the program, Police Assisted Addiction Recovery Initiative, formed in 2015 by Gloucester Police Chief Leonard Campanello to bridge the gap between the police department and those seeking treatment for opioid addiction.
Keene Police Chief Mark F. Howard said Cheshire County’s first responders share in that mission. But he also wanted to caution people against thinking that these new initiatives will eradicate the problem.
When speaking about the recovery coaches, he said: “They’re not angels who are going to be falling out of the sky. They’re angels in the role they’re playing, but they’re not an angel that’s going to solve this.
“What’s being accomplished here is huge. However, to look at the big picture, it’s maybe a blip on the radar screen of things that need to happen.”
Howard spoke of the need for more treatment centers and in-patient programs statewide, but Costa noted that initiatives of that scale are beyond their purview. The pilot program is more grassroots-based, Costa explained.
“None of us work in careers where being naive is helpful, but we also see the reality that there’s nothing right now. This is something,” Costa said. “I’m not saying that this is going to be a magic wand, but we take a certain amount of solace to having something that we put together in a short amount of time that we can put right to use.”
First responders said it’s difficult for anyone to really understand the scope of the heroin problem until he or she has seen it on the street level.
Keene firefighters have responded to overdose calls for people as young as 18 and as old as 72 since July 2014. It was that summer that city officials recognized publicly the depth of the local crisis and began calling for a heightened response.
The public forums that followed were, in part, spurred by the death of Shannon E. Lacy, a French teacher at Keene High School. The 26-year-old died June 30, 2014, from an overdose of the opioid painkiller fentanyl, after struggling with an addiction — first to Percocet and then to heroin, according to her mother, Roberta Lacy of Nashua.
Sadly, her story isn’t unique, and that is why the heroin epidemic is “our problem,” Costa said, noting it’s a public health crisis that affects us all.
Years ago if a firefighter responded to a handful of deaths — or serious calls that could have resulted in death — in one year’s time, that was considered a lot for one person to handle, Howard said.
“Today, we’re dealing with it daily, not deaths but near-deaths,” he said.
Naloxone — an opioid-reversal agent more commonly referred to by its brand name, Narcan — has been around since 1993. But firefighters used to administer it in 0.4 milligram doses, and if they used 1 milligram or more to revive someone that was considered excessive, Howard said.
More than 20 years later, first responders are administering four times that amount, he said. That’s because the makeup of heroin has changed, and often Narcan alone isn’t enough to bring someone back, he said.
In an attempt to revive the 36 people who have overdosed in the past few months, firefighters have dispensed more than 160 milligrams of Narcan in 2 milligram doses.
Pharmacies throughout the state recently made Narcan available without a prescription. While the county’s first responders said they support the distribution of the drug at the community level to save lives, they caution people about the dosage available at the drug store, which isn’t always enough to save a loved one.
They encouraged people to call 911 no matter what.
Howard told the story of a young man who overdosed nine times in Keene. The ninth time was fatal.
The fire lieutenant who responded to at least half of those calls, including the last, knew the man — his face, his name and at least a piece of his addiction story. The young man who lost his life that day wasn’t just another statistic or a number to the lieutenant who had seen him die, Howard said: He was someone’s son who needed help and couldn’t get it.