Communities Seek Strategies To Combat Opioid Epidemic

Screen_Shot_2017-09-07_at_11.14.13_AM.pngHarry Brust looked up from the chair next to his prison cot, its sheet neatly tucked under the mattress, and recalled his first attempt to shake addiction.

His leg twitched, and his foot tapped the ground with nearly every word. This isn’t his first time in prison, but it’s different. He’s in a program where a substance-abuse counselor visits every weekday, and where he’s among inmates dealing with similar experiences.

Brust, from Troy, has anxiety and was prone to violent outbursts or periods of isolation. Since his stint in the Sheriff’s Heroin Addiction Recovery Program, or SHARP, he’s gotten that under control and is on a path to recovery.

“This was a good wake-up call,” Brust said. “It changed everything.”

As the fight against opioid addiction intensifies, communities are implementing creative solutions that connect addicts with services, rather than cycling them through the criminal justice system. The SHARP program is one.

Initiatives in Albany, the Columbia County community of Chatham and elsewhere offer a glimpse at how Schenectady and other communities might begin to approach the issue and see results.

“I’m just throwing everything against the wall and, so far, it’s all stuck,” said Albany County Sheriff Craig Apple.

SHARP WING

In the bowels of the Albany County Correctional Facility — up an elevator, through several barred doors, down a hallway, down a flight of stairs and through another secured door — there’s a room with a painting on its back wall.

It depicts an eagle, wings spread, each talon crushing a syringe.

The 17 inmates in the room are there voluntarily, seeking stability and a path to recovery. One by one, they reflect on how the last days, weeks or months have given them a different outlook on life and addiction.

“I believe I wouldn’t be alive if not for this program,” said Jake Sharpe, from Grafton. “It’s keeping me on the road to recovery."

The SHARP program takes up a pod of the jail and houses up to 20 inmates at a time. It’s been operational for about 18 months. The program isn’t limited to heroin addicts. Inmates battling alcoholism or dependency on other drugs are also admitted.

Albany County ranked 13th in the number of drug deaths per 100,000 people in New York state from 2010-15, according to the Rockefeller Institute, and it faced a 29 percent increase in drug deaths during that span. The state as a whole ranked 34th in drug deaths per 100,000 residents in 2015.

Sheriff Apple said his office sees about two overdoses per day.

The idea for SHARP was born out of a lack of treatment beds in the area. Apple established the SHARP wing in October 2015. In the time since, 155 people have gone through the program. Of those, 72 have successfully completed treatment, and another 54 are still in the program.

Joan Wennstrom, a credentialed alcohol and substance abuse counselor at the facility, reviews incoming inmates' rap sheets and interviews them about their motivations for joining the program. She won’t accept anyone with a history of violence or disciplinary write-ups from prior prison stints.

From there, she works with Dennis Mosley, a counselor with the Addictions Care Center of Albany, who visits every weekday. He models his work on restorative practices, which brings individuals together to explore shared experiences and find solutions to common problems.

Almost all program participants mentioned experiencing a sense of community when they arrived in the SHARP wing. For many, this is not their first jail stint. But it is the first time they felt comfortable being vulnerable and being themselves, they said.

You can shed tears without fear of being called soft, said Abel Defreitas, from Utica.

The SHARP program provides respite from what can be a chaotic environment in which other inmates share “war stories” about time on the outside, said Walter Maybanks, who is the father of seven kids and is the grandfather of 14 more.

Stephen Van Wie said he’s struggled with heroin addiction for half his life and has had difficulty trusting anyone as a result. The program has given him a foundation for recovery, he said, and an openness with fellow participants.

“This program has given me hope,” said Dennis Nopper, from Albany.

The jail coordinates with local treatment centers before inmates are released, in order to ensure a smooth continuation of recovery, Wennstrom said.

The program, and the sheriff’s other anti-opioid initiatives, are paid for mostly through donations and with money seized through the prosecution of drug-related crimes, Apple said. Taxpayer money has only been used to cover expenses from jail personnel who have taken on additional responsibilities related to the SHARP program, he said.

A number of other communities have inquired about the program and its setup, said Kerry Thompson, chief deputy of the sheriff’s office.

“Certainly we look at anything that’s working in other counties,” said Schenectady County Sheriff Dominic Dagostino.

The SHARP wing is not necessarily the right fit in Schenectady County, Dagostino said, citing space limitations. While the Albany County Jail holds roughly 1,000 people, the Schenectady County facility has a capacity of 378. It’s also configured differently, creating space limitations for a dedicated treatment area, Dagostino said.

THE LEAD PROGRAM

The first person to ever go through Albany’s Law Enforcement Assistant Diversion program had 22 previous convictions, with most of those related to his heroin dependency.

“What would arresting this person one more time do? Clearly this guy wasn’t getting any better,” said Keith Brown, director of health and harm reduction at the Katal Center for Health, Equity and Justice.

Instead, the man went through the LEAD program, a concept piloted in Seattle and launched in Albany in April 2016. That first graduate hasn’t been re-arrested by Albany police.

Under the LEAD program, an individual picked up for a low-level crime with underlying issues related to poverty, mental health or substance abuse has the option to meet with a case manager and obtain housing or other treatment services, rather than going to jail.

The underlying concept, Brown said, is to improve public safety by connecting offenders with social services, rather than cycling them through jail, courts and hospitals without ever addressing the motives for the crimes.

That provides ripple benefits, he said, by driving down costs associated with crowded jails and cutting down on time officers might spend arresting repeat offenders for low-level offenses.

In the program’s first year, 40 people went through the LEAD program. Of those, only one failed to complete the assessment portion and, as a result, charges were filed from the original arrest.

Albany modeled its LEAD program on a Seattle initiative launched in 2011. Whereas Seattle started its program in select neighborhoods and expanded from there, Albany decided to launch it throughout the city, Brown said.

In addition, Seattle focused mainly on drug- and sex-related crimes, Brown said. The Albany program added to that list crimes stemming from poverty, such as trespassing and loitering.

When an officer is called to the scene of a crime, he or she determines whether the accused meets the criteria to participate in the LEAD program. The suspect also needs to agree to participate in the program, Brown said, and the complainant must also sign off. For example, if a store owner calls the police because someone is shoplifting, they would need to OK sending the suspect to treatment rather than jail.

If everybody consents, the officer contacts a case-management provider to connect with the individual. The case manager addresses any immediate needs, such as housing or food, and works to find appropriate treatment services for underlying addiction or poverty problems.

If the LEAD participant, doesn’t complete a follow-up assessment with the case manager within 30 days, barring extenuating circumstances, charges for the original crime are filed.

Brown said the beauty of the program is it can be adapted and shaped to fit any community. For example, he said, Santa Fe, New Mexico, decided to implement the LEAD program with a focus on opiate-related offenses.

There are some challenges associated with funding the program and getting the necessary resources to make it successful, Brown said. Albany used a $70,000 grant from the Touhey Family Foundation to hire Brown as the LEAD program project manager, and Brendan Cox, former chief of police, stepped down from that role to work on the LEAD initiative.

Erin Simao, who works in the Schenectady County Public Health Department, said the county is looking into getting funding to pilot the LEAD program locally.

“I would love to see Schenectady take a look at this,” Brown said. “We can keep people alive by making sure everyone has naloxone, and we can keep people safe. But long-term, we need to develop a better municipal response to public safety that’s not centered on locking people up.”

CHATHAM CARES FOR YOU

Chatham Police Chief Peter Volkmann knows long-term recovery from substance abuse is possible; he’s done it himself.

His last drink was in September of 1995.

More than 20 years later, he sees people dying every day from heroin overdoses and is trying to do something about it through a program called Chatham Cares 4 U. 

Chatham, a small town in Columbia County, has a police department of 22 part-time officers. If someone walks into the station and says they need help with addiction, police will work to find the nearest available bed for treatment and contact a volunteer citizen to sit with the addict and provide support while they wait. The volunteers are called angels.

Chatham Cares was launched last July. Since then, 104 people have utilized the program, Volkmann said.

The program is modeled after an initiative started in Gloucester, Massachusetts. That state had the sixth-highest rate of drug- or overdose-related deaths per 100,000 people in 2015, according to the Rockefeller report.

The program has been funded largely through donations and is aimed at eroding two key issues surrounding the opioid epidemic: stigma and access. For years, Volkmann said, addicts have been framed as “the bad guy,” and officials focused on “the war on drugs.”

“There needs to be an attitude change about people in recovery,” he said. “We don’t judge any other type of medical condition, except addiction.”

Counselors, law-enforcement leaders and treatment directors agree the Chatham Cares model is a commendable one that has enjoyed great local success. But they’re also quick to note it isn’t easily transferable from community to community.

“I have a hard enough time getting to a victim’s house who’s asking for police assistance,” said Schenectady Police Chief Eric Clifford. “To tie up an officer for two or three hours to get somebody into treatment -- while it’s very admirable and 1,000 percent a great use of resources -- I just can’t sacrifice them at this point.”

Clifford is already about 10 officers short of a full staffing level, he said. Volkmann suggested Schenectady would need to dedicate at least four officers to make the program work, in addition to having a group of volunteer angels.

Other potential obstacles in Schenectady include the city’s population and location, Clifford said. Chatham has a population of just over 4,000, while Schenectady is home to close to 66,000. In addition, Clifford said, addicts from throughout the county and neighboring counties might make their way to Schenectady to use the program.

Clifford has had discussions with leaders from TEAM Schenectady about coming up with an alternative approach. Nothing has been decided, but they’ve discussed setting up a program whereby, if someone walks into the police station seeking help with addiction, officers can at least direct them to the proper service provider.

“I think what he’s doing is absolutely phenomenal,” Clifford said of Volkmann’s initiative. “I just know it’s something I would cautiously enter into, because once you start, it’s hard to dial it back."

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