>>> AS OPIOID ABUSE CONTINUES UNABATED, SOME COMMUNITIES ARE
FOCUSING ON KEEPING THE DRUG USERS ALIVE, AND ONE APPROACH
GAINING TRACTION AROUND MASSACHUSETTS IS CALLED POST
OVERDOSE OUTREACH.
NEW ENGLAND PUBLIC RADIO'S KAREN BROWN HAS A FOUR-PART SERIES
THAT EXPLORES THIS APPROACH, AS WELL AS THE REACTION TO ITS USE
BY LAW ENFORCEMENT AND SOME MEMBERS OF THE LEGAL SYSTEM.
SHE SAT DOWN WITH ME IN THE STUDIO TO SHARE WHAT SHE
DISCOVERED IN HER REPORT.
>> WELL, I ACTUALLY HAD BEEN DOING A LOT OF STORIES ABOUT
OPIOID ADDICTION AND ADDICTION IN GENERAL, AND I JUST KEPT
HEARING ABOUT THIS NEW OUTREACH PROGRAM CALLED THE DART PROGRAM,
DRUG ADDICTION RECOVERY TEAM.
WHERE IT JUST SOUNDED LIKE A GREAT OPPORTUNITY FOR A RADIO
STORY, FRANKLY, TO GO OUT WITH POLICE OFFICERS AS THEY'RE
TRYING TO FOLLOW UP WITH PEOPLE WHO ARE USING DRUGS.
AND I JUST THOUGHT THAT WAS A NEW AND INTERESTING METHOD OF
HELPING DRUG USERS, AND ALSO A NEW ROLE FOR THE POLICE.
I ACTUALLY FOR THIS SERIES DON'T ACTUALLY GO OUT WITH POLICE ON
THEIR VISITS.
BUT I FIND OUT HOW THE PROGRAM WORKS.
>> AND YOU CHECK IN WITH PEOPLE WHO ARE ACTIVELY INVOLVED IN THE
PROGRAM, AND YOU HEAR ABOUT SOME OF THE PROS AND CONS AND SOME OF
THE TROUBLE BEHIND IT.
BUT JUST LET'S BACK UP A SECOND AND TALK ABOUT WHAT POST
OVERDOSE OUTREACH REALLY IS AND WHAT IT ENTAILS.
>> RIGHT.
SO THE IDEA IS PEOPLE WHO HAVE AN OVERDOSE ARE EXTREMELY
LIKELY, AND SURVIVE IT, ARE EXTREMELY LIKELY TO HAVE ANOTHER
OVERDOSE AND POSSIBLY NOT SURVIVE.
SO THE PEOPLE THAT DEVELOPED THIS KIND OF MODEL, WHICH IS NOT
JUST HAPPENING HERE IN HAMPSHIRE COUNTY BUT IN MANY OTHER PLACES,
THOUGHT HOW CAN WE FIND THESE PEOPLE WHO HAVE OVERDOSED AND
GET THEM HELP BEFORE THEY OVERDOSE AGAIN.
SO THAT'S ESSENTIALLY WHAT IT MEANS, POST-OVERDOSE OUTREACH.
AND THE POLICE DEPARTMENT SEEMED LIKE THE MOST NATURAL PLACE TO
START, BECAUSE THEY'RE THE ONES THAT ANSWER THE 911 CALLS, WHICH
IS WHERE YOU HOPEFULLY CALL AFTER AN OVERDOSE.
SO THAT'S HOW THESE DIFFERENT TEAMS GOT INVOLVED IN REACHING
OUT TO PEOPLE POST-OVERDOSE.
>> BUT ISN'T THAT ALSO A BIT TRICKY, BECAUSE AS I THINK ONE
WOMAN WHO YOU INTERVIEWED SPEAKS TO THE FACT THAT SHE'S USING AN
ILLEGAL SUBSTANCE THAT SHE KNOWS SHE SHOULDN'T BE USING, THE LAST
PEOPLE SHE WANTS TO HANG OUT ARE THE POLICE.
>> RIGHT.
>> SO HOW ARE PEOPLE CONFRONTING THAT CHALLENGE?
>> WELL, THE POLICE ARE FINDING THAT THIS IS NOT THE KIND OF
PROGRAM WHERE EVERYBODY IS LIKE, OH, GREAT, THANKS FOR HELPING ME
OUT.
FOR ONE BECAUSE, YES, AS ONE OF THE PEOPLE I INTERVIEWED SAID,
EVERY TIME THEY'VE BEEN ON DRUGS, THEY'VE BEEN RUNNING FROM
THE POLICE OR TRYING TO HIDE THE DRUGS OR, YOU KNOW, THAT'S NOT
THE FIRST PERSON THEY WANT TO SEE.
SO THIS IS PART OF THE LEARNING CURVE, I'M HEARING FROM POLICE
OFFICERS WHERE NAY GO OUT, THEY WAIT A CERTAIN AMOUNT OF TIME
AFTER THE EMERGENCY IS OVER, THEY INTRODUCE THEMSELVES.
THEY ARE GENERALLY IN THEIR UNIFORMS, BUT THEY TRY AND
EXPLAIN WE'RE HERE TO HELP, WE'RE NOT HERE TO ARREST YOU,
YOU'RE NOT IN TROUBLE.
BUT THEY ARE FINDING THAT NOT EVERYBODY IS REALLY EAGER TO SEE
THEM.
SO IN MANY CASES THEY GO BACK AGAIN, MAYBE THEY SAY OKAY,
YOU'RE NOT READY FOR ME NOW, CAN I COME SEE YOU LATER.
MAYBE IT TAKES A FEW MONTHS.
AND IT'S NOT JUST THE POLICE, THEY ALSO SAY, IF YOU DON'T WANT
TO TALK TO ME, MAYBE YOU WANT TO TALK A RECOVERY COACH, AND
THAT'S ALSO PART OF THE PROGRAM.
OR MAYBE YOU DON'T WANT TO TALK TO ME AT ALL, YOU JUST WANT TO
FIND OUT WHERE TO GET CLEAN NEEDLES, OR MAYBE I CAN HELP YOU
FIND A HOT MEAL.
SO THERE'S A RANGE OF OPTIONS THEY OFFER DEPENDING HOW
RECEPTIVE THE PERSON IS, YOU KNOW, AFTER GOING THROUGH AN
OVERDOSE.
AND ALSO I SHOULD ADD THAT IT'S NOT ONLY PEOPLE WHO HAVE BEEN
THROUGH OVERDOSES, THAT'S OFTEN HOW THE 911 CALL SORT OF BRINGS
THEM TO THE PROGRAM, BUT SOMETIMES IT'S JUST PEOPLE WHO
HAVE BEEN INVOLVED WITH OTHER KINDS OF CRIME, MAYBE RELATED TO
DRUG USE, LIKE SHOPLIFTING, OR THEY FIND OUT THROUGH SOME OTHER
MEANS.
>> SO IF A POLICE OFFICER IS ENCOUNTERING THIS PERSON WHO
THEY MIGHT TYPICALLY CHARGE WITH A DRUG OFFENSE, HOW ARE THEY
CHOOSING TO SAY, OKAY, I'M NOT GOING TO USE THE FULL HAND OF
THE LAW IN YOUR PARTICULAR CASE, HOW IS THAT FAIR, HOW IS THAT
EVEN LEGAL?
DO THEY TALK ABOUT THAT AT ALL?
>> YOU MEAN TO NOT DO THE ARREST?
>> RIGHT.
>> I THINK IT'S TRICKY.
I DIDN'T ACTUALLY PROBE INTO THE LEGAL ISSUES, ALTHOUGH THAT
WOULD BE A GOOD FOLLOWUP STORY.
BUT THEY BASICALLY SAY THIS IS NOT WHY I'M HERE, AND, I MEAN
THIS IS PART OF A BROADER CHANGE IN HOW LAW ENFORCEMENT IS
DEALING WITH DRUG USE IN GENERAL, TRYING TO MOVE AWAY
FROM ARRESTING FOR LOW LEVEL OFFENSES, LIKE POSSESSION OR
LIKE SHOPLIFTING.
>> BUT WE'RE NOT TALKING ABOUT THE DRUG KING PINS HERE THAT ARE
BEING OFFERED THIS TYPE OF ASSISTANCE.
>> RIGHT.
IN FACT I INTERVIEWED THE DISTRICT ATTORNEY OF HAMPDEN
COUNTY YESTERDAY WHO WAS SAYING HE STILL FEELS LIKE IT'S
IMPORTANT TO GET AT THE DEALERS AND PEOPLE WHO ARE SELLING AND
PEOPLE WHO ARE PUSHING DRUGS.
BUT THIS IS FOR FOLKS THAT ARE MORE VICTIMS OF THE WHOLE
EPIDEMIC.
>> BECAUSE IT'S ALSO A BIG CHANGE THAT WE'VE SEEN NOT ONLY
WITH THE OPIOID EP EPIDEMIC BUT WITH MARIJUANA BEING LEGALIZED,
SOME SAY MAYBE THIS IS A RACIAL JUSTICE ISSUE BECAUSE BLACK AND
BROWN PEOPLE WERE DIGS PROPORTIONATELY IMPACTED BY
MARIJUANA ARRESTS OR RELATED TO CRACK, AND IS IT FAIR TO TREAT
PEOPLE IN THIS WAY.
SO INTERESTING TO HEAR THE DISTRICT
ATTORNEY SAYING NO WE ARE STILL GOING TO PURSUE LEGAL, YOU KNOW,
THE ILLEGALITY OF THIS ISSUE.
>> YES, AND THAT'S ACTUALLY INTERESTING.
I HAD HEARD COMMENTS FROM LISTENERS TO SOME OF, A PREVIOUS
STORY I DID ON THE SAME PROGRAM, IN WHICH THEY EXPRESSED SORT OF
THE FRUSTRATION THAT WHY IS THERE ALL THIS EMPATHY NOW WITH
PEOPLE WHEN IT SEEMS LIKE THERE'S MORE MIDDLE CLASS, MORE
WHITE USERS OF OPIOIDS.
>> STATE STATISTICS POINT TO THE FACT THAT TYPICALLY IT'S 50 PLUS
WHITE MEN WHO USE OPIOIDS OR ABUSE.
>> RIGHT.
SO THERE IS A QUESTION, SHOULD THEY HAVE BEEN DOING THIS DURING
THE CRACK EPIDEMIC WHEN THERE WERE MORE PEOPLE OF COLOR WHO
WERE AFFECTED, I THINK THAT'S A FAIR QUESTION TO BRING UP.
I DON'T GET INTO THAT IN IN SERIES.
>> YOU ALSO TALK ABOUT RECOVERY COACHES, TALK ABOUT THEIR ROLE
IN THIS AND HOW THEY WORK WITH THESE PEOPLE WHO ARE STRUGGLING
WITH DRUG USE.
>> SO A RECOVERY COACH IS NOT A CLINICIAN.
IT'S SOMEBODY WHO HAS AN ADDICTION HISTORY OF THEIR OWN
AND THEY'VE BEEN TRAINED TO HELP PEOPLE THROUGH THEIR OWN
RECOVERY, OR MAYBE TO GET INTO RECOVERY, OR TO JUST BE A SOURCE
OF SUPPORT.
AND THE DART PROGRAM HAS POLICE WORKING WITH COACHES.
SO AS YOU POINTED OUT, MAYBE THE POLICE ARE THE FIRST CONTACT,
BURR MAYBE SOMEBODY WHO IS USING DRUGS DOESN'T WANT TO CONTINUE A
RELATIONSHIP WITH A POLICE OFFICER, BUT THEY MIGHT WITH
SOMEONE WHO IS MORE OF A FRIENDLY PRESENCE, YOU KNOW,
SOMEONE MO HEARINGS A HISTORY OF ADDICTION AND UNDERSTANDS IT.
SO THEY OFTEN PUSH OFF THE PROGRAM TO THE RECOVERY COACHES,
OR HAND OFF, MORE TO THE POINT, AND THEN THEY DEVELOP A
RELATIONSHIP THAT WAY AND THEN THAT TENDS TO BE WHERE THE
LONG-TERM RELATIONSHIP ENDS UP. >> AND IT'S NOT ALWAYS A HAPPY
ENDING, AS YOU REPORT, RIGHT?
SOMETIMES THESE PEOPLE JUST STOP USING THE PROGRAM OR STOP BEING
INTERESTED.
SO HOW DO THE COACHES NAVIGATE THE DIFFICULT NATURE OF WHAT
THEY'RE DEALING WITH?
>> WELL, I THINK THEY FINE IT VERY SAD, LIKE ANY HUMAN WOULD.
I THINK WHAT THEY TELL ME IS THE EXAMPLES OF SUCCESS ARE WHAT
THEY GET THROUGH AND THERE'S ENOUGH PEOPLE THAT ARE VERY
GRATEFUL AND THAT REALLY GO THROUGH THE PROGRAM AND GET HELP
AND DO BETTER.
THERE ARE MANY CASES WHERE THAT DOES NOT HAPPEN, AND I THINK YOU
LEARN THE REALITIES OF ADDICTION AND THE REALITY OF RELAPSE.
AND THEY JUST COPE WITH IT.
>> RIGHT NOW, AND THERE MIGHT NOT BE ENOUGH EVIDENCE BECAUSE
THIS IS SUCH A RELATIVELY NEW PROGRAM, BUT WE KNOW THAT OPIOID
OVERDOSES, WHILE DEATHS HAVE GONE DOWN THE OVERDOSES
THEMSELVES HAVEN'T NECESSARILY GONE DOWN.
DO THE RECOVERY COACHES OR POLICE OFFICERS TALK ABOUT IF
THEY FEEL LIKE THIS PROGRAM MIGHT HELP TO SORT OF EVEN OUT
THAT STATISTIC WHERE PEOPLE ARE ACTUALLY GETTING BETTER MORE
OFTEN?
>> WELL, THAT'S CERTAINLY THE HOPE.
THAT IS A CHALLENGE THAT THIS PROGRAM IS FINDING OUT WHAT
CAUSES WHAT.
AND THIS IS SOMETHING I TALK ABOUT IN ONE OF THE STORIES, IS
THE CHALLENGE OF MEASURING WHAT THE OUTCOME OF THIS KIND OF
OUTREACH IS.
BECAUSE OVERDOSES ARE GOING UP BECAUSE OF THE PROBLEM, THAT
DOESN'T MEAN, THEY MAY BE GOING UP SLOWER IN PLACES WHERE THEY
HAVE THIS KIND OF OUTREACH.
SO THERE'S A LOT OF CONFOUNDING FACTORS AND SOME OF THE OFFICERS
WERE SAYING EVERYONE WANTS PROOF AND THEY WANT NUMBERS, AND IT'S
JUST VERY HARD TO ACTUALLY PROVE THAT THIS IS HELPING.
I DON'T THINK ANYONE IS SUGGESTING THAT IT'S HURTING, SO
THERE'S THAT PIECE.
THERE IS A LIMITED AMOUNT OF RESEARCH SO FAR, BECAUSE THIS IS
A RELATIVELY NEW APPROACH, SO THERE ARE ADDICTION RESEARCHERS
WHO ARE SPECIFICALLY TRYING TO SEE NOT JUST DOES POST-OVERDOSE
OUTREACH WORK TO REDUCE FATAL OVERDOSES, BUT HOW DOES IT WORK
BEST.
WHAT ARE SOME WAYS A PROGRAM CAN DO A BETTER JOB THAN
OTHERS, YOU KNOW, WHEN DO YOU PUSH, FOR INSTANCE, HARD FOR
SOMEONE TO GO INTO RECOVERY AND WHEN DO YOU STEP BACK AND SAY
OKAY I'M HERE WHEN YOU NEED ME.
THOSE ARE THE KINDS OF NUANCES THAT THEY'RE STILL LEARNING HOW
TO PUT INTO PLACE.
>> WHAT DO WE KNOW ABOUT THE RATES THAT POLICE DEPARTMENTS
ARE ACTUALLY USING THIS OR INTERESTED IN USING THE PROGRAM?
>> WELL, THERE'S 150 COMMUNITIES ACROSS MASSACHUSETTS THAT USE
SOME MODEL LIKE THIS.
THE PROGRAM THAT I LOOKED AT THAT SPECIFICALLY STARTED IN
HAMPSHIRE COUNTY, CALLED THE DART PROGRAM, IS NOW IN ABOUT 13
PLACES IN HAMPSHIRE COUNTY.
IT'S JUST NOW EXPANDING TO ABOUT 10 PLACES IN HAMPDEN COUNTY,
WITH THE EXCEPTION OF SPRINGFIELD WHICH IS OF COURSE
THE LARGEST CITY IN HAMPDEN COUNTY.
I'VE BEEN TRYING TO FIGURE OUT WHY THEY'RE NOT INTERESTED IN
TAKING PART, WHAT THEY'RE DOING INSTEAD.
>> MORE DETAILS ON KAREN BROWN'S LATEST SERIES IS ONLINE AT
NEPR.NET.