In Ulster, opioid panel speaks of progress

The opiod panel at SUNY Ulster January 16. At far right are Sheriff Juan Figueroa and, standing, Vin Martello.

Seeking a local strategy to combat the devastation of the opioid epidemic, Ulster County sheriff Juan Figueroa and a panel of counselors, healthcare professionals, advocates and justice-system officials outlined methods and fielded questions from a crowd of about 60 people at SUNY Ulster Wednesday, January 15. 

“We’re trying to recognize that opioid-use disorder is a disease and it deserves to be treated as such, with dignity, respect and compassion,” said Figueora. “You being here tonight plays an enormous role in that process. It takes a community response. How this entire process started is [we realized that] what we’ve been doing in law enforcement is not working.”

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After a screening of the film Smacked, a documentary that details the plight of addicts and similar efforts of law enforcement and healthcare providers in Delaware and Otsego counties, state senator Jen Metzger, assistant county executive John Milgrim, Randi Kelder from Raising Your Awareness About Narcotics (RYAN), Dr. Matt Stupple from Ellenville Regional Hospital, John McNamara of Samadhi Recovery Community Outreach Center, drug court judge Larry Ball, Liz Berardi from Safe Sober Living, and Figueroa spoke and answered questions.

Ulster County led the state’s 62 counties in per-capita opioid-related deaths in 2018, with opioid substances surpassing every cause of death in the county other than cardiovascular complications. Last year, the local sheriff’s department embarked on a new path, dubbed Opioid Response As County Law Enforcement (ORACLE is the acronym). The department aims lessen the grip of addiction on the citizenry it serves in a three-pronged approach. 

First, the department deploys a trailer that contains a living room, kitchenette, bathroom and bedroom. It looks like an ordinary living space. But hidden in plain sight are markers of opioid addiction: a pair of work boots in the corner are missing laces, which addicts often use to tie off before injecting heroin. Little tufts of cotton pulled from swabs, used to draw up liquefied heroin into a syringe, are scattered around. In the sink, a tablespoon has been bent to serve as a heroin cooker. An educational team, including the family members of individuals who succumbed to opioid addiction, share their stories and distribute educational material. 

Secondly, a team has been amassed to respond to the homes of addicts that have been revived from overdoses. As of three months ago according to Vin Martello, Ulster County government’s coordinator for ORACLE, individuals who have been singled out as at-risk users via callers to the ORACLE hotline service. Martello said that over 80 at-risk individuals have been assisted into recovery programs by the program thus far, and that 26 peers are trained to answer the hotline. The team that responds to the addicts’ homes consist of a plainclothes police officer, a peer advocate (generally a former addict), a mental-health professional and a recovery planner. 

Finally, medically assisted treatment (MAT) using drugs like methadone, suboxone and vivitriol has been introduced to inmates at the Ulster County Jail. According to Martello, MAT greatly reduced an addict’s chances of relapse. 

“We in law enforcement,” said Figueroa, “also have barriers that we have to break down and look past. You know, giving folks narcotics in a controlled environment isn’t something that’s easy for us, either.” 

Help for parents, help from schools

The panelists discussed how the strengthened efforts to combat opioid addiction were being integrated into Ulster County’s school systems. “We have programs for parents in recovery, parents of those who are still actively addicted. Sometimes parents will come with their children to those groups as well,” said McNamara of Samadhi. “It can’t just be in school, it has to be about the whole thing. To create an understanding — I know what it feels like to maybe have parents who don’t understand what you’re going through and don’t understand the underlying cause of your addiction. I think it’s important to bring the whole family into the picture.”

McNamara said that Samadhi programming was available from 11 a.m. until 9 p.m. seven days a week. Resources include acupuncture, chiropractic services, recovery meetings and self-compassion groups. 

Currently, the program is trying to develop at 24-hour outpatient program, because “when someone is released from the ER at three o’clock in the morning, if you tell that person they have to wait until Monday morning, they generally won’t be there on Monday morning.” The program also offers recovery coach training and assists with the department’s hotline. 

In response to a question about whether inmates would be offered resources after leaving jail, McNamara said that a Samadhi peer was sent to meet with an inmate prior to release, and continued to offer their assistance after release, picking the inmate up from jail if they don’t have other options. 

One audience member noted a shortage of detox beds in hospitals and halfway houses throughout the county. Was there an intention to add more? 

This proved a difficult question to answer. “There aren’t enough halfway houses, not nearly enough,” said drug court judge Ball. “We strictly control where participants in drug court live…If you drop them right back into that, their chances are very small. We want to place them, sometimes in residential treatment, sometimes it will be a probation facility…It’s difficult to find them permanent housing because of financial circumstances and the rules of who belongs in housing.”

District attorneys, law enforcement, family members and other parties can recommend those who have been arrested on opioid-related charged to drug court, said Ball — should the individual complete the programming successfully, they can avoid jail time altogether.

“Being that we’re such a spread out county, housing is a huge issue,” said Figueroa. “We were just listening to a webinar yesterday…Forty-four percent of people who go back to their environment are going to relapse.”

Liz Berardi, bereaved mother of a son who died of an overdose, lamented the lack of regulation in sober housing. “My son died his third day out of treatment,” she said. “I called it a sober living [facility]…It wasn’t safe…I would’ve moved to the moon for him. The treatment center told me that this is what they want to do. No one told me that there were no regulations, that anything could be going on in this place.”

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