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Despite Rising Opioid Deaths in Rural Hudson Valley a New Treatment Approach Shows Promise.

While the Hudson Valley leads New York State in opioid deaths, it may also be leading the way in fighting the scourge of addiction through a new program adopted by the Chatham police department.

Vintage Bayer heroin pill bottle from the 1920s.
Vintage Bayer heroin pill bottle from the 1920s.
Photo via Wikimedia Commons.

The movement to fight the scourge of opioid addiction is gathering strength, but the epidemic rages on. The national rate of death by overdose has been on a steady uptick for years, and recent preliminary data from the Centers for Disease Control suggest that it is still on the rise.

Geographic patterns in the data point to fentanyl as a deadly accomplice to addiction:

In much of the West, overdose deaths have been flatter as the epidemic has raged in parts of the East and Midwest. That geographical pattern may be a result of the drug supply. Heroin sold west of the Mississippi tends to be processed into a form known as black tar that is difficult to mix with synthetic drugs. The heroin sold toward the east is a more processed white powder that is more easily combined with fentanyls.

While deaths from opioid overdose are rising across most of the US, and especially in the East, a few New England states with aggressive drug treatment programs have seen reductions in the overdose death toll: Massachusetts, Vermont, and Rhode Island. The numbers are still preliminary, but suggests that investments in public health and drug treatment might save lives.

The scale of the epidemic is daunting. The roots of the problem run deep: a broken healthcare system, fractured communities, crumbling social infrastructure. Decades of cracking down on drug trafficking have failed to stem the tide of suffering and death.

Here in the Hudson Valley, and elsewhere around the nation, a new philosophy is beginning to take hold: one with an ethos of care and community, not crime and punishment.

An abandoned pharmacy in Parksville, a hamlet of Liberty in Sullivan County. Photo by Doug Kerr; published under Creative Commons license.

The Hudson Valley: Ground Zero in New York State

No part of New York State has been untouched by opioid addiction. But it’s here in the Hudson Valley that the epidemic has hit hardest: rural Sullivan County, a green and rolling place the size of Rhode Island, but with less than a tenth of the population. A glance at the statistics on opioid overdose deaths in New York State for 2015 shows Sullivan County far worse off than the rest of the state, with an age-adjusted death rate of 26.7 per 100,000—nearly triple the statewide rate of 9.0.

County numbers for recent years have not yet been calculated, but given a recent rise in the New York State overdose death rate, it’s likely that the local picture has worsened since 2015.

Earlier this year, the Rockefeller Institute launched an initiative to study the problem in Sullivan County, starting by talking to local people at the most grassroots level. The result: “Stories From Sullivan,” a deep dive into what the opioid crisis looks like in a rural area, and why solutions that help in more urban settings fail to reach people living far from city centers. An excerpt:

“It’s hell,” one mother told us, describing her son’s heroin addiction.

Over the past fifteen years, Sam has been in and out of treatment, in and out of jail, and back and forth to medical appointments. She told us that it is “impossible” to succeed after addiction, and even harder in rural areas. Who will take him to probation meetings? Who will take him to doctor’s appointments? He has no car and there is no public transportation. She doesn’t give him money, but she does buy food for him and help with his rent. “Some people might say I’m enabling,” she says, but there is no playbook on what to do when your child has a substance-use disorder and few resources to help guide the way.

The Rockefeller Institute study follows on the heels of another Sullivan County storytelling initiative: The Kingfisher Project, a radio series launched in 2014 at local community station WJFF. Since then, the Kingfisher Project has been telling the stories of local people caught up in the opioid epidemic, seeking to honor the dead and support the living.

A man sends bubbles floating down Hudson Avenue at Chatham’s 2018 SummerFest. In the background: a sign advertising a mock drug user bedroom used to teach parents and family members to recognize the signs of drug addiction, sponsored by Columbia County Pathways to Recovery. Photo via Chatham Area Business and Arts.

Policing With Compassion

The Hudson Valley has been hit hard by the scourge of opioid addiction. But one of the most hopeful spots is here as well: the little upstate New York village of Chatham, in Columbia County. A picture-postcard village on the Stony Kill with a population of under 2,000, Chatham seems an unlikely haven for a drug problem – and an even more unlikely spot for a solution. But thanks to the efforts of the village’s enterprising police chief, Peter Volkmann, Chatham has become a proving ground for one of the nation’s most effective opioid addiction intervention programs.

Instead of being arrested, addicts who come to the police get encouragement, companionship, and expert help

Volkmann’s message is simple: If you need help, come to the police. Modeled after a program pioneered in Gloucester, MA, that is beginning to make converts in other law enforcement departments across the nation, the program, dubbed ‘Chatham Cares 4 U,’ trains police and community volunteers to help people who come to the station looking for a way out of addiction. Instead of being arrested, addicts who come to the police get encouragement, companionship, and expert help with navigating the system and finding a bed in a treatment center.

Public health researcher Tomoko Udo of the University of Albany is studying the program’s effectiveness, and she’s encouraged by what she sees:

“It is an extremely innovative and forward-thinking approach that has critical implications for where the public health and criminal justice system should go in terms of how to deal with people with substance abuse problems in this country,” Udo said.

Since the program launched in 2016, Chatham police and volunteers have helped more than 170 people get treatment for addiction. It’s an approach that’s catching on locally as well as nationally: Recently-elected Ulster County sheriff Juan Figueroa has praised the program and the philosophy of care over crackdown, writing in a Woodstock Times editorial that “this is not a problem that we can arrest our way out of.”

Could every town facing the scourge of opioid addiction do what Chatham did? Compassion for addiction isn’t always an easy sell in the community, and funding for initiatives like this can be hard to scrape together. Volkmann says where there’s a will, there’s a way.

“Every school, every library, every town hall, every village hall should open themselves up as a safe place,” Volkmann said. “Money is not going to correct this. It’s the will of the community that’s going to correct this.”

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