“Loneliness is a big trigger for heroin.”
Margaret, a recovering addict, spoke the words from her kitchen table in the Northeast Kingdom, among the most rural and isolated regions in the state.
“It grabs your heart and makes it all warm around it, then your whole body gets warm,” she said of the drug that killed more Americans by overdose last year – over 60,000 – than ever before. “When you don’t feel loved, heroin gives you a great big warm hug.”
Margaret’s characterization of the highly addictive narcotic opens Vermont filmmaker Bess O’Brien’s documentary “Here Today,” screened last week at Colchester’s Vermont PBS studio to kick off the station’s statewide event, “The Opiate Crisis: Stories and Solutions.”
A viewer may not realize the film’s age until nearly halfway through, when struggling addict Essence laments Gov. Howard Dean’s resistance to open Vermont’s first methadone clinic. That was in 2002.
That a 15-year-old film could all but be mistaken for a new release is troubling to those combating the state’s epidemic. Four of those key players joined O’Brien, host Fran Stoddard and a full studio audience at Vermont PBS for a live panel discussion last Thursday, Sept. 7.
The night before, PBS aired O’Brien’s 2013 film “The Hungry Heart,” another documentary on addiction focused on now-retired St. Albans physician Dr. Fred Holmes’ pioneering pediatric suboxone clinic.
“Eleven years passes between both movies – we’re dealing with heroin, and were dealing with prescription drugs,” O’Brien said. “There’s an irony to that; there’s a continuum to that.”
On last week’s panel, Holmes recounted the overwhelming response to his suboxone treatment program.
“It was frightening,” he said. “We were swamped. It was like somebody opened the dam.”
Holmes recalled massive wait lists and being forced to turn people away. He reported his patients, on average, first used heroin at age 13, became addicted at 15 and visited his office at 19.
Experts agreed youth should be engaged earlier and in more impactful ways. Panelist Reina Lowell, a community outreach coordinator and recovered heroin addict featured in “The Hungry Heart,” said normalizing anxiety, depression and other mental health conditions is a piece of that effort.
“That’s a part of the human condition,” she said.
Steve Kline, panelist and father of a daughter who died from complications of addiction, knows the importance of reaching kids at a young age.
“We have a culture that teaches us … you’ll be all right if you take a pill,” Kline said. “We have to look to other sources.”
The community activist from St. Johnsbury, also featured heavily in “Here Today,” advocates for expanded integrative healthcare.
Last week, he also touted a program in NEK schools where community health workers meet with “disruptive” children in a family room in the school. Kline said most of these children are experiencing opiate-related stress at home 50 to 75 percent of the time.
Jolinda LaClair, director of drug prevention policy in Gov. Phil Scott’s administration, said prevention is the first tine on a four-pronged approach to fighting the state’s opiate crisis, followed by treatment, recovery and enforcement.
LaClair will oversee Scott’s 21-member Opioid Coordination Council, which will release a set of recommendations in the coming months.
Rep. Ann Pugh (D-South Burlington), who chairs the House Committee on Human Services, said Vermont is a nationwide beacon for states with their own epidemics. She plugged Vermont’s prescription monitoring, clean needle exchanges, methadone clinics and hub-and-spoke model.
The latter, signed into law in 2012 by Gov. Peter Shumlin, connects “hubs” of clinics with medication-assisted treatment with “spokes” of three-person clinician teams assigned to every 100 patients for counseling and other health services.
Vermont was only one of four states to “make progress” in combating the opioid epidemic, measured in the National Safety Council’s 2016 report “Prescription Nation.”
It wasn’t always that way, though.
Kline moved to Vermont in 1994 in part to escape the drug scene in Connecticut.
“We heard Vermont was a safe place,” he said.
He learned that wasn’t necessarily the case when his oldest daughter, Jennifer, shot up heroin with a friend, chasing the promise of relief from debilitating migraines.
Another panelist heard a different characterization of the picturesque state before his move here.
“‘You’re going to find there’s a lot of heroin up there,’” Burlington Police Chief Brandon del Pozo recalled his colleagues saying when he retired from the NYPD force.
Sure enough, Burlington Mayor Miro Weinberger tasked del Pozo with finding a non-traditional police response to fighting opiates on day one of the job.
Thousands of police departments nationwide are all waging the same war, del Pozo said, and “you’d have thought we’d figure it out already.”
Part of the problem, he thinks, is in that disparate response.
“We’re all sort of at a loss for what solutions we need,” he said. “This is such a complex problem; it’s almost like each of us trying to build a rocket ship on our own and send it into space.”
He emphasized police are on the front lines of every facet of the crisis: When an addict scores, when they overdose, when they get arrested, when they die.
There’s a disconnect between the problem and the resources, but if any government agency has the ability to “be that bridge,” del Pozo offered, it’s police.
“Good policing is a relentless occupation,” he said. “Good cops aren’t hedgehogs – they’re foxes.”
Foxes know they can’t arrest their way out of the problem, he added, and a drug like heroin will require unyielding, substantive work and a collective eradication of dogmatic thinking.
“Drugs work very well until they don’t anymore,” Kline said, recounting his daughter’s demise into a “heroin hole” – eight years of treatment, detox, homelessness and shelters punctuated by stints in school or work.
“Jen was not ready for help, and when she was, there was none available,” he said. Jennifer died at 27 on Feb. 15, 2009.
Nearly exactly two years later, Lowell got clean.
“At that time, our community was not talking,” she said. “My shame … stood in the way of my ability to ask for help.”
All panelists unequivocally agreed: Curbing the state’s epidemic partially hinges on de-stigmatizing addiction.
“It’s not like people wake up in the morning and decide their life goal is to be an opioid addict,” Holmes said. “[Addicts’] biggest problem is a profound lack of self worth.”
That thread bound the stories of Lowell, Jen Kline, Margaret, Holmes’ pediatric patients and the dozens of other addicts featured in O’Brien’s films.
“We have gotten to a place where most of us, I hope, realize this is a disease,” O’Brien said. “These are our neighbors, these are our family members, and we have to treat people with respect and dignity.”
For Lowell, that means engaging people in recovery in the myriad conferences, task forces, committees, rallies and dialogues all dedicated to the problem.
For the larger community, the night’s message was clear: Look beyond “the old way of thinking,” Lowell said, that addiction is a reflection of someone’s values. “Anyone can end up in trouble.”
Be patient with people in recovery, she added, as they must find value in a world that told them they had none. And for those still struggling, a gentler refrain.
“Recovery is possible,” O’Brien said.
“Never give up,” Kline offered. “That’s our motto.”
Vermont PBS continues its network event “The Opiate Crisis: Stories and Solutions” this week. Visit www.vermontpbs.org/