Battling addiction on Martha’s Vineyard

Substance abuse counselors Dianne Mackellar (left) and Hazel Teagan, seen here at the Vineyard House groundbreaking, are available 24 hours a day to Islanders in need, by calling 508-693-0410.
Photo by Ralph Stewart

Substance abuse counselors Dianne Mackellar (left) and Hazel Teagan, seen here at the Vineyard House groundbreaking, are available 24 hours a day to Islanders in need, by calling 508-693-0410.

As the rising tide of addiction strains treatment resources on the Island, a dedicated few make sure that help is still available.

Updated 4:25 pm, Thursday, May 8, 2014.

This is the fourth installment in a continuing look at opiate abuse and its effect on the Island community and Islanders. The series began on Jan. 2 “Opiate addiction hits home,” and was followed on Jan. 22 “Martha’s Vineyard police and physicians confront opiate abuse,” and on Feb. 12 “Opiates, a love story.”

On March 27, Governor Deval Patrick declared opioid addiction a public health emergency in Massachusetts. He entrusted $20 million to the Department of Public Health (DPH) with a mandate to combat overdoses, to slow the spread of the epidemic with prevention and education, and to map a long-term solution for the Commonwealth.

Martha’s Vineyard is not immune. Six Islanders have died of opiate overdose since August, according to Dr. Charles Silberstein, psychiatrist and addiction specialist at Martha’s Vineyard Hospital. Island-wide, there was one heroin arrest in 2012 and 10 heroin arrests in 2013; in 2012 there were 13 arrests for oxycodone and percocet pills, in 2013 there were 15 arrests. Anecdotally, Island law enforcement, counselors, and physicians say that opiate addiction, and the crime that invariably comes with it, have become a scourge on the Island.

“We definitely feel it in the emergency room,” Dr. Jeffrey Zack, director of emergency medicine at Martha’s Vineyard Hospital, told The Times. “We’ve seen a big rise in cases related to opiates and heroin.”

Dr. Zack said that people often come to the emergency room (ER) for services the hospital doesn’t provide, which can take up valuable beds, sometimes for days.

“We want people to feel this is a safe place to get help. We’re the backstop on the Island, and we won’t turn anyone away. That said, we’re not a detox facility or a psychiatric facility. If it’s not a life-threatening situation, the first call I’d make would be to Hazel or Dianne,” he said, referring to Hazel Teagan and Dianne Mackellar, the substance abuse counselors at the hospital, who between them have close to 70 years of experience.

Tenacious team

“All they have to do is call the main number at the hospital, 508-693-0410, and ask for the substance abuse team,” Ms. Teagan said. “Either Dianne or myself will get beeped and we’ll answer the call.”

Even though the substance abuse team is inexplicably absent from the hospital website, Ms. Mackellar and Ms. Teagan are available via the hospital main phone number, 24/7.

“We do a lot of work on the phone, educating people, giving phone numbers to call, and finding beds for people who need them,” Ms. Mackellar said. “Hazel and I work very closely together. We know the ins and outs of a system that can be very complicated.”

Ms. Mackellar also encouraged people to call rehabilitation facilities directly. “I’d definitely recommend calling a place like Gosnold and getting on the list,” she said, referring to Gosnold addiction treatment center on the Cape, where a high percentage of Islanders have gone for treatment. “They don’t need a referral. Sometimes it can take a while, but if you call every day, you’ll get a bed.”
Ms. Mackellar said it has to be the addict, not a loved one, who makes the call. “That call is significant,” she said. “It’s the addict saying ‘I want to do something.’”

Detox deficiency

Ms. Teagan said the absence of a detox facility on the Island is a significant shortcoming. “We had a facility here and it was wonderful. It was small but it worked. It also saved a lot of people from relapsing. But after the hospital filed for Chapter 11, the detox unit was one of the first things to go,” she said, referring to the hospital bankruptcy filing in December 1996. “It hasn’t come back, and I don’t know if it ever will.”

“The numbers just aren’t there,” Tim Walsh, Martha’s Vineyard Hospital chief executive officer, said in a phone call with The Times. “I get a lot of grief about this, but it’s a very expensive proposition. You’d need at least three full-time doctors, and nurses and support staff. The population here doesn’t support it.”

Ray Tamasi, President and CEO of Gosnold, agreed with Mr. Walsh. “A detox facility on the Island has been swirling around for a number of years,” he said. “Over the long haul, it’s probably not sustainable.”

Mr. Tamasi also said that opiate addiction requires a different modality of treatment. “With the opiate crisis there’s been a clamor for more [detox]beds. I have a different take on that. If we were building a new health care system, would we focus all the attention on building emergency rooms? Eighty-seven percent of patients admitted to detox in Massachusetts are returning patients; 55 percent have five or more stays in detox. If you had 20 more beds they’d be filled in two weeks. We’re focusing on extended engagement after they leave.”

A pilot intensive outpatient program (IOP) at Gosnold for addicts between 18 and 28 years old is yielding promising results. “There is a 75 percent decline in admissions to detox units, almost complete elimination to hospitals or ER, and no issues with the law,” Mr. Tamasi said. “Detox is only one compartment of care. The biggest challenge is to manage the condition for life.”

Outpatient options

Recovery on a small island means many of the recovery groups, and the people in them, overlap. “The recovery community on the Island is very tight,” Jeremy Norton, director of Dukes County community corrections center said. “People who are committed to their recovery tend to look out for each other.”

Mr. Norton works with recovering addicts who are released on probation. “If someone gets a GED while they’re with us, they’re much less likely to reoffend,” he said. “They’re also less likely to reoffend if they know they’re getting drug tested.”

Two pillars of the Vineyard recovery community are New Paths Recovery Program, the only long-term outpatient facility on the Island, and Vineyard House, the Island’s only sober living facility.

“We’re very fortunate to have programs like New Paths and Vineyard House on the Island,” said Ms. Teagan, who is also a co-founder of Vineyard House, which was established in 1997. “People can live in a completely sober environment at Vineyard House or, depending where they are in their recovery, they can live at home and go to intensive outpatient treatment at New Paths as well as Narcotics Anonymous (NA) or Alcoholics Anonymous (AA).”

Drug testing is a way of life at Vineyard House. As house manager Rick Manning spoke to The Times, he cheerily handed a cup to a resident. “It’s got chemicals at the bottom so drugs and alcohol show up right away,” he explained. “You don’t get three strikes here. If you test positive, you’re out.”
All Vineyard House, residents are required to pay rent, to attend support group meetings, and to participate in house meetings.Mr. Manning became a resident at Vineyard House in April,  2010, after coming back from his fourth detox. As he was being discharged, the counselor told him that his mother had called to say he was not welcome in her home.

“When you lose the respect of your mother, that’s bad,” he said. “When I came back, I knew I wasn’t ready to hit the street, so I got into Vineyard House.”

Now Mr. Manning is a house manager at Vineyard House. He’ll be four and a half years sober on September 15. He’s working steadily and has reestablished ties with his daughter. “I’m proud of my recovery, and I don’t hide my disease from anyone,” he said. “I’ll stand on a rooftop and scream ‘I’m an alcoholic.’ Now people turn to me and I’ve been able to help. That’s a great feeling. Now I can go to functions where alcohol is being served and it doesn’t bother me. That’s a great feeling too.”
Vineyard House is about to expand. Following a successful fundraising campaign, on Monday, May 5, Vineyard House officials and supporters broke ground on the new Vineyard House campus on Short Hill road in Vineyard Haven.
While the future looks bright for Vineyard House, there are clouds on the horizon for New Paths Recovery Program, which operates under the umbrella of Martha’s Vineyard Community Services. New Paths began operation in 2010, funded by a one-time five-year grant from Martha’s Vineyard Hospital. The New Paths IOP program is the first stop for recovering addicts returning to the Island from detox. New Paths also offers other programs for people in various stages of recovery. Since its inception, New Paths has served over 350 recovering addicts on the Vineyard. But now it’s running at a deficit and when the hospital grant ends in December, another $51,000 will be lost from the ledgers.
“The grant from the hospital was finite from the beginning,” Jill De La Hunt, program coordinator at New Paths, said. “Insurance companies were projected to pay for a sizeable part of the cost, but they approve fewer and fewer sessions, and they also required licensed therapists to call them about billing, which takes up a lot of their time.”
Ms. De La Hunt said no one is turned away from New Paths for financial reasons. If someone comes to New Paths without health insurance, a staff member will help them through the application process.
She thinks there is a need for on-Island detox. “A detox facility is a real community need,” she said. “We have people coming to us needing more than we can provide medically. If the numbers don’t support an inpatient detox facility, we could have ambulatory detox and outpatient detox, which was offered here in the past. Some people just don’t have the means to get treatment off Island.”
Although the financial future is uncertain, Ms. De La Hunt remains optimistic that New Paths will continue to serve the Island. “We get all kinds of community support,” she said. “I think that’s the silver lining. We get in-kind donations from businesses and from individuals and that sends the message that the community cares, which is very powerful. The support from the community means people want them to be healthy and want them back.”

Correction: The original story stated that Richard Manning has been a resident at Vineyard House since May, 2012 and has been sober for two years. Mr. Manning has been a resident at Vineyard House since April, 2010 and will be sober four and a half years on September 15, 2014.

For help

For an overview of recovery options to Islanders, call Martha’s Vineyard Hospital, 508-693-0410, and ask for substance abuse counseling.

Off Island medical detox/extended inpatient care

Gosnold, Cape Cod: 1-800-444-1554gosnold.org

High Point treatment center, Plymouth: 800-922-7703 hptc.org

AdCare hospital, Worcester: 1-800-345-3552  adcare.com

Private inpatient programs

Farnum Center, Manchester, N.H.,  603-622-3020estreatment.org/farnum-center

$12,000 for 30-day inpatient care. $3,400 for medical detox.

Plymouth House, Plymouth, N.H., 800-428-8459theplymouthhouse.com

$6,860 for four weeks. No medical detox available.

High Watch Recovery Center, Kent, Conn., 860-927-3772,highwatchrecovery.com

$8,337 for minimum 22 day stay. $11,193 for one month.  Will arrange off-site medical detox.

On-Island resources

New Paths Recovery, 508-693-7900  mvcommunityservices.com
Vineyard House, 508-693-8580   vineyardhouse.org

Alcoholics Anonymous, 508-627-7084  alcoholics-anonymous.org

Al-Anon/AlaTeen, 508-394-4555  ma-al-anon-alateen.org

Narcotics Anonymous, 866-624-3578na.org

A full schedule of meetings appears in the Calendar section of The Times.

 



Comments

  1. Justanative says:

    The numbers are there Mr.Walsh. There are soo many addicts on this island.6 deaths is 2013?? I know a couple of people that tried to get in to Gosnold ..calling every day to be told..sorry no beds yet,you are on the list just keep calling. It’s time we step up and take care of our own! Everyone on this island is either related to,friends with,knows of or is/was an addict. The number is ridiculous and many of the addictions started with medical care..now we need to give the medical care to help them.As amazing as Diane and Hazel are (and they really are good hearted,amazing woman) they can’t do it on there own. Time for MVH to provide adequate care for addicts.

    1. E.L. says:

      And it would be interesting to see how many of those six were also on other narcotics or alcohol. That’s six out of how many patients on the island treated with opioid painkillers since August? We don’t know, because the Times reporters are unfortunately to lazy to ask for those numbers or are just driving up newspaper sales by reporting hype. It’s time to start interviewing pain patients on the island who have seen their quality of life improve because of these medications not just the unfortunate souls who abuse and become addicted, and sometimes die. And don’t just rely on Dr. Silberstein. There are other psychiatrists, with addiction specialties, that may have a different more nuanced opinion.

  2. Vineyard Haven Strong says:

    Well put

  3. Lisa Pachico says:

    I for one am extremely grateful to Diane and Hazel. Diane saved my life when she helped get me to treatment. Hazel has done the same for many people I love dearly. Thank you very much! I 100% agree with justanatives comment. MVH just built a huge hospital. Where’d they get money for that?? Its time to start taking care of people who are in the grips of addiction. So what if they’ve relapsed and return for the umpteenth time, cancer patients whose disease returns doesn’t have that said about them!!! There’s many ways to help get addicted people clean and the whole community needs to come together and share their knowledge of this deadly disease, come up with a game plan and put it into action. The Vineyard house has been a Godsend. Get rid of what doesn’t work and apply what does. It doesn’t cost a penny to start a committee to research this problem, gather information then start building a life saving solution. Seriously, Martha’s Vineyard is one of the richest resorts in the world. Start using resources. Lets get into the solution instead of staying stuck in the problem. If the hospital can remodel, they can add a detox!!!!

    1. Barb says:

      Considering that MVH built a monstrosity of a building with a cathedral ceiling in the inviting entryway. So much wasted money when there were much needed help for our friends and family.
      Hazel is one of the best most helpful and I’m sure Diane is the same as they have to be to see and hear and help those in need of this.
      Wouldn’t it be great if MV was more self efficient.
      Dr Zack, Dr Maxwell, Dr Silberstein and many of our health care providers and Community Services and their counseling staff are A1.
      Maybe they CHOSE not to deal with that elephant or ‘embarrassment’
      Remember MV is a beautiful wonderful tourist destination. MV does not appear to have THOSE issues. How could we?
      I’m sure management and their family can get excellent care.

      1. Justanative says:

        Exactly right..Top dogs CHOSE not to deal with it..they didn’t want “addicts” dirtying there pretty new building

  4. E.L. says:

    Yet again, a story by the Times on this serious issue without any comment or comparative statistics from pain specialists or patients. It’s as if there are only patients who are prescribed these meds, who turn to addicts and then go on to Heroin and die of overdose. When in fact, the majority of legitimate pain patients prescribed opiate medications treat their suffering and live a certain quality of life without abusing or overdosing.
    Here are few figures worth noting: According to the CDC there were 16,651 deaths in 2010, more than cocaine and heroin combine–as is often reported by this and many other media. But what the media rarely mention is that nearly 29.4 percent of those deaths involved only opioids. Many of those deaths, roughly 30 percent, involved benzodiazepines. Alcohol, was also involved in many of those overdose deaths. According to the CDC, 443,000 Americans die nearly every year from cigarette smoking, and more than 80,000 die annually from alcohol use. NSAIDs kill between 7,000 and 10,000 American adults a year. Another study, by the University of Rochester, found that non-opioid analgesics and psychotropic agents are more likely than opioid analgesics to be associated with drug poisoning overdose.
    Perspective and balance has been sadly missing from this ongoing series of articles. Yes, the roughly 17,000 poor souls who abuse and overdose on opioids is 17,000 too many, but that is 17,000 out of over 200 million pain patients treated every year, legally and without overdosing.

    It’s time for real pain patients to add their voice to this ongoing media frenzy over these pain medications.

    1. yerpski says:

      200 million? That’s about two thirds of America. Typo?