Combating substance abuse requires long-term coordination and funding


The MV Times addiction series, which began on January 2 with“Opiate addiction on Martha’s Vineyard hits home” and the on-target Editorial of February 27 [Time for concerted action, community strategy] bring home the base reality and attendant consequences of substance abuse. The recent rash of heroin-based overdoses and associated deaths focus public attention on what is a long-term and persistent health problem.  The prevalence on Island is exacerbated by seasonal employment and isolation.

The question posed in last week’s editorial was: “How to do better?” Reaching more of our neighbors, coworkers, and family members with this condition requires three broad strokes:

First, while the Island has specific components for treating addiction — e.g. prescribers, outpatient counseling, sober living, 12-step meetings for adults, and youth prevention efforts — the Island doesn’t have a funded, coordinated system of care. The Island lacks a capacity to detoxify and establish medical stability, that can hand the patient off to an intensive outpatient or residence-based continuing care system, that is followed with integrated medication and counseling based outpatient care for family and patient as appropriate, and where recovery is supported by peers over time.

Second, concerted and more consistent screening and identification of substance abuse by primary care physicians, school staff, the emergency department, first responders, and other related parties can increase the opportunity to connect people with local treatment resources.

Third, as with any chronic health condition, the key to controlling and improving the condition is ongoing follow-up. This is difficult to achieve when detoxification is done 50-plus miles across the water; where no organizational or other connection between a medication provider and counselor exist; where the primary medical provider is not connected to the whole episode of care.  At the crux, this isn’t about collaboration between organizations; it’s about making continuity of care into a seamless, coherent experience for the patient and their family — here, locally.

Martha’s Vineyard Community Services (MVCS) and our partners, including the Martha’s Vineyard Hospital, Island Health Care, Vineyard House, Youth Task Force, Vineyard Health Care Access, law enforcement, and the court system, schools, town boards of health, private practitioners and other interested parties have participated in several planning efforts over the last decade that have come to the same conclusion — a seamless system of care is vital, and each iterative effort has resulted in meaningful, but small steps.

A case in point.  The New Paths Recovery Program run by MVCS, the only intensive outpatient recovery program on-Island — and the result of the most recent community effort to do something to address this problem — has served more than 350 Island residents since its inception in late 2010. New Paths is funded in part by a generous Martha’s Vineyard Hospital grant, which will expire in January, 2015. The program’s future is unknown, as it lacks the requisite financial base.

The long-term funding of New Paths and increased coordination of current services, as well as the addition of services not currently available on-Island for those suffering from substance abuse and their families, will take a determined focus that cannot waiver.

Substance abuse and the devastation it causes to individuals, their families, and the community is not new. Substance abuse will not simply go away.  As a community, we can do better and we must do better, and the time is now.  It will take money, time, community commitment, and creativity.  Let’s take a giant step forward and actually create the necessary system of care and ensure its long-term sustainability.  Attention to this issue must be defined in years, not months.

Victor Capoccia is the board president of Martha’s Vineyard Community Services. Juliette Fay is the executive director.