Islanders marshal forces to fight opiate addiction

A "Recovery Team" t-shirt is held up by James Derick, president of the S.A.F.E. coalition. — Sam Moore

A town-meeting-size crowd filled most of the Martha’s Vineyard Regional High School Performing Arts Center on Monday night to take a collective stand against the rising and increasingly lethal tide of opiate addiction on the Vineyard.

Over the course of the evening, substance abuse experts, community stakeholders, and Islanders in recovery shed light on the insidious disease of addiction, the devastation it creates, and how families, loved ones, and communities can work in concert to overcome the growing scourge.

Were it not for the fact that some people on the dais had to catch the last boat to get home, the 2½-hour dialogue could have lasted much longer.

“Tonight is about a planned action,” Richie Smith, assistant superintendent for Martha’s Vineyard Public Schools, said in his opening remarks. “We’re looking to these proceedings to give us some direction. We don’t want folks to walk away feeling that this was just another meeting with no action.”

Mr. Smith shared the sobering results of a Dukes County Health Council survey that asked 50 Islanders on the front lines to assess the situation. “There’s agreement that the problem is severe, that it’s getting worse, and that it affects all age groups,” he said. “The extent of the problem is overwhelming available resources. Care is unanimously regarded as inadequate because of the lack of an inpatient detox facility, [a lack of] caregivers, long waits for medical care access, no residential inpatient treatment, and the inability of local groups to work together.”

Mr. Smith said that the survey replies should not obscure the fact that the Vineyard already has a dedicated core group of clinicians working tirelessly to help, and that the Island has more resources than many small, rural communities.

“This panel is a starting point, a representation of what we might do moving forward,” he said.

Understanding addiction

Four members of Narcotics Anonymous (NA) shared intimate, painful, and sometimes horrifying details of their battles, at times leaving the packed auditorium pin-drop quiet.

Their stories about their hard-fought recoveries, empowered by NA and the Island community, also elicited thunderous applause. Each speaker, in keeping with NA policy, was identified by his or her first name, and in some cases an initial.

“We used to be the people you read about in the obituaries and in the court report,” contractor Bill P. said. “Our parents would be up all night, wondering if the phone would ring, and if it was the coroner calling.” Bill P. said he started shooting heroin in his teens, went to his first detox at age 21, and got clean at age 32. He celebrated 20 years clean this February. “We’ve found a new way of life, and we’re living proof that recovery is awesome,” he said.

“What we represent here is a lot of hope, and I suspect there are some people here that need hope,” Bill H. said, adding that he has more than 16 years clean time, or 6,034 days, to be exact: “Today my life is unrecognizable compared to what it used to be.”

Bill H. said his life was off to a great start, New England boarding school and Ivy League college, before addiction derailed him. “In the end, I wasn’t alive in any real sense of the word,” he said.

As in the case of Bill P., one trip to detox wasn’t enough for Bill H. “Not everybody gets it the first time, but you don’t give up,” he said. “Thinking about it as a disease helps; you don’t get turned away from the hospital for having a second heart attack.”

Eventually, three trips to Gosnold later, Bill H. gained his footing, moved into Vineyard House in 1999, and became active in NA, where he began a successful business which he runs today.

“Our job in NA is to keep doors open and to keep hope alive,” he said. “In NA we have the sense of surviving the same near-fatal catastrophe. For whatever reason, that tames the endless onslaught of obsession that is addiction. I’m not a doctor, but I know this beautiful, mysterious solution we found in NA, and I’ve seen it change the lives of many, many people. The sickest people, the ones that you don’t know what to do with, we want them. Please send them to us. We know what to do.”

There was nothing about Kelly M., a fresh-faced, well-spoken, effervescent  young woman, that hinted of a past of heavy drug use, blackout drinking, and jail time. “I was born and raised here in a loving family, with a lot of happy memories of summer camps, school sports, dance lessons, and sleepovers,” she said. “I mention this because there is no such thing as a typical addict. Addiction doesn’t care who you are or where you’re from.”

Kelly said her addiction kicked in at age 13, after her father died. After years of substance abuse, skipping school and acting out, she hit bottom, when a few days before high school graduation, she was driving drunk and had an accident that killed her best friend.

“Some of you probably remember that,” she said. “It’s been seven years and five days since that accident. Change happens slowly, and not a day goes by when I don’t think about her. Now, I’m in school, and in two years I will graduate with my master’s in licensed mental health counseling, and I intend to come home to work afterward.” Kelly said two years ago she found a close friend dead from an overdose, and was tempted to use again. “Through NA, I knew that was my addiction talking. I knew that using wouldn’t bring him, or my friend, or my dad back. I have seen miracles happen in the room in NA, not just with my life, but with many other people.”

Emmett, 22, a sturdily built young man with the tan of an outdoor tradesman, nervously stumbled over his words, then he shifted gears. “I have 15 months clean time; can you guys please clap?” After the applause died, Emmett spoke about his extensive arrest record, doing jail time, shooting heroin, and all the bridges he’d burned. “It’s a miracle that I’m here today,” he said, adding that addiction runs deep in the family. He said moving to the Island and joining NA eventually enabled him to gain a foothold. ”This was the only place left for me,” he said. “NA is my family, and I’m endlessly grateful for that.”

The disease of addiction

Catherine Dotolo, LICSW, director of special projects at Gosnold on Cape Cod, an addiction treatment facility, spoke about the physiology of addiction, the additional collateral damage it does to the brain, especially younger brains, and how that damage can be reversed over time.

“Addiction is predictable; we know that genetics play a big role, as do emotional or psychological disorders,” she said. “Research has indicated that young people who begin to use substances before the age of 16 are 40 times more likely to develop addiction than those who wait until after age 21. The brain is not fully developed until between ages 21 and 26.”

Ms. Dotolo said research shows addiction saps motivation and memory, and leads the addict to irrationally pursue the reward.

“Areas of the brain are hijacked by substances,” she said. She described how drugs induce the pleasure center in the brain to release more dopamine, the “feel good” chemical of the body that is also released with exercise: “Dopamine becomes the primary motivator in their lives, to the point where they engage in behavior they never would have engaged in.” Ms. Dotolo said that disturbances in the brain caused by addiction can lead to the decline of moral reasoning and clear cognition — the voice that tells someone not to get behind the wheel while intoxicated is silenced.

“When the reward circuit is overstimulated, you’re not able to perform rational decision-making,” she said. “When the chemical messaging of the brain is constantly disrupted, the person needs more and more just to feel normal. Over time, the brain loses the ability to enjoy activities that used to be pleasurable — the girl who loved playing soccer decides it isn’t fun or important anymore.”

Ms. Dotolo also brought hope. “The great news is that these [brain] pathways can be repaired,” she said. “It’s not a quick fix. It can take 14 months for the brain to repair. Detox won’t do it alone. Willpower cannot do it alone. It takes time, it takes [drug] abstinence, it takes therapy, and it takes the kind of long-term engagement that NA can help provide.”

Forming a coalition

The stated purpose of the evening was to lay the groundwork for a proactive, Island-wide network to confront the opiate crisis head-on.   

To that end, West Tisbury Police Chief Dan Rossi introduced Jim Derick, a close friend from Franklin, who founded S.A.F.E. (Support for Addicts and Families through Empowerment).

“S.A.F.E is a coalition that covers six different towns in Norfolk County — imagine that, six different towns can work together one project, what a concept,” he said, eliciting knowing laughter from the room.  

Chief Rossi said he quickly saw that S.A.F.E. could be a model for an Island-wide plan. When Mr. Derick agreed to speak at Monday’s event, he also shared the 65-page S.A.F.E. business plan. “There’s no reason to reinvent the wheel,” Mr. Rossi said. “We can take this business plan and adapt it to the Island, and hopefully, it will work.”

“This community-coalition idea certainly isn’t mine,” Mr. Derick said. “All the ideas I’m going to share tonight are from other coalitions. There are over 28 coalitions in Norfolk County alone, and many more across the state, supported by grants.”
Mr. Derick stressed that he was an insurance salesman, not an expert in the recovery field. “Stigma and shame that a family feel when one of their own has a drug or alcohol problem is enormous,” he said. He described his shame and verbal dodging, which went on for years, when people asked about his son Jack.

After Jack miraculously survived a high-speed, single-car accident, Mr. Derick said he spoke at a memorial service for a young man who’d died of an overdose. “I looked out at the audience, and I said, ‘My son, Jack Derick, is an alcoholic and an addict,’ and at that moment, the weight of the world came off my chest,” he said. “As a parent, one of the frightening and most difficult things is to find your child help, even if they’re ready to go.”

Mr. Derick said S.A.F.E. began at a community opiate meeting of police officers, EMTs, clinicians, recovery workers, politicians, and concerned citizens, who had gathered to discuss an action plan. “They had that first coalition meeting, just like this,” he said.

Mr. Derick said over time, the coalition took shape. “The goal is simple — to create a place where people can turn and to reduce the barriers to getting help,” he said. “You can do the same thing here, so when Chief Rossi has someone in a holding cell, he can get a recovery angel to that person. He can get someone from Gosnold on the phone and get them into detox. He can get someone who can talk to the family about Section 35.”

Mr. Derick said the creation of  a 24-hour hotline and “drop-in centers,” which are located in various churches in a rotating order, have been particularly effective.

“A drop-in center is like a health fair for addiction. There’s tables for NA, AA, Alanon, various treatment centers, and most important, there are recovery angels who are able to take you by the hand and guide you through the process,” he said. “You or your loved one can be placed in detox that night, or certainly by the next morning. In Bridgewater, in less than a year, [drop-in centers] helped 227 people go into treatment. Over six sessions, we got 17 admitted to treatment. In off-treatment hours, we had three times as many through the hotline. That’s all just by saying our doors are open. What would have happened if our doors hadn’t been open? We were you 10 months ago.  All you need is to get moving.”

The first meeting of the Martha’s Vineyard S.A.F.E. coalition will be held at 10 am Thursday, June 10, at the offices of the Island Wide Youth Collaborative across the street from the Regional High School, in the back parking lot of the Community Services campus.

A complete list of Island support services for substance abuse disorders can be found at the MV Community Forum Facebook page.

Families who want free legal advice on getting their loved one into mandatory treatment (Section 35) can call a hotline sponsored by the Massachusetts Bar Association at 844-843-6221.

Correction – an earlier version of this article incorrectly state that Mr. Derick’s son had a needle in his arm at the time of his automobile accident.