Chilmark selectmen discuss Vineyard substance abuse crisis

Chilmark police chief Brian Cioffi in November 2016 announcing his resignation as chief. – Edie Prescott

Chilmark selectmen on Tuesday, Nov. 1, were not short on real issues to confront. They addressed the serious substance abuse problem Island-wide, and discussed growing kelp and mussels together.

Marina Lent, Chilmark board of health administrator and inspector, was on hand to walk selectmen through a report completed by the Rural Scholars, a group from UMass Medical School who spent two weeks on the Island compiling data.

Substance abuse data from Rural Scholars

“One person under 30 is dying every month from substance abuse disorder on Martha’s Vineyard,” according to the report, which also states that “1,450 people are dealing with substance abuse disorder on the island (66 percent of which is alcohol and 33 percent of which is drugs — with a large amount of overlap).”

The report addresses emergency room visits as they relate to substance abuse going from about 5 percent in 2010 to about 10 percent in 2015. These are just the people who got into medical trouble; there are also the ones who end up with the police, and ones who remain below the radar.

There have also been 19 Narcan administrations in the first five months of 2016, according to Karen Casper, M.D., affiliate medical director for EMS at Martha’s Vineyard Hospital, who was credited in the report. Narcan reverses the physical effects of opioids.

“There has been a recent, sharp increase in anxiety, fear, and attention to the problem,” Ms. Lent said. “There was data collected from mortality to hospitalization, to law enforcement, to people who go for treatment both on- and off-Island.”

Ms. Lent will be heading a substance-abuse-disorder committee of the health council to update and refine the data that has been collected, with “the aim to get something that is aggregate to the Island, valid in terms of data collection, and HIPAA-compliant, so we can say, ‘This is what’s happening on Martha’s Vineyard,’ so we would know five years from now, Is it getting better? Is it getting worse?”

The medical students also directly interviewed people suffering from substance-abuse disorder, and family members who have tried to help them.

Early intervention, education, and prevention were found to be of key importance, but the students also uncovered a need on Martha’s Vineyard for a facility to help people with substance-abuse disorder.

“We don’t have a drug detoxification center on Martha’s Vineyard,” said Chilmark Police chief Brian Cioffi. “That is an issue. That needs to be fixed.”

“Our hospital is not a licensed detoxification center,” Chief Cioffi said. “If they’re drunk and they’re not in a medical risk, they go to the jail and sleep it off. If they are a medical risk, we employ the ambulance service and get them to the hospital.”

“People who come for treatment are the tip of the iceberg,” Ms. Lent said. “The only crack we get at the iceberg below is when they get in trouble — they get arrested, they get medical trouble — those are the unwilling, but end up on the radar.”

“We’ve known for a long time that early use of substances, whether alcohol or narcotics, affects the brain because the brain is still developing,” Chief Cioffi said.

“We know that for whatever reason there is a cultural belief that it’s OK on Martha’s Vineyard, that it’s a rite of passage, but we don’t agree with it,” Chief Cioffi said. “The study hit on a point that we’ve been talking about for years. Nobody in this room is immune to this issue, trust me.”

“As I’m listening to this, this is a huge issue,” selectman James Malkin said. “This is a board of selectmen meeting. What could selectmen do to be helpful in this process with this problem?”

“What you are doing by putting it on the agenda — and saying that this is an issue that the entire community needs to pay attention to — is a contribution,” Ms. Lent said. “This is an insanely complex issue.”

Chief Cioffi agreed. “This is not a down-Island issue or an up-Island issue; it is an Island-wide issue,” Chief Cioffi said. “The best thing we could do is generate more funding so we can increase the number of people who are working full-time on a task force.”

Currently, the chief said, the task force is made up of a couple of people from each town who do it on a part-time basis. “We can’t pull people off patrol,” Chief Cioffi said.

The red house

Chief Cioffi discussed “the red house” at the hospital, and how it was talked about being a temporary alcohol and drug detoxification center, but that it remains an administrative building.

“Getting a place that has some beds with the right counsel is a good thing,” Mr. Cioffi said.

Chief Cioffi would like to see the red house at the hospital become a temporary detox center for a crisis stabilization period, which has been talked about for a while. “God knows probably some state code changed, and now they have to change the door sizes,” he said.

Ms. Lent said the Vineyard House provides a living space, but it does not provide programs and does not provide inpatient treatment.

“Something needs to change,” Chief Cioffi said. “I’d love them to stay in rehab for six months or a year to make sure it takes the full effect, but that’s not possible. The hospital does what they can do with what they have. I wish we could have more.”

Matt Montanile of Tri-Town Ambulance said he is “stuck in one small role.” They just drop off at the hospital, and their protocol does not allow for follow-up. Mr. Montanile feels his group could play a role in prevention and possibly go into the schools to tell children “why not to do this.”

Selectmen approved writing a letter to Joe Woodin, the Martha’s Vineyard Hospital CEO, asking what is being done with the red house, and what is being done to get a detoxification center on the Island.

Growing mussels and kelp together

Scott Lindell from Woods Hole Oceanographic Institution (WHOI) told the selectmen about a proposal for growing kelp at a site in Vineyard Sound. The grant, which has been used for blue mussel cultivation, is owned by Stanley Larsen of Larsen’s Fish Market in Menemsha, who was present at the meeting. Also present were Rick Karney, director of the shellfish group, Isaiah Scheffer, shellfish constable, and newly appointed assistant shellfish constable Will Riech.

Kelp farming is funded by the National Oceanic and Atmospheric Administration (NOAA) and Mr. Larsen has “graciously allowed” Mr. Lindell to use his lease for the project.

Mr. Lindell has written a 17-page report on the project that details the proposal to integrate mussel and sugar-kelp longline culture structures and their management thereafter. Mussel and sugar kelp have been two of the fastest-growing sectors of marine farming in the Northeastern United States over the past 10 years, according to Mr. Lindell’s report.

Mr. Lindell highlighted the advantages.

“A farmer can diversify his crop, and a species of kelp called sugar kelp is gaining popularity among chefs and foodies all around the country,” Mr. Lindell said.

Mr. Lindell said it makes sense to integrate the cultivation of the two crops because it provides “better utilization of limited permitted sites (3D farming); both crops are being grown in the same basic longline structures on private leases in public waters; both crops share use of the capital costs of expensive anchors, buoys, and lines; better risk management for crop diversification; and lower risk to protected species by using fewer vertical lines.”

The time frame is to plant at the end of November and harvest in April.

“Fried kelp! I’m looking forward to it!” selectman Bill Rossi said; the comment was met with laughter, and led to a tangent on all the ways to enjoy kelp.

“Kelp is the new kale,” selectman James Malkin added jokingly.

Selectmen approved adding kelp lines as an experimental project to the authorized mussel grant.

Oil spills and the emergency response

Bret Stearns, director of natural resources for the Wampanoag tribe, addressed selectmen regarding emergency response to oil spills. Also on hand were Chilmark fire chief David Norton, harbormaster Dennis Jason, shellfish constable Scheffer, and Chilmark executive secretary Tim Carroll, who all participated in the drill.

The drill was run out of the Menemsha Coast Guard boathouse.

“I was quite impressed with the drill,” said chairman Warren Doty, “and I was impressed with everybody involved working so hard at it.”

Mr. Stearns provided some background.

“In 2003 there was the Bouchard oil spill,” Mr. Stearns said, referring to the April 27, 2003, event when Bouchard Barge 120 hit an obstacle in Buzzards Bay, creating a 12-foot rupture in its hull and discharging an estimated 98,000 gallons of No. 6 oil. “We did not receive a lot of direct deposits,” he continued, “but that we did receive some oil later upon our shores. This was a catalyst to create a ‘geographic response plan.’ The state funded each community to have an oil spill response trailer that has the boom and supplies that we use, and they are owned and maintained by the state.”

After 2004 the communities worked with contractors to create these “paper” plans.

In 2013 Mr. Stearns contacted Nuka Research, an environmental consulting firm, to come out and test an oil spill. “What we learned is that the water runs too swift,” Mr. Stearns said. “We had a hard time managing the boom, and it was relatively ineffective.”

A boom is a piece of floating plastic with a piece of material that hangs below it. An oil boom guides oil to another location, and Mr. Stearns talked about possibly guiding a local oil spill to West Basin.

“It’s not a very appealing concept to say we’re going to take oil and put it in West Basin, but oil spill response is making a horrible situation less horrible,” Mr. Stearns said.

“We took what we learned [from 2013] and applied it to the drill the other day,” Mr. Stearns said. There were lessons learned. “We can deploy what we have under certain circumstances — not in a raging tide,” Mr. Stearns said. “We need to organize our trailers a little better, we need to better prepare to get this done quicker, and we need to each have a communications person on our boat. We learned in 2013 that we work great together when we have a common cause, and the other day was no different.”

Selectmen thought that the fire chief would be the natural leader in an emergency situation to organize and deploy people and equipment.

“I can do two or three things at the same time,” joked Chief Norton, whose comment was met with audience laughter.

“Now that this works, we can pursue having permanent anchors on the Chilmark side and on the Aquinnah side so we’re not messing around with trying to secure it,” executive secretary Tim Carroll said.