In-patient detox is a critical step on the road to recovery for people with substance use disorder (SUD); historically, it has been a gaping hole in SUD treatment on Martha’s Vineyard.
The newly signed memorandum of understanding (MOU) that Martha’s Vineyard Hospital (MVH) and Martha’s Vineyard Community Services (MVCS) have crafted with two off-Island detox centers — Gosnold in Falmouth and Stanley Street Treatment and Resources (SSTAR) — fills that hole, and represents a quantum leap in SUD treatment on the Island.
Prior to the MOU, the lack of an on-Island detox facility, combined with the acute statewide shortage of detox beds, added another layer of difficulty for Islanders to an already fraught and time-sensitive event.
“People’s resolve to get clean wanes after a period of time,” MVCS executive director Julie Fay told The Times. “There’s a little window, and the hopelessness of not getting a bed can close it very quickly.”
MVH CEO Joe Woodin told The Times the new agreement is an immediate, cost-effective way to compensate for the lack of an on-Island detox facility.
“It’s really not feasible or practical to open up detox beds here on the Island,” he said. “We don’t have the volume, we don’t have staff; there’s so many reasons. Money isn’t the issue. Even if someone donated a check, you can’t create vibrant group sessions with folks going through detox when there’s only two people in the room.”
Mr. Woodin said there are also advantages to detoxing off-Island: “When you go to detox, you want to be cloistered, away from family and friends. You don’t want ready access to all the people you used to know.”
Previous to the new agreement with SSTAR, an Islander had little or no chance of getting a bed there unless he or she stayed in Fall River the night before, and even then there was no guarantee.
“SSTAR works on a first-come, first-served basis,” Mr. Woodin said. “They open at 7 am,. and the people who are there and reasonably sober get in. With the ferry schedule, we could never get someone there in time. Now, we can call [SSTAR] at 11 pm, tell them we need a bed, and they’ll say, ‘OK, have them here by 11 tomorrow morning.’ This is a real change for them.”
Although the new MOU was officially announced Jan. 2, trial runs quietly began in November. “We decided not to announce it to the public until we worked out the details and ran some people through it,” Mr. Woodin said.
Ms. Fay said that the program was put to the test immediately — an Islander was placed in a detox facility within 24 hours of the MOU signing in November.
“We got the call at 4 pm on a Wednesday afternoon, and I thought, well, here we go,” she said. “I called a recovery coach, and made the connection between the two people. The recovery coach talked to the relative of the person who wanted to go, and talked to the person, and then he called Gosnold. As it turned out, the Gosnold intake person most familiar with the process was gone for the day. As part of [the MOU], there was an understanding that while we’re working out the kinks, if something went wrong, we would call the CEO of Gosnold or SSTAR. Before I called the CEO, the recovery coach called me back and said they had an intake appointment at Gosnold for 7 am the next day. We were shocked how fast it happened.”
To date, six Islanders have been checked into inpatient detox through the new program.
“We had a chief of police call the hospital substance use disorder (SUD) number one night about someone in crisis, and that person was on the boat the next morning with a recovery coach. [The chief’s] jaw was on the table when we told him,” Ms. Fay said.
MVCS recovery coaches are key to the process.
“The recovery coach is optional. We offer it, but the person doesn’t have to have one,” Ms. Fay said. “So far, everyone has elected to have one.”
A recovery coach is assigned as soon as the call comes in to MVCS or MVH. The coach will guide the patient and loved ones through the process, accompany the patient on the boat, and make sure he or she gets to the facility, which means passing liquor stores, bars, and places where drugs are readily available. The recovery coach will also be at the facility when the patient checks out. Once Islanders have completed detox, they will either enter a treatment program on the mainland or come home.
If the Islander chooses to come home, Vineyard House, the only sober-living community on the Vineyard, may or may not be an option, but New Paths, an intensive outpatient program at MVCS, will definitely be one. “A recovery coach will take them right to New Paths,” Ms. Fay said. “That’s a no-brainer. It’s really important to continue that thread.”
Ms. Fay said an anonymous donation was instrumental in cementing the MOU. The money can be used to cover transportation expenses to the detox facility. It can also reimburse facilities for “empty bed days” — when a bed was held for an Islander who changed his or her mind at the last minute, which was an important component of the deal.
Started with a phone call
Ms. Fay said the MOU announced last week was started with a phone call in April, when West Tisbury Police Chief Dan Rossi called MVCS to suggest a more collaborative approach to counter the growing opioid scourge.
Asked what got him to pick up the phone, Chief Rossi told The Times, “It was all the stories in the paper about the issue, and hearing stories about people overdosing; many of them I knew since they were young.”
Ms. Fay said a spirit of collaboration was fostered quickly.
“We pulled together a group that included Joe [Woodin] and several people from the hospital, several police chiefs, members of the Drug Task Force, the superintendent of schools, his deputy, the [executive director] of the YMCA, people from Vineyard House, members of the Dukes County Health Council, and clergy. That’s when we began pulling together the June 6 community forum,” she said, referring to an evening when Jim Derick, founder of Support for Addicts and Families by Empowerment, or SAFE Coalition, spoke to a packed crowd at MVRHS Performing Arts Center about the power, and necessity, of community collaboration when it comes to battling addiction.
“That was just the beginning,” Ms. Fay said.
Over the course of the summer, the group broke into three subcommittees, one of which addressed the need for Islander access to inpatient detox. Mr. Woodin served on the detox subcommittee along with Ms. Fay and Victor Capoccia, a substance abuse disorder expert and former MVCS chairman of the board.
Mr. Capoccia completed a study on substance abuse disorders (SUD) in Dukes County in May of last year. Based on rates from the 2013 National Survey of Health and Drug Use (NSHDU) for Massachusetts residents, he concluded 1,450 Island residents could benefit from SUD treatment.
“I’ve been so impressed with the followthrough that took place after this spring’s forum,” Mr.Capoccia told The Times. “It’s not like they came together once and faded away. It was amazing how so many different people, police, medical professionals, educators, and concerned citizens kept showing up every week. I can’t say enough how Joe Woodin put the hospital right in the mix. Getting this done required having everything in place on our end, and that’s Julie and Joe. The anonymous donor was also a crucial part of the alchemy.”
Mr. Capoccia also had praise for Richard Curcuru, CEO of Gosnold and
Nancy Paul, CEO of SSTAR. “This speaks to their willingness to help,” he said. “They see a lot of pilot programs. They did this as a matter of goodwill toward the Island.”
Mr. Woodin said the MOU will be reviewed in a year. “We’ll see what needs tweaking,” he said. “I’m sure we’ll get better at working together. We have to; these are complicated issues. It’s our friends and relatives and neighbors. We’re learning that communities that come together, and where agencies and hospitals and law enforcement work together, are doing much better. I think that’s a recipe we’re going to keep following.”
To access the MVH/MVCS inpatient detox program, Islanders can call the MVCS 24-hour help line at 508-693-0032 or the MVH Substance Use Disorder Team, also available 24/7, at 508-684-4600.