NEWSLETTER: Week of Dec. 28

The election of a new state Speaker of the House could send ripples through the addiction community, a hazmat response from police to an overdose call has sparked controversy, much more

Welcome to the Substantive Newsletter, a weekly source for news from Boston’s addiction and recovery communities. 

After the chaos of 2020, this new year has started with a bang. In this newsletter, alone, see State House politics and ongoing recovery services controversy converging. That’s alongside a persistent debate over police responses to drug-related calls. Then, there’s at least one bright light of good news in what can be a depressing topic in addiction and recovery. 

In personal news, meanwhile, I’m a day late on this week’s newsletter due to a bit of a COVID-19 scare here at home. 

I live in a one-bedroom apartment in West Roxbury with my partner and my best friend. This week, we all came down with virus symptoms and got tested. While two of us, including myself, tested negative, we have one COVID case in the house. So, it’s been a hectic week. 

All that, aside, though, the news pushes onward. 

Here’s the latest...

THE BIG STORY

Mass. state reps elect new leader intertwined with Long Island Recovery Campus politics

Elected this week with broad support from democratic legislators, Massachusetts’ new Speaker of the House brings a potentially unique perspective on state and local addiction policy to one of the most powerful offices in state government. 

For nearly 30 years, Ronald Mariano has represented the 3rd Norfolk County District on Beacon Hill, boasting a constituency that includes portions of Quincy, alongside two other communities. 

Recently, that districting has put Mariano at the center of this state’s addiction crises as the closure of the Long Island Recovery Campus in the Boston Harbor in 2014 particularly inflamed drug and homelessness issues up the road in the South End and Roxbury. 

Once vocally supporting the expansion of a recovery center in the southern end of his district, Mariano has fallen quiet in recent years particularly as some of his Quincy constituents in city government have openly fought efforts by Boston officials to rebuild the Long Island Bridge. 

The demolition of that historic structure was the reason the state had to close the Long Island Recovery Campus now nearly seven years ago. 

Rebuilding the bridge could alleviate problems throughout the Greater Boston area, experts say. But Quincy leaders oppose current proposals, citing environmental concerns. 

Read my coverage of all this...

STAYING ON TOP OF THIS: Ongoing stories we ought to follow 

Overdose call prompts controversial hazmat response from BPD

Boston Police determined they needed a hazmat team while responding to a double opioid overdose in Brighton, Jan. 1. That decision, though, is now under fire from advocates and experts who say situations like this too often see first responders act on misguided and overblown fears of fentanyl exposure. 

The situation in question followed reports of a medical emergency at the Charles River Inn, a small hotel nestled between its namesake river and the bustle of the Mass Pike. 

It remains unclear whether the people suffering from overdoses actually survived. 

As police have declined to comment on this story, harm reduction experts and addiction researchers see this as part of a larger problem, where first responders delay rendering aid by calling on and waiting for hazmat teams to suit up and arrive. 

That default response, in turn, is based on a disproven fear that first responders could overdose by simply touching fentanyl, those experts say. 

Read my coverage of this incident…

And see initial reporting from the Boston Globe that first publicized the use of a hazmat team by the Boston Police on New Year’s Day...

SNAPSHOTS: Other stories in the news this week

Society must focus on building ‘recovery capital’ researchers say

The authors behind an uplifting paper on the viability of addiction recovery responded to Substantive requests for comment, this week, offering suggestions on how society should reframe its view of addiction itself. 

Discussed in last week’s newsletter, a recent paper by five area researchers in the journal Psychology of Addictive Behaviors posited its perspective in its title -- “Reasons to be cheerful.” 

“In spite of what people think about addiction being a hopeless condition, the majority of people who continue to seek addiction recovery eventually find it,” David Eddie of the Harvard Medical School wrote in an email to Substantive, summarizing his paper’s findings.

Through this project, researchers combed through the stories of more than 25,000 people in recovery, mapping moments of progress and regression, through treatment, relapse, sobriety and more. 

Their work now shared publicly, Eddie and his colleagues are hoping social leaders in government, medicine and culture can shift perspectives and stigmas about addiction. 

“There’s a large literature showing the benefits of emphasizing positives and taking a strength-based approach (rather than only focusing on deficits) when treating addiction and other mental disorders,” Eddie wrote in his email.

As for actual treatment and rehabilitation mechanisms, Eddie elaborated, society should focus on what he describes as “recovery capital.” 

Communities should understand “the internal and external resources needed to initiate and sustain alcohol or drug problem recovery,” he said, specifically itemizing education and employment programs.  

“As a society we pour a lot of resources into helping people stop using alcohol and other drugs,” Eddie wrote. “But we don’t do a good job of helping them rebuild their lives, which is the best relapse prevention strategy.” 

Read my earlier coverage of this paper via last week’s newsletter

And see the entire paper itself...

Doctor encourages harm reduction practices for people using drugs on New Year’s Eve

Harm reduction expert Kim Sue shared an earnest plea, this week, with communities possibly using drugs on New Year’s Eve. She wanted everyone to stay safe.

Sue is the Medical Director of the National Harm Reduction Coalition. She also works with Harvard Medical School and Mass. General Hospital, regularly seeing the realities of Boston’s street-level drug crisis. 

“Please watch out for each other tonight,” she tweeted, on Dec. 31. “Carry Naloxone, even for stimulants just in case, alternate water with drinks, avoid mixing and stagger use, go slow with a new supply, make sure to eat.”

On a day that saw at least one pair of people using drugs overdose, as mentioned earlier in this very newsletter, Sue touched on common anxieties among Boston’s addiction and recovery communities. Likewise, she shared a series of harm reduction strategies, like testing substances before use, when possible. 

Her call, more so, to carry Naloxone, also known as Narcan, does reflect awareness of a larger trend in drug consumption here in Boston.

Targeted as a way to reverse an opioid overdose, when administered early enough, Narcan was long of little use to people addicted to so-called “uppers” like cocaine or methamphetamine. 

Now, though, meth use is on the rise and experts are growing increasingly worried about drug makers cutting their supplies with strong opioids like fentanyl. 

Read my feature article from last month detailing how data collection mechanisms have failed to properly illustrate surging rates of meth use…

And see Kim Sue’s initial tweet from New Year’s Eve… 

Expert warns of COVID vaccine reluctance among addiction communities

The medical field’s systemic stigmatization of people with addictions may soon hamper COVID-19 vaccination efforts if public and private leaders don’t take targeted, relationship-building action, Boston doctor Joshua Barocas warned in a recent article. 

Published in the New England Journal of Medicine, Barocas’ article details how people with addictions find themselves primed by life experience to accept medical misinformation as fact. 

“Addiction remains a disease for which people are routinely denied appropriate care on the basis of providers’ beliefs,” he writes. “[As a result,] many people with substance use disorder have turned to illegitimate information sources and have fallen prey to conspiracy theories. 

“It is, therefore, naive to believe that people with SUD will unquestioningly and willingly line up for vaccinations,” he elaborates.

To build trust on what is an unquestionably unsteady foundation, Barocas says vaccine distribution administrators need to bring clinics to communities where people with addictions already cluster. 

They can, and should, he says, further partner with leaders like social workers, counselors, therapists, and recovery coaches to promote the coronavirus vaccine. Barocas goes so far as to call these hypothetical allies “vaccine ambassadors.” 

“Some people will argue that such extraordinary measures should not be taken for this population,” Barocas argues near the end of his article. “These arguments, though, are rooted in the same stigma that caused such mistrust in the first place.” 

Joshua Barocas is a researcher and doctor specializing in addiction medicine at Boston Medical Center. Read his article...

What’s next?

I said, in my most recent newsletter before this entry, that I’d soon be spending time pushing for answers on a few of the requests for comment I’d sent sources in the addiction community.

I’ll be continuing in that effort in this coming week. 

Rep. Kathrine Clark remains at the center of a number of huge stories that particularly interweave federal and local policy. I sent questions to her office last month and am hoping to hear back soon. 

Gubernatorial Candidate Danielle Allen also still ranks high on my list of people I hope to talk to soon as she boasts a fascinating body of writing on addiction that I’ve discussed previously here on Substantive. 

There are plenty of other stories I’m beyond excited to share. 

If you have topics you would like me to look into, though, please reach out…

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