Meeting an epidemic head on

The rise of substance abuse in the Shenandoah Valley has resulted in 30 opiate-overdose deaths and 55 opiate-overdose injuries reported in the area in 2015, up from only two reported opiate overdose deaths in 2012. Community members in Winchester and Frederick and Clarke counties have joined together to help prevent further injury and loss of life through the Northern Shenandoah Valley Substance Abuse Coalition (NSVSAC).

The genesis of the group was a meeting in April 2014 of more than 100 people who gathered for a heroin summit at Shenandoah University. After presentations, participants formed breakout groups to brainstorm solutions to the epidemic. Soon after, Winchester Police Chief Kevin Sanzenbacher hosted the initial meeting of the Heroin Task Force, which has evolved into the nonprofit NSVSAC.

The NSVSAC includes representatives from law enforcement, health care, substance abuse treatment, and youth advocacy organizations, as well as families affected by the disease of addiction.  “These efforts started after local law enforcement saw a significant increase in the number of heroin overdose deaths between 2012 and 2013, when the deaths increased from one to 21,” says NSVSAC executive director Lauren Cummings. “Law enforcement officials recognized that we were not going to be able to arrest our way out of this problem, it would take community support, buy-in, and treatment to address the public health crisis.”

Winchester Medical Center (WMC) was key to the group’s establishment. According to WMC vice president and founding NSVSAC member Nicholas Restrepo, M.D., the need to act was clear. In 2012, WMC initiated a hospital-wide “safety call,” which provided a daily snapshot of any patient safety issues that need special monitoring or action.

“We were struck by the growing frequency of patient care challenges due to substance abuse, from the emergency room to the newborn nursery,” Restrepo says.

The mother-baby unit and the neonatal intensive care unit leadership had developed protocols for these patients, but the need for more was clear throughout the hospital. “We welcomed the opportunity to shed light on the disease of addiction and join the broader discussion of how we might best address opioid abuse in our regional community.”

NSVSAC works to decrease the effects of heroin in several key areas: overdose deaths, infant drug exposure, children with addicted parents or caregivers requiring social services intervention, and incidence of addiction-related crime.

Community collaboration is critical to the success of this venture. The City of Winchester, Frederick County, and Valley Health donated $60,000 each to fund NSVSAC, and Clarke County contributed an additional $15,000. The executive committee is comprised of the Winchester Chief of Police, a public defender, a juvenile court judge, health care providers, and a concerned citizen.

“It’s not every day that you have the chief of police, the public defender, and a judge all agreeing on one topic,” Cummings says. “This is a unique situation in which these individuals, who recognized the severity of this problem, were willing to all sit down at one table and come up with solutions.”

The NSVSAC’s top priority is to establish a Drug Treatment Court Program for Clarke County, Frederick County, and the City of Winchester by July 1, 2016. They will seek grant opportunities to implement best practices. “One of the strongest messages we have heard over the past year and a half is our area lacks affordable, accessible treatment options, and we hope to find solutions to this challenge,” says Cummings.

According to Cummings, “The goal of the drug treatment court is to promote public safety by treating addiction and substance abuse among non-violent offenders involved in the judicial system.” The court will identify eligible participants from the criminal dockets in the circuit courts of Winchester and Frederick and Clarke counties. Accepted participants will be transferred to the drug treatment court docket, overseen by two circuit court judges.

“The program will offer comprehensive substance abuse treatment, as well as other counseling and services to help participants maintain sobriety and live productive lives without violating the law,” says Cummings. It will also offer “intensive supervision of participants, monitoring of progress through the phases of the program, and frequent, random drug screening. Participants will be held accountable for their conduct and any violations.” Ten to 15 participants will enroll in the first year.

“Without the program, offenders face incarceration. If incarcerated, upon their release, they are returned right back into the same environment that fostered their addictive behavior, except now they may have lost their job, and carry the stigma of being a convicted offender,” says Cummings.

NSVSAC is also working to reduce or eliminate the stigma of addiction, because, according to Cummings, this stigma prevents people from seeking treatment. “Our message is clear,” Cummings says. “Addiction is a disease, not a choice or moral failing and if you are suffering with an addiction, there is help.”

NSVSAC has initiated a number of outreach efforts aimed at reducing the stigma associated with addiction, including a website (www.roadtorecovery.info) launched in 2014 to educate the public on the disease of addiction. Further, a support group called Families on the Road to Recovery formed for families of loved ones struggling with addiction and for family members who have lost a loved one to addiction. The group meets twice monthly. Finally, NSVSAC hosted a screening of Heroin: The Hardest Hit, a documentary by the attorney general’s office on the heroin and prescription drug epidemic and its effects on Virginians. “We feel continued outreach efforts like the aforementioned initiatives will help reduce the stigma of addiction,” Cummings says.

Prescription drug abuse is a significant factor in the increase in opiate deaths. “Unfortunately, prescription drug abuse skyrocketed nationally as a result of a focus on pain management that didn’t adequately resource alternatives to narcotics,” says Restrepo. “This increase led to availability of a drug choice, and greatly contributed to our current crisis. One aspect of the coalition’s efforts has been to encourage using medications as prescribed, storing them in a secure location, and disposing of unused medications.”

According to the NSVSAC website, more than 60 percent of local overdose victims had a prior history of prescription drug abuse. They have set up drug collection units to reduce the amount of unnecessary medicine in peoples’ homes and decrease prescription drug abuse, especially among teenagers. A 2014 Partnership for Drug-Free Kids study shows that more than 70 percent of teenagers say it is easy to get prescription drugs from their parents’ medicine cabinets. Drug addiction can begin early — the average age of the first-time heroin user is 23 years old.

Drug collection units take medicine with no questions asked at several Winchester, Frederick, and Clarke locations. Affordable drug lock boxes can also be purchased at the Valley Health Pharmacy and at Valley Home Care for those who have prescription medications in their homes and want to ensure they don’t end up in the wrong hands.

Anyone seeking more information or help can call CONCERNS HOTLINE at 540-667-0145 to speak soemone. The NSVSAC website provides substantial resources as well. Community members who wish to help can educate themselves on the signs and symptoms of drug use, clean out their medicine cabinets, support local substance abuse education, and donate to the NSVSAC.