POLICE CHIEFS: Mandatory Rehab for Narcan Recipients

Duggan Holds Opioid Summit with Four Local Police Chiefs

[youtube https://www.youtube.com/watch?v=6Xz5o9L1ur0&h=280&w=380]

Valley Patriot publisher Tom Duggan debuted his new Paying Attention TV Podcast last month. The show is a TV adaptation of the Paying Attention Radio program that Duggan started on WCCM in 1999 and ended in 2015 at WCAP in Lowell after spending time at Haverhill’s WHAV and WTTT in Boston.

In his first program Duggan tackled the controversial opioid crisis with four Merrimack Valley Police Chiefs; Methuen Police Chief Joe Solomon, Boxford Chief James Riter, Haverhill Chief Alan DeNaro, and North Andover Chief Charles Gray.

From left to right: Tom Duggan, Methuen Police Chief Solomon, Boxford Chief Riter, Haverhill Chief DeNaro, and North Andover Chief Gray


DUGGAN: We have asked four Police Chiefs to come in and talk to us about the opioid crisis. What are you finding in your community with this opioid crisis? Is it as bad in your community as it is everywhere else, and how are you handling it?

METHUEN CHIEF SOLOMON: For us, our overdoses this year are down 25% compared to last year and 30% compared to the year before.
However, our deaths have doubled.

We attribute that to the Fentanyl, it’s that and not Heroin, where over the years we’ve seen heroin cut with Fentanyl. But now, it’s pure Fentanyl. And kids are taking pills that they think is a percocet, vicodin, or a xanax, when it’s actually Fentanyl. So, we’re seeing the deaths increase in my city, but the total number of overdoses are down, and I think what we’ve gathered from our statistics is that the overdoses [being reported] are down in Methuen because we aren’t getting the calls. People are carrying Narcan themselves. We might get the call that someone has been Narcanned twice, and now he has to go to the hospital, so we believe the proliferation of narcan is saving lives. And again, the cost every time we go out somewhere in the area is $125-$230 depending on the actual narcan cost, because it fluctuates. But, is it worth saving 250 lives, even if it’s $120 a life? I’ve had this argument with people where a man confronted me and thought we shouldn’t be wasting money and we shouldn’t be using it. We talked about this during past interviews.

I also believe that all of us up here are doing the outreach afterward. So, it’s not that we narcan you and send you away, but you go right into our program and our addiction specialists try to get you into an immediate rehab. We get you in, detox you, and put you in long-term care.

DUGGAN: Now, Chief Riter, you’re in a small community of Boxford, where there’s mostly single-family homes, a predominantly white population, and a wealthier middle-class standing, the statistics show that these are the people who are victims of this stuff. It’s the white, middle-class that’s dying every day. How are you guys handling that in Boxford?

BOXFORD CHIEF RITER: We’re obviously carrying Narcan in all of our cars, and we’ve used about 20 doses since 2015. We deal with the families, we see the crisis that is left behind when there’s addiction in the household and it’s crossing all age groups from your late teens and your 50s and we’re constantly aware. We know the things to look out for and if it’s a regular occurrence. It’s one of those things that you can see coming over the years, but here it is, and it’s been building for a while.

DUGGAN: Do you have to put your guys through any kind of special training because this is all very new to everybody? Do you see many opioid problems in the schools?

BOXFORD CHIEF RITER: We have not seen many issues in the high school, but we are seeing issues right outside the high school age. We see it happen with different groups of kids; it’s seen as throughout generations, whether it be from the class of ‘79 or the class right now. You see lots of different kids that get hooked up in that culture and then a lot of times they come back to their family, and then there’s something we have to deal with. We have to work with the family and the kids, and we see what happens as far as the devastation with this.

DUGGAN: Have you seen the numbers in Boxford fluctuate?

RITER: They aren’t going as far as doubling, but they are getting more prevalent. We don’t see a lot of it because there are people who try to take care of it inside their houses. They have the ability to send people away, whether it be kids or family members, and get treatment outside the community. We hear bits and pieces of it but there’s other aspects that go along with it.

DUGGAN:. Chief DeNaro is from Haverhill, which is a very different community than Boxford or even Methuen. Haverhill is like Lawrence where it has a large population of lower- class citizens and immigrants. That has to pose the same kind of problems as Lawrence. Can you talk about what you guys are doing?

IMG_0062HAVERHILL CHIEF DENARO: We currently have a Sergeant and two Patrol Officers who are designated as my contacts and we have a social worker who goes out with him. We contact every person who overdoses, and in the last two years we’ve had over 500 overdoses.

They will contact those people and try to get them into programs. Last year we had 23 deaths, and this year we have 14 to date, so they are down. What we do is meet the family. We get them into grief counseling, and see what we can do for them on that aspect. Predominantly, one of the biggest problems that we have is that when they knock on the door, 99 out of 100 times the door shuts and nobody wants to talk about it. When I talk to my officers, when we are utilizing Narcan, once they wake people up, they don’t want to go to the hospital. There are a lot of issues as far as being able to address this problem.

And as Chief Solomon alluded to before, our overdoses, last year a count of 62, and this year 249, which is a grossly understated number because when we talk to people out there they tell us that they have narcan and revive those who need it, but fail to call it in. They do not report these incidents.

DUGGAN: So, the numbers that we have are probably double, or even triple, the amount stated because of what you are saying about those failing to report these incidents?

DENARO: I think a better gauge would be to determine all of the agencies that are giving out narcan and asking how many doses they give out. That would give a pretty good idea of the extent of the problem. I’m sure there has to be a way to track it; there must be some type of check and balance for that.

DUGGAN: Chief Gray from North Andover, you’ve got a very different community. North Andover borders Lawrence like Methuen does, but it’s a town. And just like Boxford, it is mostly middle to upper-class white people with a little bit more disposable income and yet you see the same types of problems Lawrence has because you are on the border. Can you talk about that a little bit and what you’re doing, and I want all the chiefs to answer; when someone gets narcan, should it be mandatory that they go for a temporary rehab placement before being let back out?

N. ANDOVER CHIEF GRAY: I think that should be up to the medical professional. But, I know in North Andover if we narcan someone, they go right to the hospital under the new PC guidelines. North Andover has, what I would call, the crimes secondary to the opioid crisis, your car brakes, are what people are using as a means to get money to buy more opiates. Another thing that we see as well as in Boxford is the commuting. What is happening is, people are driving after injecting the drugs and they are impaired. They cannot drive a vehicle safely and they are causing crashes. That’s something that we take very seriously. But, it’s also the legislature hand that’s helped us out yet. We’re talking about the implied consent law is all good for alcohol, and if you get pulled over you have made the agreement that if I get stopped by a police officer, and I think I am impaired by alcohol, I’ll submit to a breath test or face sanctions.

This is the biggest thing I’m talking about with the opioids epidemic, and also the cannabis. There’s nothing in the legislature to say that if we think you’re under the influence [of opioids] while driving a vehicle, [that allows us] to test you right now. That’s one thing we are all dealing with now, is how to go around that.

DUGGAN: How do you handle it if somebody shoots up heroin, they get behind the wheel of a car, and you know they’re impaired on something, but how do you determine what that is without violating their rights.

GRAY: Some officers have special training that allows them to make that judgement. We do training with other officers just to give them a go by, but believe it or not, there are a lot of ways to tell.

DUGGAN: How do you guys handle it in Boxford? You have the same type of community as North Andover, so is it handled in a similar way?

RITER: We have one officer, who is a D.R.E., and we are also in contact with the North Andover community and other D.R.E.’s in the area, so if we have a concern, we make sure we check it out.

DUGGAN: Chief Gray, do you think that after being narcanned someone should go mandatory for a certain period of time, because I know you guys make them go to the hospital, but they can check themselves out, right?

GRAY: Yeah, in North Andover we carry two four-milligram doses, which has helped us with our overdose cases immensely because, as the issue Chief Solomon said, they defend those a lot more potent, and because of that we have had to carry a heavier dose. Also, if an officer is exposed to it while they are given narcan, we want the officer to have a dose for themselves. It depends again on the medical professional to see whether they would deem this person ready for a 20-day program, or for them to say “no, they haven’t hit rock bottom.”

DUGGAN: What do the other Chiefs think? Do you think those being narcanned should have to go into a program in order to stop being a constant drain on the system? I remember Chief Solomon had told me people were getting narcanned up to 4 to 5 times and either still refusing treatment, or not coming back [dying] due to their bodies getting used to it.

SOLOMON: What’s actually happening is that narcan can get stronger, so we were always carrying two 2 milligram doses. We currently carry four 4 milligram doses plus each officer has two four milligram doses that are only to be used on themselves in case they get exposed. Sometimes we saw ourselves giving five or six regular doses, now maybe three or four of the 4 milligrams. We are giving stronger doses which is helping, but obviously, from our analysis with the fentanyl impact is why the dose is so much higher. Now, if you can get a paramedic there, they can give them an intramuscular shot of narcan, and they can use less of a dose and have a better impact. I firmly believe, and I actually had the opportunity to testify last year at the House and Senate hearing on the mandatory stay, we asked for 14 days.

If you overdose or have narcan used on you for an overdose, and you go to the hospital, we ask that they have to go in and be held for 14 days at least, to give them some time not only to immediately detox, but to begin a rehabilitation program. Currently, it’s up to 72 hours, and we thought that was at least a gain, but what happens is that it is the option of the mandatory 72 hours or ‘being medically cleared.’

So, there is still a little bit of an issue, but I absolutely believe that they need to be turned into a program and at least detox, and that is when you can try to convince them. They must be willing to get help. But, the problem is they overdose, we narcan them, they go to the hospital, and if the doctors clear them in 12-16 hours, they go out and re-overdose and the effect is even stronger which could lead to a possible death.

DUGGAN: Chief Riter, what do you think?

RITER: They need the break for themselves. They need to get away from where they are, who they are surrounding themselves with, and they need a break just from the area they’re in to try to get them a head start to get clean.

DUGGAN: Chief DeNaro, what do you think?

DENARO: I’m gonna guess it’s a funding issue, right? It’s a no brainer, they need to go in. One of the problems we had, and Joe [Solomon] kind of alluded to this a little bit, is that we were seeing overdoses and they were going to the hospital, getting a cab back to their vehicles and still being somewhat under the influence, they drive off. So, we started a program about two and a half years ago where if we take you [arrest you] on an overdose, we tow your car.

They kept going back to the car, and I did it not only for their safety, but it seems that when they’re behind the wheel, they seem to be crashing into innocent people who were going about their business, and more times than not it’s the innocent people who are being seriously injured or killed. It is the same situation as drunk drivers.