September 6, 2018
What happened on the New Haven Green last month was not an overdose, but “a series of poisonings,” Professor Robert Heimer told a capacity crowd Wednesday in the Yale School of Public Health’s Winslow Auditorium. Heimer was one of six expert panelists addressing addiction and the recent episode on the Green where more than 100 people became sick after using a synthetic marijuana known as K2.
The distinction is important given that more than 1,000 people will likely die this year in Connecticut alone from opioid-related overdoses, added Heimer. One key piece of a public health response is to get Naloxone (an opioid antagonist drug that blocks receptors and restores breathing and cognition long enough to get a patient to a medical facility) into the hands of first responders and drug users, themselves. Naloxone has been on the market for some 20 years.
Dr. Kathryn Hawk, an emergency room physician at Yale-New Haven Hospital, said that emergency departments have changed their protocols in recent years in response to opioid disorders. Patients are linked to treatment before discharge and peer counselors are often introduced in the emergency department.
Another panelist, T.J. Aitken, a counselor with Hartford-based Connecticut Community for Addiction Recovery, is one of those peer coaches. In recovery himself, Aitken stressed that you have to meet each person where they are and help them choose a plan. There are many pathways to recovery, including abstinence, medical treatment, counseling and harm reduction. “We lay out the buffet. If people choose their own plan, they are more likely to follow through.” This is true not just for people with opioid disorders, but any addiction, he said.
Anthony Campbell, chief of the New Haven Police Department, stressed that the people on the Green who became sick on August 15, were, in fact, poisoning victims and should not be treated as criminals. In fact, the situation could have been much worse. After a fentanyl outbreak in the summer of 2016, New Haven police and first responders changed response procedures to 911 calls. Since an overdose is a medical issue, police did not respond before. Now they do so in order to collect evidence in such situations such as this. They have also implemented procedures for scaling up response. As a result, suspects were apprehended within hours of the August 15 incident and more drugs were prevented from being distributed.
We are not going to arrest our way of this
Campbell agreed with the other panelists that addiction services are key to addressing the underlying problems of addiction. Noting that several of the victims were released from the hospital only to return to the Green and overdose again, he added, “We are not going to arrest our way of this.”
Mark Jenkins, founder and CEO of the Greater Hartford Harm Reduction Coalition (GHHRC), called for a stronger public health approach, even if effective methods such as safe injection facilities are not popular. “We’re in the midst of an epidemic unlike anything this generation has experienced, but we haven’t changed our methods.” GHHRC offers weekly educational programs for drug users to help them use more safely. Jenkins called for emergency departments to include care packages that include Naloxone along with a patient’s discharge papers.
Dr. Byron Kennedy, director of the New Haven Health Department, described the role of his department in coordinating and activating a swift response from the state to ensure an adequate supply of Naloxone during emergencies. He also called for easier access to statewide data. Many of the victims on August 15 were not city residents and access to pertinent records was not available to his department during the crisis.
The panelists agreed that education, harm reduction measures, cooperation between agencies, destigmatizing drug use and widespread use and training of Naloxone are essential to ending America’s opioid-overdose epidemic.
This panel discussion was organized by the Addiction Medicine Collaborative (AMC), a committee of students from the Yale schools of public health, nursing and medicine. Sten Vermund, dean of the Yale School of Public Health, moderated the discussion.
This article was submitted by Denise Meyer on September 6, 2018.