Peter Goodwin, a prevention professional out of Santa Fe, (L) and Monica Blea with the County's RACSTOP program, discuss important points in drug and alcohol abuse prevention between sessions at the "Community Discussion On Heroin," June 25 at the County Commission Chambers in Espanola. Photo by Robert A. Naranjo for the Valley Daily Post
Community Discussion On Heroin: Saving A Sinking Ship That Is Our Future
By Robert Naranjo
A call for a “Community Discussion on Heroin” was sent out by the Rio Arriba County Health & Human Services Department. The call was answered and on Saturday, June 25 those tired of seeing the devastation that heroin addiction has wrought on the families of northern New Mexico answered the call and came to help bail water from a community ship that many fear is sinking fast.
For almost seven hours, health professionals, family members and concerned citizens met in the county commission chambers at the Rio Arriba County Annex in Espanola to begin to shape the model that can be used here and in other areas of the state and nation that are facing this same problem of opiate addiction which is sinking communities around the nation.
That is the scope of the heroin addiction problem in this proud, historic community of Rio Arriba.
Heroin, an opiate derived from the poppy plant, was largely unknown in northern New Mexico until after the Vietnam War. The street names for the drug are numerous: “smack,” “H”, “skag.” “brown,” “junk,” “brown sugar,” “black,” “white,” “horse,” just to name a few. The names are usually associated with the geographic location of where it is found and what the actual heroin has been mixed with to change its color and texture. For example, white powder heroin that is mixed or “cut” with lemon juice or citric acid powder, changes it from white to a brown or black thick, tar-like solution that is generally heated or injected, giving it the name “brown sugar,” or simply “brown” or “black.”
When the County health department asked people to participate in the meeting, it was a call to do something to help those who want to get out of the grips of heroin addiction and lead a normal, productive life before it’s too late. And just as important, it was a call to save the young people who have yet to get in the clutches of heroin addiction, by not going there in the first place-prevention. An entire breakout session at the community discussion dealt with the issue of youth prevention. If left unchecked, participants realized that the next generation of lawyers, doctors and teachers will instead ride away on the “heroin horse” straight to the “sinking ship of heroin addiction.” Although shocking, heroin addiction is manifesting itself in junior high and even in elementary schools.
At the community discussion one man repeated the often-told story of a young, smart individual in his family with a bright future. This man, from Taos County answered the call for a discussion on heroin in Rio Arriba after watching his grandson succumb to the drug. His grandson said the man was in the top 10% of his class at a New Mexico university, with a definite, attainable dream of becoming a medical doctor. But like so many stories shared that day, this man’s grandson, who was on his way towards a successful life, boarded the “sinking ship of heroin addiction.” “I don’t know what happened” said the grandfather, with the disillusionment apparent in his voice and eyes. Gone were the grandson’s dreams of being a doctor. Now instead he needs a doctor.
These stories of lost opportunity and potential weaken the community as a whole, but the grandfathers, grandmothers, uncles and aunts, and all family members carry the heaviest burden. According to the Rio Arriba County Health & Human Services Department, the family of the addicted have been the most impacted as their own sons and daughters have become “lost in space” due to opiate addiction. Grandparents often end up becoming parents again as addicted family members often leave their young children behind without their parents to care for them.
The statistics are staggering. In the most affected communities in New Mexico, including Rio Arriba , around 60% of students of some school districts are being raised by grandparents. Grandparents who had already raised their own children and were on the brink of retirement instead are bringing their grandchildren into their own homes to raise. And raising them is no easy task for these seniors. One grandparent shared the story of an 11 year-old girl who is acting out and exhibiting the trauma of being exposed to the loss of her parents to addiction. This child is hurting and unable to process all she has seen and is rebelling against the only structure she has, which is her grandparents.
Many grandparents spoke of this phenomena, where grandchildren, maybe in defiance because their world is now in pieces, begin to say or do things the grandparents do not understand or can’t stop. Eventually many of these grandchildren also board “sinking ship…” and the problem becomes trans generational.
Much of the June 25 discussion gravitated towards the issues of grandparents raising grandchildren and the associated problems, like communication, transportation, school and others. The participants tackled related issues by breaking into smaller groups for more focused conversations.
What does a community need to combat a problem like heroin? Funding.
Lauren Reichelt, the Director of Health & Human Services for Rio Arriba County has been working for the county on health related issues for a generation. When she started some of today’s heroin users hadn’t been born yet. What she has realized over the years is that you cannot fight an epidemic like this without the proper resources so Reichelt has made it a priority to raise the funds to meet the problem. Reichelt has used her community organizing skills to pursue numerous grant opportunities, standing up in County Commission meetings to tell members that funding is there, but the community needs to step up as many grants require community involvement.
Rio Arriba County, through Reichelt’s efforts, has recently received $2.5 million for a “Behavioral Health Investment Zone Opium Reduction Network” which is, in effect, the communities first step towards saving a considerable percentage of the current and future generations.
At the community meeting one person asked if there was an example anywhere in the country where a community was able to counter the grip of opiate addiction, which could be duplicated here. Clarissa Duran, a manager with the County’s senior citizens program answered “we are the model.”
Lauren Reichelt, Director of Health & Human Services for Rio Arriba County at the follow-up Task Force meeting on Tuesday, June 28 at the County's Health Commons. It was the second follow-up meeting to the June 25 "Community Discussion On Heroin," and on Monday, June 27 area judges met to discuss jail diversion. Photo by Robert A. Naranjo/Valley Daily Post
Reichelt then detailed a vision of how the $2.5 million grant will streamline the process of helping an individual quit an addiction. Before it was a cumbersome process, she said. For example, a person with an addiction would have to be clean before a rehab center, such as HOY would admit them.
There were no local detox facilities in the community, but one is in the works, according to what Reichelt said. The nearest “detox unit” was in Taos, so the individual needing help would wait for a space (bed) to open up. When it became available, A TB test is done, paperwork filled out, and the person admitted into the Taos detox unit (now closed). After they had been there seven days, a county employee would go pick them up and take them to Hoy. Another TB test and more paperwork to be filled out.
Reichelt said that will no longer be the case, de-tox will take place in Rio Arriba without the need of lengthy transport of clients. Moreover, the recent funding will make provider to rehab center much more streamlined, gone will be two TB tests and filling out forms. Now, Reichelt explained, the client will “walk across the hall” instead of going to get TB tests and filling out forms all over again just to go from one step to the next in their treatment. Now Espanola Presbyterian Hospital is working in cooperation with the County, and the hospital is where a person seeking treatment will start, then cleared for social detox to be placed at HOY. Presbyterian will make sure there are not more serious problems with the individual seeking treatment, like liver, kidney or any other major organ that is seriously damaged by drug or alcohol use. If no problems found, that individual is cleared by Presbyterian medical staff for the next step in their treatment at HOY.
Reichelt mentioned how the judicial system with “jail diversion” programs at the magistrate, district and municipal courts can be a part of the equation by sending someone to treatment instead of to jail. To do this effectively, she explained necessitates “an IT system” and that’s where Reichelt has started with recent purchases of computer equipment, including tablets, software, technical support, etc.
Moreover, there is one immediate step that will definitely save lives, and that’s the use of Narcan, which reverses opiate effects instantly. The training of its use is being spread to more emergency responders. Some police agencies in the area are now using it, which is a novel use of Narcan by public safety professionals in the country, however training of those first responders in the use of Narcan is required.
Now, Reichelt explained at the community discussion is to make sure detox clients are protected under the Health Information and Privacy Act (HIPA). Once Reichelt is comfortable with internal policies and procedures to protect a client’s medical privacy, and county legal gives it their blessing, the bailing of water with more than cups, from the sinking ship of addiction will begin.
Update Since The June 25 Community Discussion On Heroin
On Mon, Jun 27, a meeting of the Jail Diversion Committee took place with law enforcement and judges attending, Reichelt informed the Outreach Task Force.
On Tuesday, June 28, the Outreach Task Force meeting took place at the Rio Arriba County Health Commons. On the Agenda was “minimentries,” (mini documentaries) and videos for outreach purposes that will be produced to get the message out.
Narcan use and distribution to law enforcement, health professionals who are certified, and preliminary discussion on getting Narcan in the hands of families to save a family member from an overdose, brought lively discussion and what would be required, and how to track the containers, and self reporting of non-law enforcement (families) who may be issued Narcan to save a family member who has overdosed. The Santa Fe Mountain Center’s Phillip Fiuty, a program coordinator, was in attendance and said the Center has experience in usage of Narcan and offered input by informing the Task Force what are the best practices vis a vis the use of Narcan in saving opiate related overdoses.
Additionally, a good amount of discussion centered on family or friends with an overdose (OD) victim on their hands not calling 911 because a warrant or other reasons prevent someone from calling. According to Espanola Chief of Public Safety Richard Gallegos, police abide by a state law that protects someone from being arrested after calling 911 to save an OD victim.
The best thing any family member or friend can do for an OD victim is to call 911 immediately, do not wait. Do not put off placing an immediate call to 911 to potentially save the life of an overdosed victim out of the fear being arrested by police, because time is a factor and emergency responders carry Narcan which instantly reverses opiate effects on a person. Do not put the overdosing person in a cold shower, put ice on them, give them coffee or milk, or slap them hard, etc –.that is just wasting time, call 911 so emergency responders can give the OD victim Narcan. That is the only way that there is a chance of a family member or friend surviving an accidental overdose.
At the Outreach Task Force meeting, it was continually stressed that the goal is to save an overdosed person, and not worry about getting arrested when calling 911. Saving the victim is priority number one. And that message has to reach people, and as more and more people help the OD victim by calling 911, the result will be less OD victims and your loved one’s lives will be saved.
All other ways to try to get a person who has overdosed on heroin to come to or to come out of it are not useful at all. Family and friends are simply wasting valuable time. Don’t worry about warrants, syringes laying around, etc., police are not there for that purpose. The overdose victim and anyone helping them by calling 911 is protected by law.
After the Task Force meeting was over, Chief Gallegos was asked if the warrant is for a very serious offense and issued by a District Court and what happens when 911 is called and the OD victim has a warrant for serious felony charges out of that court. “In those cases, we call the judge to see what they say,” Gallegos said.
Gallegos said that it it depends on the warrant and the severity of the original charge, but for warrants issued for speeding or failure to appear, “…we hope they recover and take care of it immediately.
”KNME TV, a public television station in Albuquerque, filmed part of the Task Force meeting and interviewed some Task Force members for a special, “Small Town, Big Change,” by Solutions Journalism.