Pubdate: Sun, 15 Jan 2017
Source: Boston Globe (MA)
Copyright: 2017 Globe Newspaper Company
Author: Jacob Carozza


[photo] (Debee Tlumacki for The Boston Globe) Paul Jehle, pastor of the
New Testament Church of Cedarville, shook hands with recovering addict
Justin Todd at a Project Outreach drop-in center hosted by the church in

One in a series of occasional articles about opiate abuse and its

It took multiple applications of the overdose-reversing drug naloxone,
Paul Hachey of Plymouth recalled, to revive him in late September. The
38-year-old was "dead" from an OxyContin overdose for three minutes before
he slipped back to life, he said.

The next day, after a short stay at Beth Israel Deaconess
Hospital-Plymouth, Hachey was sitting on the couch, unsure what his next
steps should be. Then he heard a knock on the door.

It was a Plymouth police officer in plainclothes, along with a recovery
specialist from the Gosnold on Cape Cod treatment organization. Hachey's
father arrived soon after.

Paul Hachey of Plymouth.

"Before I know it, there was some kind of intervention going on," Hachey
said in an interview. In 20 minutes, he said, the trio convinced him to
accept inpatient treatment for his addiction.

The visit was a part of Project Outreach, a program that links police
departments, treatment providers, and other organizations in 14 Plymouth
County towns in the fight against the opioid abuse problem in the region
by proactively offering treatment for addicts. The program launched in
December 2015 following meetings between Plymouth Police Chief Michael
Botieri and officials from substance-abuse treatment centers in the area.

Like in many places across the country, opioid overdoses had been climbing
in Plymouth. Botieri said local police responded to 120 overdoses in 2014,
with 15 resulting in deaths. The introduction in January 2015 of naloxone
for emergency treatment of an overdose did not stem the tide of opioid
deaths that year. While the antidote was used more than 90 times, Botieri
said, there were still 23 deaths from 202 overdoses in 2015.

Initially limited to Plymouth, Project Outreach has since expanded to
include Carver, Duxbury, Hanover, Kingston, Lakeville, Marion, Marshfield,
Mattapoisett, Middleborough, Pembroke, Plympton, Rochester, and Wareham.
Botieri estimated that some 200 people have received follow-up visits like
Hachey's, and plans are in place to have the entirety of Plymouth County
included by February or March.

The outreach process kicks in when there's an overdose resulting in
hospitalization in a participating community. If the person who overdosed
doesn't accept treatment, a police officer in plainclothes and a clinician
from a treatment facility will follow up with a visit within 24 hours of
the overdose -- even if they're not wanted.

"We've had a half-dozen people go to the emergency room and say, 'Don't
come to my house tomorrow. Don't send that outreach program.' And we went
anyway," Botieri said.

Before the visit, the officer will check for outstanding warrants. If
there is any, the wanted person is arrested by a uniformed officer and
enters the criminal justice system, through which he or she might receive
addiction treatment. Project Outreach is reinitiatied if the person is

Each visit is unique, said Sarah Cloud, director of social work at Beth
Israel Deaconess Hospital-Plymouth.

"There are occasions in which we can't locate the individual. [That]
happens about 14 percent of the time in Plymouth. Other times we're
encountering a family member who may or may not have known that their
loved one almost died the night before of an overdose," she said.

Those approached are not legally required to accept treatment, but if they
do they may be on the hook for at least part of the cost, depending on the
treatment plan and their insurance coverage. As opposed to a "one size
fits all" solution, officers and clinicians work with patients on a
case-by-case basis to find a preferable treatment option.

About 85 percent of those visited will accept treatment, Botieri said.
Treatment does not necessarily have to come from the employer of the
specialist who was part of the visit.

For various reasons -- a need for childcare, fear of losing a job, even a
previous bad experience in recovery -- many patients don't like the first
treatment option proposed to them, said Peter Monaghan, director of
community development for CleanSlate treatment centers in Massachusetts.

"Being able to have a Plan B, C, and D in your back pocket is huge," said
Monaghan, who is heavily involved with Project Outreach.

As part of Project Outreach, the New Testament Church of Cedarville hosts
a drop-in center in the fight against opioid abuse.

The program also enables addicts and their loved ones to get help
themselves from weekly "drop-in centers" at alternating locations in East
Bridgewater and Plymouth. There, treatment providers and support groups
set up stations to dispense information and aid.

"They come into a very welcoming environment," said Neil Eaton, pastor of
New Hope Chapel in Plymouth, which hosts drop-in centers every month.
"There's a place just to kind of sign in, and then they can kind of
meander about without any pressure."

Visitors are treated on a case-by-case basis. Meanwhile, the drop-in
centers have fostered relationships among those working against the opioid

"Before this, none of us really knew each other. We're kind of building
bridges with each other, so we can help the community," Eaton said.

Volunteer Lisa Robinson and Plymouth Police Chief Mike Botieri setting up
Project Outreach's table at a drop-in center in Plymouth.

But despite the gains, those involved with Project Outreach concede opioid
abuse may be an intractable problem.

"It's going to take time to stem a tide like this. It's like a tsunami.
The problem has increased so rapidly and exponentially, a few drop-in
centers are not going to turn it around on their own," said Paul Jehle,
who heads the New Testament Church of Cedarville, the other location for
Plymouth's drop-in center.

A year after Project Outreach's launch, the frequency of opioid overdoses
and deaths in Plymouth has not decreased significantly. There were 211
overdoses in the town in 2016, 19 of them fatal. Naloxone was administered
120 times in Plymouth last year, some repeatedly to the same person,
Botieri said.

"We're measuring our success in small doses," he said.

For those brought into treatment through the program, there is always the
chance of relapse. In September, a Duxbury police officer working with the
program managed to convince Jennifer Bylo's 22-year-old son to accept
inpatient treatment.

But Bylo said it was only a few weeks later, after a stint at a treatment
facility, that he suffered a heroin overdose while living in a sober home.
Naloxone saved his life, she said.

"What they should be watching is what happens after [patients] get into
treatment. Where do they land after the 30 days" of in-patient treatment?
Bylo said.

Hachey said he plans to stay in his Falmouth sober home for a few more
months. He's had help compiling his resume and hopes to start working --
he specializes in flooring -- again soon. And he has a goal in mind -- to
take college classes and eventually get a job helping others recover from
substance abuse.

"For once," he said, "I'm actually looking forward to the future."

For Hachey, who says he was sober for six years before the end of a
relationship triggered his relapse in September, Project Outreach "was
like a godsend."

"I had barely had time to consider what to do next when they were there"
to offer treatment options, he said.
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