Lives saved, lives
lost

Local treatment and prevention drug program continues to provide relief to those affected by addiction


December 1, 2011 | by David Aquino


On Nov 18, Tapestry Health held a press conference at its Florence branch to celebrate its heralded Needle Exchange Program, based in Northampton, which provides safe and confidential use of and disposal of syringes for people struggling with drug addiction. In its 15 years of operation, the program has saved 139 lives.



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Members of the press, public health officials, and community representatives were all present at Tapestry Health's Needle Exchange 15th anniversary. Pictured center is Tapestry's founder and CEO, Leslie Tarr Laurie and; Northampton city councilor-elect Bill Dwight.


It all began with the work of Leslie Tarr Laurie, the nonprofit's founder and CEO. During her opening statements, Laurie expressed great joy, and concern, for the future of the program and the state of public healthcare in general. “I was fortunate enough to work with an organization that understands what must be done in the interest of all,” said Laurie. “The federal government hasn't spent one cent on the Needle Exchange, but the Commonwealth recognizes its importance.”

Timothy Purington, director of Prevention Services, said the correct political leadership in the City of Northampton has always been a pillar of strength for the program. It was fifteen years ago, when Laurie approached the now former Mayor of Northampton Mary Ford, who was open and receptive to the idea of creating the pilot program to the Needle Exchange.

But obstacles are on the horizon for Tapestry and other public health nonprofits, as funding is slowly becoming less available. “Over the past ten years, funding for prevention has been cut significantly,” said Purington. “For this reason, hours at the Exchange will be reduced beginning early January, 2012.”

While the program has had great success in most areas of the state, Purington concluded that, “It's just a drop in the bucket.”

Nevertheless, these are some big drops.

According to Kevin Cranston, director of the Massachusetts Dept. of Public Health and director of Bureau of Infectious Diseases, “In Massachusetts, we are seeing some of the sharpest decline in new cases of HIV-infection anywhere in the country, and [ultimately] the world.”

There has been a 50% reduction of new cases over the last decade, which is justifying the state's contribution to the program, he said. “There are similar programs in other states, but Massachusetts is becoming the standard model for such work. It helps people help themselves.”

But prevention is just one component of this public health service. Tapestry Health also provides family planning, reproductive health exams, STI screenings, HIV counseling and testing, insurance enrollment, and a WIC nutrition program. The organization also has strong community outreach and practices legislative advocacy.

An example of this was witnessed in 2006, when the Massachusetts legislature was moved to decriminalize syringe possession, allowing individuals to purchase clean needles at their local pharmacy, which brought down the spread of infection across the Commonwealth dramatically.

“Even more remarkable,” said Cranston, “is the fact that we only saw 44 new cases of HIV-infection in 2009, and that number continues to decline” referring to Tapestry's efforts. Still, according to a state report, from 2000 to 2009, the number of people living with HIV / AIDS in the Commonwealth had increased by 35%.

The good news is that in the last few years, there has been zero-infection among newborns. But HIV / AIDS is not the only concern. “Where we have not seen much impact, is with the Hepatitis-C virus. We continue to see 8000-10,000 new diagnoses a year.”

Organizations like Tapestry Health are being challenged by the federal government to prove their effectiveness; a shift in dollars will only go towards highly effective programs. Crantson, among others involved in the public health sector, recognize these policies are becoming 'back burner' issues and are concerned about the 50% reduction in funding over the next 5 years. “But we think it's a reasonable expectation that organizations like Tapestry will still see some restoration over the years,” said Cranston.

Northampton city councilor-elect Bill Dwight, stated that the public at large has skewed its priorities, choosing self-interest over public health, and that the social stigma associated with the human services industry is a constant social and political hurdle to overcome. “There is a certain label of public shame that is often associated with drug use and premarital sex, and any condition that stems out of that is considered unnatural and deviant. That idea is grotesque.”

Dwight said a change in the conversation must take place among fellow politicians and policymakers. “A point that people miss,” he said, “is that these programs don't encourage drug use, they prevent people from dying. People allow themselves to disconnect from this reality to make the argument that substance abusers are not like them, that they don't experience the same things. It is this type of denial that puts us where we are today. Harm-reduction is a community philosophy – it's what makes us whole.”


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Liz Whynott, program supervisor of the Needle Exchange, demonstrates the Narcan emergency medical device.


Liz Whynott, program supervisor of the Needle Exchange, described the use of a new life-saving drug called Narcan, or Nasal Naloxone. The substance blocks heroine and restores normal breathing when sprayed into the nasal cavity of someone who has overdosed. Tapestry Health in Northampton and Springfield were the first in western Massachusetts to provide Narcan to families and service provides, not just substance abusers.

The last speaker at the event was Joyce Rescia, founder of Never Another Death (NAD). Rescia lost her son Matthew over 11 years ago to a drug overdose while he was awaiting a bed in a treatment facility. Matthew started using heroine at 15. He passed away three years later.

“I like to envision Matthew being right here by my side,” said Rescia. “The day Matthew died, he was anticipating going into detox. He had been in and out [of treatment]. Methadone worked best for him. Being a teenager, being invincible, he assumed he could just stop using. But as the disease progressed and he used more, the harder the treatments became.”

Rescia found her son lying dead on his bed. She said that when police and EMT showed up, there wasn't much that could be done. Emergency personnel regrettably told Rescia that they were not qualified to administer Narcon, or a similar drug, and that it could only be provided at the hospital. “We were able to spend the next six hours with Matthew after his death, to say our good-byes.”

Rescia believes Nasal Naloxone could have prevented her son's death.

Now, Rescia spends her days giving informative speakings at high schools and colleges, prisons and drug treatment centers through NAD. During this journey, she said she has met many addicts. A troubled mother she met along the way requested Rescia see her son, Billy. Rescia agreed, and upon meeting the young man, told him bluntly, that she was not a counselor, but a mother.

Bill didn't like that advice. “That's okay,” said Rescia. “I'll see you again, and next time, it will be at your funeral.” Bill took that to heart, so the very next day he called Rescia. They agreed to meet at Matthew's grave. Bill broke down at the site of Matthew's tombstone and told her, “Maybe I should get some help.”

Rescia worked with Bill and coached him through detox. He was “in and out”. He overdosed four times, but was eventually weened off heroine with Siboxin. “Now he makes good money as a roofer, he's put on some weight, and has made a decent life for himself,” she said.

Bill stays in close contact with the Rescia family.




Related Story


Local reaction to reinstatement of ban on federal funding of syringe exchange programs


Late last week, Congress made the decision to reinstate a ban on federal funding of syringe exchange programs. This is a huge setback for the national fight against HIV / AIDS and directly undermines and contradicts President Obama’s National HIV / AIDS strategy that highlights needle exchange programs as an evidence-based way of reducing infections.

The Tapestry Health Needle Exchange Program, in operation since 1995, is primarily state funded but received federal funds to operate the program in 2010 and 2011.

Liz Whynott, Tapestry Health Needle Exchange Program Supervisor says, “This is a great setback for prevention work within the HIV / AIDS field. People’s lives are literally at stake because of the reinstatement of this ban”.

Timothy Purington, Director of Prevention Services says, “It is disappointing to see the federal government retract its support of an evidence based intervention that could save this country millions of dollars in future healthcare costs. Syringe exchange programs have been shown to reduce HIV transmission and are cost effective.”

The Massachusetts Department of Public Health has credited the work of the Northampton Needle Exchange Program with the reduction in HIV infections among injection drug users in this area. Hampshire County has a lower rate of HIV infection due to the Needle Exchange program, and it is the only exchange program outside of the Boston area. Within the past 15 years, Tapestry Health Needle Exchange has exchanged over 800,000 syringes and has served thousands of clients. The Needle Exchange also serves as a disposal site where community members can bring used injection equipment for safe disposal.

Syringe exchange programs not only work to reduce the spread of HIV / AIDS and Hepatitis C, they also work as a bridge to treatment for drug addiction. Unfortunately, the reinstatement of this ban means that there will be an increase in health care costs for the country in regards to new infections of HIV, Hepatitis C and other blood borne illnesses that can be avoided through the availability of easily accessible clean syringes.



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Chickley River dredging halted by State

The Connecticut River Watershed Council (CRWC) today praised the state’s decision to shut down further post-flood work on the Chickley River in Hawley and to order the contractor to repair the environmental damage it caused. The action came after the environmental group submitted a letter documenting the damage and asking the Massachusetts Department of Environmental Protection (DEP) to take action.

While the group was pleased that DEP enforced the state’s environmental laws it also questioned why the agency had not inspected the site until CRWC and other state agencies sounded the alarm.

“It’s really clear that the straightening and dredging of the Chickley for several miles went far, far beyond what was necessary to repair and protect roads, bridges and private property and apparently residents were complaining weeks or months ago,” said Andrea Donlon, CRWC’s River Steward for Massachusetts. “Not only did the work harm wildlife and habitats, it likely increases risk next spring or in any future flooding.”

The Chickley River, a tributary of the Deerfield River, drains hilly topography some 10-15 miles west of Greenfield. The Chickley is regulated as a cold water fishery, is home to two state endangered aquatic species, and is annually stocked with Atlantic salmon fry each spring. In late August, Tropical Storm Irene dumped more than 10 inches of rain in the region, causing flooding of the Chickley and destroying portions of Route 8A and other nearby roads so badly that supplies had to be air-lifted to Hawley residents right after the storm.

To facilitate recovery efforts, the state temporarily amended its environmental protection laws to allow emergency work to be done without the usual permitting and public notice. Work falling under the temporary regulations was meant to minimize impacts and be focused solely on repairing and protecting infrastructure and property.

In addition to the work done to rebuild and protect roadways, the work done in Hawley included straightening, digging deeper, rip-rapping the river, and building gravel berms on both shorelines through wooded areas far from any infrastructure. After both the CRWC and Trout Unlimited raised questions, the DEP, the MA Dept. of Fish and Game, and the Natural Heritage and Endangered Species Program conducted site visits.

Contractor for the work in Hawley was E.T. & L. Corp. of Stow. According to the findings in the DEP order, when the company was interviewed by DEP on Nov 15, they said they had not read any documents regarding what work was permitted.

On Nov 22, NHESP sent the town a notice of non-compliance with the Massachusetts Endangered Species Act. On Nov 29, DEP revoked the town’s emergency certification, and the following day ordered E.T & L. Corp. to stop all work. The state is also requiring the company to repair the damage it caused. DEP’s order requires the company to hire an environmental engineer to evaluate the river and develop a plan to address the harm to fish and wildlife, the loss of floodplains and floodways, and risk to public safety, and then to go back and repair the damage to the extent possible.

Penalties for not complying with the order can go up to $25,000.

The Watershed Council said it will ask to review the plan created by E.T. & L's environmental engineer and has informally asked DEP to do a compliance inspection of the Cold River in Florida along Route 2 because that work is also being done by E.T. & L.

“In most cases,” Donlon said, “towns took necessary action to recover from this catastrophic flooding. It is not clear why such extensive work was executed in Hawley and who is paying for it. Rivers need to bend and dissipate energy from the water. Boulders and woody debris provide habitat for living organisms in the water.

“A 4-5 mile stretch of some of the state’s best cold water habitat has been ruined. Obviously, what’s done is done. But it’s our hope that moving forward the DEP understands that there needs to be better communication and oversight to avoid this kind of environmental tragedy in the future.”