The Island Institute, publisher of The Working Waterfront, is working to understand the opioid epidemic on the coast of Maine, and to learn more about the issue, we recently hosted a presentation by Dr. Ira Mandel, founder of the Knox County Recovery Coalition.
One comment from a staffer summed up the reason for our interest: “It will impact our work or our families or both, if it hasn’t already, so we better understand what’s going on.”
Mandel’s wide-ranging comments prompted thought and reflection; our first takeaway is that the toll this epidemic is taking on our communities can’t be overstated.
We should begin understanding addiction as a brain disease. Opioids hijack the brain. Those who start taking opioids experience arrested development, Mandel said, not maturing beyond the year the abuse began. This means your 28-year-old coworker, addicted since age 13, still acts like a young adolescent.
Mandel compared opioid use among fishermen to performance enhancing drugs among professional athletes. Fishermen, like athletes, have a limited period in which they can make a lot of money. They also work long hours and the work often is painful or leaves them injured. They may take opioids to dull the pain, and then stimulants to work those long hours.
Regardless of the reason for starting, addicts eventually must take drugs to avoid the pain of withdrawal.
Mandel is one of very few doctors providing out-patient addiction treatment in Knox County. He has 100 patients. Similarly, Maine Behavioral Healthcare’s Rockland facility only has one doctor treating addiction. Doctors can now take up to 275 patients, but one person can only do so much. Five or six calls per week to Mandel go unanswered because of the lack of available physicians.
“It’s as if the Titanic has sunk and I am trying to save my 100, while the rest are drowning,” he said. And Mandel is nearing retirement.
A normal course of action for an epidemic of this scale would be to focus on prevention, treatment, and then look at underlying causes, such as poverty.
There is nothing like the Mothers Against Drunk Driving initiative pushing for programming in schools to teach children about the dangers of these drugs. Health classes may address drug abuse, but a greater effort is needed to combat the scale of the problem.
Our treatment programs are similarly underdeveloped. The only detox center in Knox County is available only to those deemed suicidal.
It’s understandable that people don’t want detox or rehabilitation facilities in their neighborhoods because addicts can be dangerous. But if someone wants help, it’s better to offer it close to their home. When someone goes away for a month to a facility in Florida or New Jersey and then comes home again, they are surrounded by the same friends and social pressures. Help must be sustained. The Coastal Recovery Community Center that opened this month in Rockland is an important step in the right direction.
Incarcerated populations are another component of the issue. Some 90 percent of those behind bars have drug issues, yet our prison system is not set up to help them. Mandel and his colleagues are advocating for re-entry programs for incarcerated addicts; without support, those leaving jail and in pain from withdrawal will urgently seek to get high again.
Mike Felton, superintendent of the St. George School (and Island Institute board member), recently noted that the federal government is not likely to help address addiction in our schools. But Felton was hopeful that our strong communities will help children and parents who are suffering. Mandel echoed that idea, saying, “A healthy community is stronger than any drug.”
The years ahead are going to be a test. We either pull together as communities to intervene and provide support for those who want to heal, or we stand on the sidelines and watch as our communities are torn apart.
The Island Institute is looking at ways we can support the organizations working directly on the opioid epidemic on the coast and islands. If you have thoughts on how we can be supportive, please contact Yvonne Thomas at firstname.lastname@example.org.
Rob Snyder is president of the Island Institute (publisher of The Working Waterfront). Follow Rob on Twitter: @ProOutsider.