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U.S. Rep. Joe Kennedy speaks with Sarah DeJesus, a clinical medical assistant at Tapestry Health.
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Congressman Kennedy Speaks With Needle Exchange, Gang Prevention Agencies

By Tammy DanielsiBerkshires Staff
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Congressman Kennedy visits 18 Degrees, which is operating a gang prevention program.
NORTH ADAMS, Mass. — Congressman Joseph Kennedy III's campaign tour of the commonwealth brought him to the city on Saturday morning to hear about the work being done on substance abuse issues and youth diversion in North Adams. 
The 4th District Democrat later in the morning was endorsed for his run for Senate by Berkshire District Attorney Andrea Harrington at an event in Pittsfield. He has launched a primary challenge against U.S. Edward Markey.
He was hosted by Harrington and Mayor Thomas Bernard as he spoke with clinicians at Tapestry Health and the program directors at 18 Degrees, both located in the West Main Street building owned by the city. 
Tapestry Health runs a needle exchange and offers overdose prevention services including Narcan, testing for HIV and hepatitis C, basic wound care and health advice, and a portal to addiction services and counseling.
"We provide them with new supplies for their drug use with the goal of having folks use new equipment every time they inject to avoid many things like HIV and Hep C, and prevention of abscess, and things like that," said Sarah DeJesus, assistant director of rural drug user health, adding that the focus of the program is "harm reduction," including a whiteboard filled with heroin names that caught the congressman's eye. 
The program gets anecdotal information on the types of drugs coming into the region and the board notes street names that carry a higher risk of overdose, like "Godfather." DeJesus says North Adams is on the route that brings drugs from Hartford, Conn., up through Greenfield.
"So when we in Tapestry know about an increase or a spike in overdoses in those two locations, we know that within a day or two, it's going to kind of hit our area," she said. 
In response to questions, Harrington said there wasn't much in the way of formal cooperation with law enforcement although she is interested in participating with the U.S. Department of Justice's "overdose map" that could provide more data to her office.
"It would be a way of us having greater communication in our community about where the overdoses are happening," she said.
Tapestry HIV Health and Prevention Director Liz Whynott said one obstacle is that the information changes so quickly. "I think the important thing is we want work towards getting as much real time information out," she said. 
Northern Berkshire EMS Assistant Chief Amalio "AJ" Jusino said there is a sharing of general information within the emergency response community, but not on the level of law enforcement in tracking names down. (Health organizations have much stricter limits on sharing medical information.)
"But if we do see a spike, we know that that day, or those next three days, are going to be brutal for emergency responders," he said. "And then, like they said, it stops so quickly."
Stephen Murray, a paramedic with Northern Berkshire EMS, said there was a case a couple years ago when a spike in overdoses of a particular heroin, Superman, lead to a dealer and the overdoses stopped. 
"In Pittsfield a couple years ago, where we had like 26 overdoses in one weekend, it's a pretty small area and law enforcement did manage to track down the dealer that was responsible for that spike," he said. "And they did apprehend them based off that data they were collecting the field."
Bernard told Kennedy that communication is a topic within the prevention work groups. 
"How do you get the word out to to give people the appropriate caution without doing it in a way that you are increasing risk for another population?" he said.
Kennedy also asked how the exchange funded and if Narcan was available. Whynott said it was all funded through the state Department of Health since a pilot program in 2007. Tapestry does have the ability to bill for medical testing but that would not allow for the anonymity that keeps people coming, she said. 
"There's a federal ban still on needle exchange. So we only have state funding. And we find it important also to keep it as low a threshold as possible. Keeping it anonymous, so we don't operate through MassHealth," Whynott said.
Harrington said she had looked at the mobile methadone clinics being deployed by Portugal during a trip there. 
"The way that they're able to provide really harm reduction and medical care to people mobiley, which here in a rural community, we feel like would be incredibly helpful," she said. "But there, it's the way the federal government restricts the methadone that makes it basically impossible for us to do that."
The congressman said he thought they should be taking any opportunities to move people off addiction, or to control it, and toward a healthy lifestyle. Given the risk of heroin or fentanyl, methadone or suboxone seems more logical -- if it is a pathway toward treatment, he said. 
"That's not necessarily the uniform view in Congress," he said. "I think we're getting there, but there is a viewpoint that is held by some -- oftentimes but not exclusively -- from my more conservative colleagues that it is substituting that substance for another one. So it just perpetuates addiction."
Whynott says views are changing when you put methadone or other medication-assisted treatment in the language of treating a chronic disorder.
"People sometimes compare it to someone with diabetes or someone with heart problems and even like with the behavior sometimes," she said. "With like diabetes, we wouldn't stop giving a diabetic insulin because they're, you know, eating too much cake or something. ... I think the more we try to compare it to other chronic disorders, it will be more accepted."
Murray, who is in recovery himself, said it also is about overcoming the stigma related to addiction.
"I think one of the one of the challenges when we look at past policy was that we had this idea that this was a poverty-stricken illness that, you know, no one ever got better from, that people were dying and that was that, but it's not actually the case," he said. "I mean, there are a lot of us in health care, in law enforcement, who are in recovery. So I think that the more people realize that there are people like me around that are survivors of that, I mean, I am a fully functioning member of society. ... 
"These are all things that I think people need to hear. You know, so stigma is stupid."
Upstairs at 18 Degrees (the former Berkshire Children & Families), two grants are being used to prevent kids from losing their way. The agency got $127,000 Shannon Community Safety Initiative state grant and another $350,000 from the Safe and Successful Youth Initiative to open the North Adams office. 
Harrington said there's more and more young people who are carrying firearms and it seems to be a national trend of drugs and guns going together. 
"We have to make some really tough choices .... we don't have a lot of good options. So we really see this program as just absolutely critical to building public safety. And when we consider public safety, we're thinking long term public safety," she said. "We know that when we send an 18-19-20-year-old to be incarcerated, that the outcomes are not very good. ...
"We like to avoid sending young people to jail. So we're really, really grateful to have this."

District Attorney Andrea Harrington explains the limited resources available to the region. 
Local law enforcement refers youth ages 17 to 24 who are at risk of being involved in criminal and gang activity to the program, usually young people with whom they've encountered over and over. The other grant also allows for referrals from family and community members. The program's counselors then reach out by knocking on doors, contacting through social media, or partnering with other social service agencies. 
"It's having our folks step out on the streets, in the schools, in the parks. I mean, really trying to be visible, and having them be great sources for the young people we have," said Erin Sullivan, director of community relations. "They're walking down the streets in the neighborhoods and those kids know who they are and talking to them ... they already were part of the neighborhood and really now becoming of leaders in the neighborhood."
Sullivan said what they're hearing from young people is a lack of resources and opportunities. If kids are into sports, what other activities do they have? They can't imagine a good education and good job, so joining a gang seems a logical option. 18 Degrees seeks to help them find alternatives and starts with early intervention, such as the Kids 4 Harmony music program.
"People from Boston thing that Berkshire County is an idyllic place. some significant challenges. Six percent of our population is addicted to opioids. It's one of the highest in the state. We have very high rates of domestic violence. The median income here in North Adams is $24,000-something," Harrington said. "So you know, what we're seeing in the courts is totally underresourced, and we haven't been able to take advantage of some of the other kind of programs they have in larger areas because we are small population."
Kennedy said he wasn't unaware of these issues, noting that he, too, had been a prosecutor and even though his first case was on Nantucket, there were similar issues in the eastern part of the state with overdoes clusters and struggling mill towns. Some haven't been able to reinvent themselves as quickly as others but they are "proud, they're scrappy, they're hard working."
"So you have that tension of folks that are really proud of their community, that want to be in their community, want to contribute to their community, and lift that community up but with the sort of policies, resources, structures, that are not actually empowering those communities to succeed," he said.

Tags: drug treatment,   gangs,   harrington,   needles,   social services,   youth empowerment,   

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