Pubdate: Fri, 05 Feb 2016 Source: Bangor Daily News (ME) Copyright: 2016 Bangor Daily News Inc. Contact: http://bangordailynews.com/opinion/submit/ Website: http://www.bangordailynews.com/ Details: http://www.mapinc.org/media/40 UNRAVELING DRUG ADDICTION REQUIRES COMMUNITY APPROACH Rutland, Vermont, unwittingly became the poster child for America's drug epidemic several years ago. The national attention and a sense that their city had bottomed out galvanized local residents and leaders to fight back. They formed committees, made lists of recommendations and, most important, set goals. Project Vision hasn't eradicated heroin from Rutland, but it offers a "take back our community" template other communities can model. In Bangor, like Rutland, groups of concerned citizens have been meeting for years to address addiction in the area. A working group, created by the Bangor City Council in 2014, developed a list of specific, achievable recommendations. The Bangor Community Health Leadership Board, which helped coordinate a community forum in 2014 where the federal drug czar, Michael Botticelli, spoke of the need for treatment to help opiate addicts, is focusing on five of them. It has developed pain medicine prescribing protocols for use by local medical facilities. It pushed for a new local detox facility, which is funded in the drug legislation passed last month by the Legislature and signed into law by Gov. Paul LePage. It is seeking ways to make the anti-overdose drug Narcan more widely available. The group also worked with local lawmakers to draft legislation aimed at making treatment more widely available and effective. Now the group aims to spread its message about the need for treatment and acceptance of people with addictions - especially those in recovery - to the community as a whole. Community buy-in is an important element of the Rutland effort. So is the coordination of public health, social service and law enforcement responses to the addiction epidemic. A supportive governor and state government agencies also boost Rutland's work. On the other hand, many of the policy changes Bangor's groups have advocated, such as more widespread use of Narcan and an increase in medication-assisted treatment - along with an expansion of Medicaid to extend health insurance to poor Mainers - have met with opposition by LePage. Project Vision, the group overseeing Rutland's rehabilitation, is headquartered in the police department, and staff from numerous social service agencies work there as well. This co-location ensures that local residents struggling with addiction - or other co-occurring problems such as poverty, unemployment and mental illness - receive the services and support they need. The police arrest drug dealers but also recognize that directing addicts to treatment will be effective in reducing drug use. "You can't separate child abuse, domestic violence and opiate abuse, because in many situations, it all resides in the same house," Rutland police Chief James Baker told The New York Times in 2014. "Now we'll set up an intervention, not just wait for something to happen." His department also used data and mapping to zero-in on problem areas in the city of 17,000. They identified a 10-block problem area that was responsible for nearly three-quarters of police calls. Within this area, many former single-family homes have been divided up into apartments, which easily lend themselves to drug dealing, Baker said. Much like LePage, Baker speaks of men from New York bringing heroin to Vermont to sell it for five times what they paid for it - and sleeping with local women, who get food and rent assistance. Arresting the dealers is part of the solution, but addicts who want help get it. Baker notes that a drug conviction can prevent an addict in recovery from getting a job, so his department directs addicts to help rather than putting them in jail. After years of resistance, the city opened a methadone clinic, which now serves 400 clients. Removing problem properties, many of which are owned by absentee landlords, is another priority. Project Vision aims to reduce the number of blighted properties within the target area by half. The group has purchased a handful of properties. Some will be demolished, but the group hopes nonprofits will rehabilitate others that will be sold to owners who will live in them. There are small successes. Theft and burglary rates are down as are noise and disorderly complaints. Three blighted properties are being rehabilitated. There is no evidence yet that drug use has been reduced. Like Project Vision in Rutland, Bangor's drug addiction groups have done commendable work and laid the groundwork for continued efforts to reduce substance use and address its consequences - even in the face of significant state-level obstacles. - --- MAP posted-by: Jay Bergstrom