Is education a key?
Can we learn to spell ‘addiction prevention’?
Gill-Montague Regional School District Superintendent Michael Sullivan in his Crocker Avenue office.
Recorder Chris Curtis Purchase photo reprints »
Teacher Kelly Kaczmarczyk teaches health classes at Turners Falls High School. Recorder/Paul Franz Purchase photo reprints »
School resource officer Richard Brook of the Greenfield Police Department and Maureen Donovan, coordinator of the Greenfield Safe Schools Smart Schools Coalition in Greenfield High School. Both were new to the schools this winter and are involved in substance abuse prevention and other areas of student safety.
Purchase photo reprints »
Dr. Ruth Potee counts empty containers of Suboxone, a drug for people addicted to opiates, to make sure her patient is taking the drug properly.
Recorder file photo/Paul Franz Purchase photo reprints »
“What I see often is a civil commitment petition brought by a parent who has just discovered their child is a heroin addict, much to their shock,” said Greenfield District Court Presiding Judge William F. Mazanec III.
“If they were perhaps better prepared, better educated about the nature of the problem, they might have recognized the signs sooner, and if their child had been educated much earlier, say in a school setting, maybe that wouldn’t have happened in the first place.”
There are many paths into opiate addiction. Never going there in the first place or turning away sooner is one way to contain the scourge, experts say.
Education about addiction dangers can come from a range of places: from homes to schools to doctors’ offices, to newspaper articles. Schools have been raised frequently in discussions of how the community can help fight the problem , often described as the only place to reach a broad captive audience early enough.
Health class, the traditional home for drug education, exists in area high schools but is just showing signs of returning to the middle schools. What the schools are doing at present varies by district.
Gill-Montague Regional School Superintendent Michael Sullivan included a full-time health teacher for the Great Falls Middle School in his budget proposal for the next school year, preserving the addition even in a pared-down budget that includes multiple staff cuts.
The middle school has not had a health teacher since that position was cut in 2010.
Sullivan called the need today self-evident, but said heroin is just one facet of the fuller picture students need to understand.
“Middle school kids really need information about drugs, about understanding drugs and their bodies and the choices that they need to make,” he said. “A lot of people around here feel strongly that we need to equip young people with this information.”
Martin Espinola, district director of teaching and learning, also chairs the district wellness committee. Espinola said the health program should cover everything from fitness to mental health, nutrition and drugs.
“Especially now with the medical marijuana issue going on, there are probably some students who probably don’t understand that because their brains are still developing, (drug use) can be something that can damage their young minds,” he said.
The preoccupation with alcohol and marijuana use at the middle and high school level is backed by data showing that these are the overwhelming drugs of choice, backed by brain studies that show significant deficits after use of alcohol, marijuana or any drug during the brain’s formative years.
“You don’t get a whole lot that are starting off with heroin; it’s a buildup drug,” said Greenfield Police Chief Robert Haigh Jr., an observation often voiced throughout the law enforcement, treatment and recovery communities.
The state Bureau of Substance Abuse Services concentrates on alcohol at the teenage level, funneling money to coalitions aimed primarily at preventing underage drinking.
Younger abusers, greater risk
“One of the things that isn’t well understood is that the younger you are when you begin to drink alcohol, the more likely it is that you will have a substance abuse disorder in your lifetime,” said Bureau of Substance Abuse Services Director Hilary Jacobs, speaking at a forum organized by the regional Opioid Education and Awareness Task Force in February. “So when we start at the place of preventing prescription drug abuse or opiate use we’ve already skipped a really important beat.”
In Greenfield, the Safe Schools, Smart Schools Coalition is funded by the federal Drug Free Communities program.
Coordinator Maureen Donovan said the coalition is required to focus on the problems identified in the data from the annual Communities That Care Coalition surveys. The current focuses are “social hosting” — parents allowing underage drinking at parties — and marijuana.
“The prescription drug piece ... hasn’t reared its ugly head yet,” Donovan said, although she included some information on the problem in the January newsletter sent home to parents.
Police in school
A parental audience is one of the advantages Greenfield school resource officer Richard Brook sees to working in the schools.
Two area school systems, Franklin County Technical School and the Greenfield School Department, have recently instituted or re-instituted an in-school police presence.
Greenfield Chief Haigh — a recent transplant from Orange, where he was himself a school resource officer for a time — is a strong believer in the program. He says school officers create a direct line of communication between the police, school staff and students in the critical age range “before they turn 18 and walk out the door.”
Brook is based in Greenfield High School.
“We’re lucky in the fact that we’ve got a lot of people we can reach through their children,” Brook said. Brook believes parents need to educate themselves in particular about the dangers of over prescription to themselves and to their children, because the prevalence of opioid painkillers in the home can contribute to incidental abuse.
In the neighboring Gill-Montague district, the Gill-Montague Community School Partnership’s five-year Drug Free Communities grant ended last year, and the prevention coalition is running on fumes while pursuing renewed funding.
In the meantime, recovering addicts from the RECOVER Project in Greenfield visited Turners Falls High School this winter to share their experiences with the students.
In the Mohawk Trail Regional School District, Superintendent Michael Buoniconti said health is taught in high school, with what amounts to a puberty class in 5th grade taught by the school nurses.
After listening to Judge Mazanec, Buoniconti said he is considering adding opioids to the 5th grade curriculum, but is moving cautiously.
“Because it’s such a young age, kids are really vulnerable ... we want to start with a conversation with the parents first before we start talking with the kids,” he said.
Mohawk middle school and high school Assistant Principal Joey Kotright-Clark said staff attended the Opioid Education and Awareness Task Force’s April 15 documentary screening and discussion about addiction dangers.
He intends to “come home as a community and start with a parent conversation as a district.”
At present, drugs are included in the high school health curriculum and touched on in the middle school science class with a cursory dating and drugs segment, he said. “But again obviously we’re recognizing that needs to be more current with the times,” he said.
The school also brings in a speaker each year to talk to athletes and their families about drugs, but the speaker model alone is weak, he said, and they are looking to expand. There is room, with time for extras beyond the standard curriculum recently added in the creation of a quasi-advisory period during the middle and high school day.
At Frontier Regional School, Superintendent Martha Barrett said health became an annual requirement for all grades, 7 through 12, several years ago. “We decided we just did not have enough time to cover all the topics that we needed,” she said. Drug education appears alongside nutrition and financial literacy.
Sarah Mitchell, Frontier health coordinator, said the doubling of health education gave room to react, and the school is looking at prescription abuse and now heroin. Mitchell is also a member of the Communities That Care Coalition, and said the topic has been discussed.
“It’s really a philosophy of the group that heroin use doesn’t start with heroin,” she said.
Outside the schools, the Opioid Education and Awareness Task Force and the Community Health Care Initiative — an advocacy group concerned with medical services — have organized events to raise awareness and discuss possible solutions, and the Task Force is developing educational material among its other efforts.
But the leaders of the task force report a surprising lack of direct participation from the schools. Sheriff Christopher Donelan, a founder of the task force, said school administrators were invited to the table when developing the organization, but did not show. From meetings of 30 or so in an upstairs conference room of the Greenfield Community College’s main building, the task force has grown to meetings in excess of 70 people.
Representation from the educational community remains in the neighborhood of one, Donovan said.
One route to addiction is through use of prescription painkillers that gets out of hand. It’s common to see reports of “stolen” painkillers that experts suspect fuel a black market.
In medical settings, education begins with doctors. A program called Scope of Pain is one avenue. It’s online training and live conferences for opioid prescribers, aiming to promote responsible prescription practices. The nationwide program is funded by major pharmaceutical companies, on the orders of the Food and Drug Administration.
Greenfield physician Dr. Ruth Potee participates in the program as a trainer, and has held trainings at Valley Medical, Baystate Franklin Medical Center, Athol Memorial Hospital and elsewhere.
The point is to help people who prescribe powerful painkillers to manage the risk of addiction, Potee said. Part of this is what is considered the new standard of care, she said, instituting very clear agreements between patients and prescribers, patient-prescriber contracts providing for monthly or semimonthly check-ins and random urine screens for patients with long-term pain management.
“This is not rocket science; Valley Medical has had this in place three years now,” Potee said.
Potee said Franklin County is lucky in that it does not appear to have any problem prescribers, or “pill mills,” although the North Quabbin area is apparently not so lucky.
The health care subcommittee of the Opioid Task Force is working on a pledge for prescribers and pharmacists.
“We’re working on getting all or as many as possible health care providers in the area to agree to a pledge that basically gets everyone on board in terms of safe opioid prescription,” said member and Baystate Franklin Medical Center spokeswoman Amy Swisher. The subcommittee includes doctors, pharmacists, the Franklin Regional Council of Governments community services director and outgoing BFMC president Chuck Gijanto.
Another state program, aimed at tighter control of prescription drugs through information-sharing, has recently become mandatory.
Mandating the use of a prescription monitoring program by physicians and pharmacies was among the immediate steps ordered by Gov. Deval Patrick in his March 27 declaration of an opioid addiction public health emergency.
Previously, a voluntary program, the Massachusetts Online Prescription Monitoring Program is an online reporting system feeding a database that allows prescribers and pharmacists to view a patient’s prescription history for a single year. The information is also used by state and federal investigative agencies in addressing prescription drug diversion, by prescriber, patients or pharmacies, according to the DPH.
According to the Centers for Disease Control and Prevention, the majority of prescription drug abusers get the pills free from relatives and friends, but those most at risk for overdose are equally likely to receive the pills directly through prescription. The CDC director urged greater use of state monitoring programs.