Rep. Santiago Hosts Opioid Epidemic Town Hall

A large crowd gathered at the McKinley South End Academy on March 7 for an opioid epidemic town hall hosted by Rep. Jon Santiago and the Mayor’s Office of Recovery Services. The crowd was ready and willing to speak out on this issue that has become a topic of conversation across the city as people work towards solutions.

In addition to a large number of community members, several elected officials or their representatives were in attendance, including Mayor Marty Walsh. “There’s been no bigger advocate for these issues,” Santiago said of Walsh.

Walsh spoke about the investments the city has made in the area of recovery, including the creation of the Office of Recovery Service, which Walsh said helps deal with addiction “in the homes of everyone across Boston.”

Walsh said that they are “working together to create pathways for recovery,” and brought up the controversial issue of Safe Consumption Sites. Walsh said that he was originally against them, but after hearing things and thinking about it some more, he questioned his position. Walsh said his view on them “has completely changed,” and cited Toronto and Montreal, who have used the facilities, as “thoughtful” examples. He said that in those situations, people were not taking the needles out of the facilities, nor were they overdosing.

One of the roadblocks for bringing Safe Consumption Facilities to Boston is that they are illegal in the United States. “A lot more work of education has to happen,” Walsh said. “The issue tonight at hand is about what we are doing about the addiction that’s happening in the City of Boston right now. How do we save lives?”

The town hall consisted of presentations from three speakers, followed by public testimony. Santiago spoke first, telling the crowd, “If you’re here, my guess is that this is affecting your quality of life. I hear you, and I see where you’re coming from.”

As an emergency room doctor, Santiago sees and treats people affected by the opioid crisis every single day. He also said he sees the needles on the ground on his walk to work, just like many other concerned citizens.

“Massachusetts has been a leader when it comes to advancing opioid legislation,” Santiago said. He gave a brief presentation of some of the legislation that the state has passed since 2016, including that opiate prescriptions must not exceed seven days, and there must be “rigorous training” for practitioners who prescribe them.

Santiago spoke about the prison system and its effects on people dealing with addiction. He said that when someone enters the system, they often go through withdrawal and begin to lose tolerance. When they leave prison, they go back to the same areas, use again, and die. Santiago said that people are 60 to 100 times more likely to die from overdose after release from jail.

Santiago said he wants to increase access to Medication Assisted Treatment (such as Suboxone) so that people can get it from their primary care physicians. He said this was especially important for the more “vulnerable populations” such as people in prison.

As far as Safe Consumption Sites go, Santiago said he believes in the science behind them, but he “think [s] there is some lower hanging fruit we can get to before this.”

Next up was Marty Martinez, Chief of Health and Human Services, and Jen Tracey, Director of the Office of Recovery Services. Martinez said that the national opioid epidemic is more deadly than gun violence, car crashes, or the AIDS epidemic. He said there is an increase in people of color being impacted—state data shows that people of color have higher rates of overdose, while the number of white overdoses has briefly gone down. He said that while the face of the epidemic may be changing, it is still a serious epidemic.

Tracey talked about some of the work that the city has done to address this problem. She said there are over 80 licensed treatment programs in Boston for substance abuse disorders, and that 10-20 people are placed in treatment per day. With the detox beds that have been added over the past few years, it has become easier to get people into treatment, she added.

Tracey said that people were having difficulty accessing care and didn’t know where to go for help, so she talked about the launch of 311 for Recovery Services, which was created to help people access care. They also increased the number of Street Outreach Workers, as well as expanded the hours at PAATHS, the city’s access-to-care program.

She said that there have been cross-department efforts to make infrastructure improvements, including increased lighting and security cameras. As has been reiterated at numerous public safety meetings, Tracey said that people should call 911 for emergencies and 311 for trash and syringes.

She said that EMS and BPD launched initiatives to help the high number of people struggling with substance use, homelessness, and mental health issues across the city.

Martinez said that they are working to rebuild the Long Island Bridge to “create a recovery campus to expand essential recovery resources, fill in gaps, and serve as a national model for a long-term recovery campus.” He said that the bridge construction is scheduled to take three years to complete and is “several years away.”

The third speaker was Michael Botticelli, Executive Director of the Grayken Center for Addiction at Boston Medical Center. As a person in recovery himself, Botticelli is dedicated to helping people get the help they need. “Stigma is one of the major drivers for this epidemic,” he said. He said that the thought process in the past was that “these are bad people doing bad things,” and the issue has been underfunded for years. He said that only 14 to 20 percent of people who have addiction actually get care for the disorder. “We have to acknowledge the fact that we need more of everything,” Botticelli said.

Boston Medical Center has “a very robust primary care clinic that integrates treatment in everything we do,” he said, adding that society has a responsibility to keep people alive in order to get them care. He said that BMC has also invested in a community housing development, as “this is an all hands on deck issue.”

The public was then allowed to testify. Several people spoke about the fact that services need to be spread out across the city so they are not concentrated in a single area. Another person mentioned that there is a “severe shortage” of recovery programs, and suggested that jails provided a path for recovery instead of branding people as criminals.

Others were concerned with the fact that this meeting was held in a “safe zone,” and not at Orchard Gardens K-8 school, where the issues are much more prevalent. People said they do not see the “collaboration and cooperation” that city officials and others have spoken about.

Santiago said that this is one of many meetings, and “we will be over there, I promise you.”

A teacher at Orchard Gardens testified, saying that she walks to school everyday and sees or teaches someone affected by the opioid crisis. “My sixth-graders have been affected by it with mental health,” she said, adding that many of her students have to walk to school. “I know what I see and it’s not okay and it’s not okay for students to see it. My students have seen blood coming out of people’s arms. All of them are affected in many ways, but one is just getting to school.”

A student at Orchard Gardens said she was afraid to walk outside. “All I see are people addicted to drugs,” she said, and wanted to know what could be done to make walking in her neighborhood safer. “When we drive by the Methadone Mile she asks to lock the doors,” her mother said. “She is scared to even walk in her neighborhood.”

Others said that people from plans like Dorchester, Mattapan, and Roxbury are being left out of the conversation. “We don’t see these services in the black neighborhoods,” someone said. “When it does come, it’s in the form of a police cruiser. These kids are not getting resources at Orchard Gardens.”

There was not enough time to get to questions after public testimony, so people were asked to submit questions via text. These questions will be placed in a document with answers that will be circulated to meeting attendees.

“There are communities that have not been heard,” Santiago said. “We’ll be the first to tell you that we can do better. This is the first of many more to come. Your voices are being heard.”

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