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A different kind of essential workers

Members of New London's Opioid Action Team are a different kind of essential workers than the medical personnel and grocery store clerks and others whom we have thanked, inadequately but repeatedly, through the pandemic.

To be a humane, insightful, empathetic source of support for people with substance abuse disorder is to serve in a pandemic that began light years before COVID-19 and will never be completely cured. People afflicted with drug abuse disorder are used to being dismissed and dumped on. The OAT, a joint effort by many public and non-profit partners, acts on the belief that there is no such concept as a throwaway person, but after a year in which 100,000 Americans died from overdoses — 1,300 in Connecticut in a comparable time frame — it's hard to argue that does not happen. 

In New London, they will continue to try.

The godmother of the nearly 5-year-old effort is soft-voiced Jeanne Milstein, director of the city's Human Services Department. She is a former state Child Advocate and currently guides the structuring of a Birth-to-8 developmental program for New London children with American Rescue Plan funds. She is that rare person who sees both the forest and the trees. She acknowledges the timelessness of the forest without conceding the significance of a single tree.

The field marshal is Kelly Thompson, CEO of the Alliance for Living. She is fierce — and she battles for dispelling the stigma of addiction and for recognition that it is an affliction of a brain altered by opioid use and not just some sort of bad seed. It takes a certain steeliness to keep reminding the fortunate not to judge while assuring people whose self-esteem has taken many hits that her team wants to know not what's the matter with them but what matters to them. Her troops include peer navigators with substance abuse experience; her allies, EMTs, paramedics, police.

As the regional resource for HIV/AIDS, the Alliance is expert at strategies involving safe syringes for heroin users and cooperation with law enforcement to steer users to help, not jail. The development of drugs that could change the AIDS diagnosis from terminal to chronic gave the agency a focus on long-term services. The Alliance's strengths match the needs of the OAT.

Jennifer Muggeo, deputy director of the Ledge Light Health District, is referred to as the project manager for the Opioid Action Team but her passion is saving lives and her frustration is that solutions proven to work in other countries can't get a foothold here.

"We would not respond to any other public health crisis the way we respond to this," she told me. "We have an evidence base of policies that could save lives."

People are at the greatest risk of overdose when they are socially isolated, using drugs alone. Muggeo points out that Canada and some European nations have overdose prevention centers where users can consume drugs with medical personnel present. People there do not die.

The task these three and their partners have committed to is to stay available for the long haul with each individual while fighting for better public policy. Success is hard to quantify with the usual sort of statistical comparisons of how many their efforts might have saved this year vs. last; often someone from the team will have an initial conversation, then months of silence, and then a call; "I'm ready." Having convinced users and loved ones to keep the antidote naloxone on hand, they may not hear about it when an overdose is halted.

The challenges will keep on coming in new forms — another Covid variant that might mean reopening safe isolation centers; a terrifying degree of adulteration in drugs that can kill someone who doesn't even know they are ingesting it. Fentanyl is the additive most people have heard of; now it's xylazine, which is not treatable with naloxone and hard to test quickly. The team and its leaders are essential workers, all right. They have earned our thanks.

Lisa McGinley is a member of The Day Editorial Board.

 

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