A group of 11 towns in northwestern Connecticut are combining funding received from the national opioid settlement to jointly address the local crisis.
In July, four major pharmaceutical companies agreed to pay a total of $26 billion to 46 states. Connecticut will receive $300 million, of which about 85 percent will remain in the state and 15 percent will be distributed to towns over multiple years.
Most towns use the funds to educate youth about the dangers of opioid use, and in many cases, the funds are diverted to local youth services departments, according to a report from the state Opioid Task Force. ing. Some are using the money to buy Narcan and support nonprofit organizations and substance abuse clinics.
But the northwest corner is unique in its search for regional solutions.
Council of Governments project manager Leonardo Ghio said the decision made sense given the town's size. Of the 11 communities he has agreed to pool funds with, nine have populations of less than 4,000, with the largest, Litchfield, having a population of about 12,300.
Gregory LaCava, first selectman for the town of Warren, which has a population of about 1,300, said the small donation the town received (about $4,700) would be best used in conjunction with neighboring towns.
“Many of the towns in our region [Council of Governments] We share the same responsibility and concern as everyone facing the epidemic,” Lacava said.
Litchfield First Selectman Dennis Raab said the town received more funds than it could effectively spend, so the town decided to donate a portion of the funds (approximately $21,300) to the City Council. said. She said she hopes these funds can help other towns that don't receive as much funding.
Approximately $18,000 in additional funding will be distributed between Litchfield Prevention Council and Greenwoods Counseling Center, organizations that work with youth.
“Sometimes you think it's just people who are inexperienced and naive,” Raab said, adding that he was surprised by the number of people in their 50s and 60s who have experienced non-fatal opioid overdoses. . “So I think it's important to get better education out there and for people to realize that what they're receiving isn't exactly what they think it is.”
Department of Mental Health and Addiction Services Director Nancy Navarreta told the CT Examiner that she supports the plan for Northwest Corner organizations to pool their funds.
“They have good leadership in that part of the state. They really rallied people and made a difference in the numbers early on,” she said.
fight the stigma
Lauren Prest, coordinator of the Richfield County Opioid Task Force, said that while the total number of overdoses in the town is low, the county had one of the highest overdose rates per capita several years ago. said.
“There may be a single fatal overdose, but when you look at the population proportions, it's heartbreaking that a significant proportion of the rural population is actually affected,” she said. .
She said that number has since decreased thanks to increased access to naloxone and coordinated care.
The number of opioid overdoses in Litchfield County peaked in 2019, rising from 52 in 2015 to 76 in 2019, according to the data. Last year, that number dropped to 44.
But Presto said she remains concerned, mainly because of the changing types of drugs available on the street. While fentanyl remains the opioid currently responsible for the majority of overdoses, the equine tranquilizer xylazine is becoming more popular. About 14 percent of fatal overdoses in the region involved xylazine, according to data from the Western CT Coalition, one of five regional oversight agencies under the Department of Mental Health and Addiction Services.
Ghio believes one of the biggest barriers for rural areas is the misconception that small towns are not affected by the opioid crisis, which prevents people from learning about it.
“If you're biased and say, 'We don't have that problem,' it's hard to reach the people in your town who actually have that problem,” Gio said. “If we can create awareness and education about the signs and symptoms and how it happens, for example, about counterfeit pills and the increased amount of fentanyl that is being discovered and mixed into things… step one. is to fight against that prejudice.”
So far, the task force has agreed to put some of the money toward “leave-behind kits,” kits containing two doses of naloxone, gloves, contact information for a treatment provider, and instructions on how to administer Narcan. are doing. Then perform cardiopulmonary resuscitation.
Emergency medical workers responding to an overdose incident can provide kits to family members and loved ones to ensure they have them on hand in case it happens again. According to Gio, his 90% of overdoses occur within the home.
Presto said this is especially important in rural towns like the Northwest, where people may live far from hospitals.
“It's extremely important to help someone regain their breathing as quickly as possible,” Presto said. “And naloxone is [neural] receptor [that opioids bind to in the brain]”
LaCava, who is also a paramedic, agreed on the importance of delivering useful supplies to residents.
“We can now leave something like this at a local level where many residents may not be in large cities or high-traffic areas where campaigns and advertising and media and marketing take place. to affect change,” LaCava said. “We're really going to bring support to communities and families.”
Maria Skinner, CEO of McCall Behavioral Health Network in Torrington and co-chair of the Opioid Task Force, said solving the opioid crisis requires more than simply educating people about opioids. He said it would mean changing everything from the way children are supported in school to the way families are supported. Understanding addiction.
“What are the barriers to access when someone starts showing signs of trauma, mental health or addiction issues, and what is in place to provide early intervention to change the trajectory?” ” asked Skinner. “When someone is really suffering and struggling, what do we have and what do we lack? And frankly, despite our best efforts, what do we have in place and what do we lack? , are we going to keep putting money into the very same systems that have been failing people…over and over again, for generations?”
too little, too late
Despite the recent influx of money, Presto said it's too slow.
“Given the opioid settlement, even a little bit of funding is way too slow to address this crisis that has been raging for years,” she said, noting that many towns are already implementing measures to prevent youth offending. Opioids, he added, where strong efforts are being made.
Pills like Xanax and OxyContin sold on the street can be contaminated with fentanyl, said Emma Hollis, behavioral health director for the Western CT Coalition, which coordinates mental health and substance abuse services in the region. He said it was particularly dangerous.
“Some parts of the tablet may contain very high concentrations of fentanyl, while other parts may not. “It's very difficult to distinguish between the two,” she explained.
Hollis added that youth prevention efforts don't necessarily focus on teaching about drugs themselves, especially to young children. Instead, she said, children are taught to seek out trusted adults who can help them with difficult emotions.
“That's the root of prevention work, raising healthy children, healthy young people, and feeling OK when they get older and not necessarily needing maladaptive coping skills like drug use.” Hollis said.
But Presto said young people make up only a small portion of the population suffering from opioid addiction. Many of them were adults suffering from trauma, she said.
“It could have started with a prescription. It could have started with something else. It could have started right away under the influence of drugs,” Presto said. “These are people who have gone through a lot of trauma in their lives, a lot of negative events that have really hurt them deeply. They are people who have been deeply hurt. And that's why they're okay with being in their own skin. It’s the only thing I feel.”
Navarreta said she and state researchers agree that while prevention is important, opioid settlement funds need to be spent on treating people who are at immediate risk.
“We agree that this funding is really there to prevent overdoses and that it is the one that has the greatest return on investment in terms of people's lives. And to that end, naloxone and [medications for opioid treatment] It really ranked at the top of my list,” Navarreta said. “The first dollars that will be provided will be dollars that immediately stop people from dying.”
make a difference
In 2022, the state Legislature established the Opioid Settlement Advisory Commission, tasked with determining how settlement funds will be spent across the state. Navarreta, the council's co-chair, said he has begun working with researchers at Yale University to review the current situation and consider strategies that other states are implementing.
Connecticut ranked 14th in population-adjusted opioid overdose numbers in 2021, according to CDC data. The number of overdoses has decreased across the state in recent years. Navarreta said opioid deaths are on track to decline by 4.3% from 2021 to 2022 and by 4.5% from 2022 to 2023, the largest decline in the entire New State. became. England.
“We feel like we’re making a difference and the numbers are starting to show up,” she said.
Ghio said Connecticut is committed to providing programs that provide access and safe disposal of syringes, overdose prevention centers that allow people to inject drugs in a safe space, access to naloxone, and ensuring that the drugs are not contaminated. He said funding should be provided for harm reduction services, such as programs that provide drug testing to ensure that people are safe.
Another promising practice is diverting people who commit low-level crimes related to drug use, such as loitering or shoplifting, to social services rather than being sent to prison, he said. He said teams will be introduced in Torrington, Winsted and Watertown to provide housing, food and harm reduction to people who have overdosed.
“We often see them getting addicted, they don't have food, their kids are taken by DCF, they're kicked out of their homes. There are so many complicating factors that at that point you don't have to say, 'Yeah. You can't just say, 'I'm going to stop doing the one thing that makes me feel good.'” Gio said.
So far, the City Council has approved one use for the funds: supplying the syringe exchange program. Funding for these programs has remained flat, Navarreta said, but the need has doubled. He said he hopes to bring more recommendations to the council at its next meeting.
While many programs are often concentrated in the state's urban areas, Navarreta could focus special assistance on those hardest hit: Black men between the ages of 45 and 54. said.
Federal rules prohibit Connecticut from using funds to support overdose prevention sites where people can actively use drugs. But she said the state will support the creation of other spaces where people can gather for recovery.
“We know that connection is so important in the recovery process, so whether it’s in the form of a self-help conference or something like a drop-in center or recovery center, Those are all things we want to support now,” she said.