Panel: Opioid scourge is 'public enemy number one' for its toll on youth

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PITTSFIELD — Recently, the city encountered a drug sale in a school — an elementary school.

A student brought in drugs from home and sold them to another student.

Ann Marie Carpenter, unit leader of school psychologists and school adjustment counselors for the Pittsfield Public Schools, shared that story Wednesday with a group of about 25 people at a forum on the opioid epidemic's effects on families.

The eight panelists at the forum, drawn from state agencies, education, social work and medicine, shared their roles in handling the crisis and how it affects families, especially children of all ages.

"To be perfectly honest, I wish this room was fuller," said Todd Hould, area program manager of the Berkshire Area Office of the Department of Children and Families.

He oversees intake and response units, which are responsible for taking and investigating reports of abuse and neglect.

The opioid epidemic is a priority — it's "public enemy number one," he said.

In about 75 to 85 percent of families, they work with, one or both parents have substance issues, he said.

In response to pointed questions from audience members, Hould emphasized that the last thing DCF wants to do is have to remove a child from their parents.

DCF often refers parents to support centers, like the Brien Center, he said.

On the panel were two representatives from the Brien Center: James Mucia, who is division director of the child and adolescent division, and Megan Eldridge Wroldson, who is division director of adult and family services.

"Has our referral rate increased with the opioid crisis? Yes," Mucia said after introducing himself.

He described working with children who are using drugs.

"Adolescents, when they're using, don't come to treatment much," he said.

Why?

They're in the early stages of substance use, generally. They're having a lot of fun.

Mucia said his office sees a lot of children who have been subjected to "parentification," which happens when parents who are using drugs cannot function, forcing a child to take on a parental role.

Mucia recalled a young woman describing times in her childhood spent cleaning up her alcoholic mother's vomit, putting her to bed and caring for younger children.

People who work around this issue should be talking about the disorders these children develop as they grow up, as they didn't go through normal developmental stages, he said.

"They don't know what to do with themselves, and they're a mess," he said, describing what happens when they reach adulthood.

Wroldson described how her work is based on the premise that treatment can help — there is hope.

Right now, they're focusing on how to approach treatment in a trauma-informed way.

She explained that trauma can be a part of addiction, arising from experiences during that addiction.

And addiction can also result from traumatic experiences.

The question-and-answer driven forum, hosted jointly by the Central County RX/Heroin Workgroup and the Berkshire Opioid Abuse Prevention Collaborative, often expanded to discussions of other drugs besides opioids, including marijuana.

Over the last several years, Joan Roy, nurse leader for the Pittsfield Public Schools, said she's noticed that the marijuana students are smoking is so strong that they pass out, their hearts beating at 170 beats per minute.

"I'm really concerned about the dispensaries coming, and the edibles that are going to be available," Roy said, referring to the upcoming opening of retail marijuana establishments in the state. "[They'll] think it's a gummy bear or a gummy worm, and it's not."

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Roy said it was her impression more students are smoking marijuana — and they don't see that as problematic.

The Pittsfield Public Schools have also seen an increase in "vaping" and "Juuling," said Carpenter.

Juul is a brand name for a product that delivers a potent dose of vaporized nicotine to the lungs.

Along with the opioid epidemic and high levels of poverty districtwide has come a lot of unaccompanied minors — students who don't have a legal guardian, but may be too old for DCF involvement.

"They're living on friends' couches, those sorts of thing," Carpenter said.

And with kids who are themselves addicted to substances, there are very few options for them in the county.

There are no bona fide housing or day programs for students struggling with these issues. If they have to go get treatment elsewhere, they're "just dumped back into the school" when the program is over, Carpenter said.

Another barrier comes with providing special services to these students, as substance abuse is not considered a disability that qualifies a student for special education, and the county does not have a recovery high school.

The district is also seeing students with drug-addicted parents who have to deal with the trauma of being in multiple foster homes, Carpenter said in response to an audience member's question.

The district has the opioid-overdose antidote naloxone in all of the schools, and is actively screening students for potential issues with drugs, referring them to treatment confidentially if they agree, Roy said. This year, the district screened seventh- and ninth-graders.

As the discussion opened up for audience questions, one woman asked the panelists what the one thing they'd change in the epidemic, if they could.

It's a struggle to help someone when they're ready for treatment, but the treatment is not available, Wroldson said.

"We'd like to have no waiting list," she said. "I'd like to see more of what we already do."

On top of that is the stigma attached to parents who suffer from substance use disorders.

Many are afraid to ask for help, thinking their children will be taken away.

She also mentioned the need for role models of recovery, who can help provide inspiration for change.

"Why aren't they at the table?" she said.

People need space to support their recovery. Wroldson said she'd love to see peer-led recovery groups with state funding and more recovery coaching by those who have lived experiences in addiction. "That feels like the big gap," she said.

Hould, gesturing to Wroldson, said his office constantly looks for family success stories as many families are bogged down in their struggles.

If they can see the light at the end of the tunnel, they can keep going, he said.

Jennifer Kimball, who co-chairs the Central Country RX/Heroin Workgroup, asked Hould about how DCF handles relapses when working with families struggling with substance abuse.

"Relapse is part of addiction," he said. "We realize that. It's not going away tomorrow."

One woman in the audience said a majority of people she works with have a negative view of DCF — they're "scared to death" of it. And with the constant turnover at the agency, people get confused. She's heard reports of parents who had children taken away under questionable circumstances.

"The last thing you want to do is pull the rug out," Hould said of the removal process. "We're constantly working on that; decision-making isn't perfect."

A few years ago, the agency streamlined its response to investigations, so only one worker would handle a case after the initial 15-day period.

Unfortunately, DCF definitely has staffing issues. Hould said.

Multiple staff members have left Berkshire County, he said.

Patricia LeBoeuf can be reached at pleboeuf@berkshireeagle.com, at @BE_pleboeuf on Twitter and 413-496-6247.


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