Berkshire DA, Brien Center medical director talk fighting opioid crisis

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LENOX — Treat medically, not criminally, people with a substance use disorder.

The county's top law enforcement official and a leading local mental health expert delivered that message Sunday morning, during a two-hour forum at Lenox Town Hall.

Berkshire District Attorney Andrea Harrington and Dr. Jennifer Michaels, medical director at the Pittsfield-based Brien Center, the county's largest mental health care provider, spoke to and answered questions about the legal and health ramifications of the opioid crisis in Berkshire County.

Michaels and Harrington were guests at the sixth annual meeting of the Maimonides Society of the Berkshires, organized under the auspices of the Jewish Federation of the Berkshires. The society hosts programs that are open to all healthcare professionals.

A proponent for treatment over jail time, Harrington believes many of the local court cases involving defendants accused of unarmed robbery or breaking into people's homes looking for drug money could have been avoided had their addiction been dealt with sooner.

"When people are receiving the kind of medical treatment they need, they are not out committing those types of crimes," she said.

With the annual cost of incarceration per person in Massachusetts running about $55,000 compared to $10,000 for treating someone with a substance use problem, the latter is the obvious choice to Michaels.

"It's such a bargain and a long-term solution," she said.

Michaels opened the forum with disturbing statistics showing the Berkshires with a 6 percent rate of opioid addiction, the highest in Massachusetts and nearly double the rate in the Boston area, Suffolk County. Furthermore, the county's recorded number of annual opioid deaths has jumped tenfold from four in 2010 to 40 in 2018. The death toll has gradually increased each year during that period, except for a decline from 36 in 2016 to 27 in 2017, before spiking at 40 last year.

Michaels said addiction is a brain disease best treated with methadone or other medication over a long period of time.

"You can't cure [the addiction], you can only knock it into remission," she said. "As you increase the amount of time on medication, you can increase the length of one's life."

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On the prevention side, Michaels says education in the schools, at home and among medical professionals is crucial in recognizing someone is misusing drugs and how best to intervene. The education includes using positive language to describe individuals who have a substance use disorder or are in recovery. Michaels noted the stigma of calling someone a substance abuser, addict, clean vs. dirty and other derogatory labels is a "lead reason people don't seek treatment."

Keeping a campaign promise, Harrington says she's working toward changing a criminal justice system that isn't designed to help provide medical treatment to those with a substance use disorder.

"When I ran for district attorney last year, I found people in our community who were starting to see the effect the criminal justice system was having on their neighbors," she said.

Three months ago, Harrington headed to Europe, returning with potential ways to decriminalize the approach to the opioid crisis.

She and several other district attorneys from around the country went to Portugal in mid-May on a trip sponsored by Fair and Just Prosecution. According to its website, the nonprofit organization "brings together newly elected local prosecutors as part of a network of leaders committed to promoting a justice system grounded in fairness, equity, compassion, and fiscal responsibility."

The crux of the Portugal trip was an opportunity to examine the results of nearly 20 years of a policy decriminalizing personal possession of narcotics that emphasizes treatment over prosecution for most drug offenders.

"It's a medical health model for substance use disorder," she told the audience. "It's an act of treating people with compassion and dignity."

Harrington says jail is no place for treating nonviolent people with a substance use problem.

In the long run, the district attorney believes treating individuals misusing drugs can keep help them employed, improve family relationships, and make them a vital part of the community.

"I don't want to build a community just to keep people out of jail, I want to build a community where people can thrive," she said.

Dick Lindsay can be reached at rlindsay@berkshireeagle.com and 413-496-6233.


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