By TIM O'NEIL
The radio dispatcher relays a report of an unresponsive person. Police officers find a man down, barely breathing. At his side is an injection needle, in his pocket a capsule of powder.
Paramedics rush him to a hospital. Police apply for drug-offense charges. After a few days in jail, the man goes free on bond.
Another radio call, the same man down. Now what?
"There has to be more than just arresting drug addicts and prosecuting them for low-level crimes, and then doing it all over again," said Chief Matt Vanyo of the Olmsted Township Police Department near Cleveland. "Isn't that one of the definitions of insanity?"
St. Vincent Charity Medical Center in Cleveland worked with Vanyo to create Safe Passages, a means for police in four suburban districts to offer medical help to substance abusers rather than incarceration. St. Vincent Charity also assisted in obtaining an $87,500, two-year state grant to provide follow-up counseling to participating substance abusers.
Also working with St. Vincent Charity and the four suburban departments — Olmsted Township, Berea, Newburgh Heights and Bedford — is the School of Social Work at Cleveland State University. The social work school has partnered with St. Vincent Charity on many projects. The school's role is to collect and analyze case data in hopes of finding whether the Safe Passages program increases the rates of success in rehabilitating drug abusers.
Public health partnership
St. Vincent Charity has the area's only psychiatric emergency department and has for decades specialized in treating chemical addictions. The hospital offers detoxification and long-term treatment to patients referred by the Safe Passages police departments.
"Behavioral health and addiction treatment are part of our mission and are among our core competencies," said Thom Olmstead, the hospital's director of university collaborations.
The Safe Passages collaborative is one of several that St. Vincent Charity and Cleveland State announced in October 2016 to promote research and innovations in public health. The two institutions are near each other on the eastern edge of downtown Cleveland.
Vanyo initiated the Safe Passages program with Police Chief Joseph Grecol of neighboring Berea. They, like their peers nationwide, witnessed a sharp increase in opiate overdoses in the past few years, increasingly from widely available and inexpensive heroin and fentanyl.
"When you say heroin addict, the vision is of some guy in an alley," said Vanyo, who worked as a narcotics officer for a decade. "This drug is nondiscriminatory — its victims are moms, athletes, professionals, from high socioeconomic levels down to the homeless."
The Centers for Disease Control and Prevention reported that more than 33,000 people died from opiate overdoses in the United States in 2015, nearly triple the toll of only five years before.
The CDC says opioids including prescription drugs, heroin and fentanyl killed more than 42,000 people in the U.S. in 2016, more than any year on record. A preliminary report of all overdose deaths during the 12 months ending in April 2017 shows a nearly 18 percent increase over the previous 12 months — to 65,669 from 55,778.
Services, not a jail cell
Many police officials across the country are searching for ways to blend social services with law enforcement to reduce deaths and overdoses. Chiefs Vanyo and Grecol made their offer in August 2016 to assist abusers in seeking help through Safe Passages without fear of incarceration as long as they are not wanted for more serious offenses. Vanyo and Grecol also promised to work with anyone who is suspected of lesser offenses without the threat of jail. So far, Vanyo said, about 150 people have accepted the offer of help.
Vanyo called St. Vincent Charity "a galvanizing force in helping us get started. (The hospital staff) opened their arms to us."
Mary Matzinger, nurse manager of inpatient detox at St. Vincent Charity, worked closely with the two police chiefs in devising the program. Matzinger said police officers offer the opportunity to drug abusers, who are either transported or agree to show up at the hospital for treatment.
"Just because somebody gets revived by Narcan doesn't mean they want treatment," she said. "It's a lot easier to detox here than in jail. But the potential for the help we can give any individual is great."
Following the Safe Passages cases is the task of Patricia Stoddard Dare, program evaluator and associate professor at the Cleveland State School of Social Work. Dare said nurses, psychiatrists and patients at St. Vincent Charity offered advice that helped her design the Safe Passages outcomes study.
Dare said she also provides training for officers and for citizen volunteers who help collect data and assist in follow-up work. "One of the first steps is to change the traditional belief system, from regarding someone struggling with addiction as a person who needs incarceration," she said. Rather, "These are people in need. How do we get them help?"
She said she plans to provide a preliminary report sometime this year.
Grecol, the Berea police chief, said St. Vincent Charity and Cleveland State "have provided a strong hand in guiding us on the best ways to proceed. They showed us the other side of the addict and the work that can make a difference for people. You want to talk about softening the attitudes of hardened cops, this is the way."
Vanyo said the other two departments joined Safe Passages this year and other police officials are interested in taking part. That's good, he said, because Cuyahoga County, which includes Cleveland and the Safe Passages communities, recorded 660 overdose deaths in 2016 and was on pace for more than 780 in 2017. "It's going to get worse before it gets better," Vanyo said.
Olmstead, the hospital's director of university collaborations, said the addiction-recovery study is one of about three dozen projects already underway between St. Vincent Charity and Cleveland State. Another example, he said, is work by members of the hospital's Spine & Orthopedic Institute and the university's Washkewicz College of Engineering to develop improved prosthetic devices and rehabilitation techniques.
Olmstead said the hospital-university partnership also can improve classroom instruction on the urban campus, both in curricula and opportunities for students to work directly with hospital staff. Dare, the university researcher, offered another poignant potential for benefit — many of the students in her social work classes have friends and family members who abuse drugs, or are struggling with, or recovering from, addiction.
The hospital-university partnership began with the announcement of $550,000 in donations to finance its work. Dr. David F. Perse, president and chief executive of St. Vincent Charity, said he was "confident that others will want to help us grow these efforts in scope and sophistication."
Copyright © 2018 by the Catholic Health Association
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