Police can't arrest their way out of the heroin epidemic. Nashville tries a different approach to break the cycle.
July 09--Help Spread Hope
Supporters of the Nashville Police Department's Hope Initiaitve can make a tax-exempt donation online at www.nashhealthcarefoundation.org or send a check to: Hope Initiative, Nash Health Care Foundation, 2416 Professional Drive, Rocky Mount, N.C. 27804
NASHVILLE -- Addicts collapse on the couch in Police Chief Thomas Bashore's office every week, reaching with needle-scarred arms to dab bleary eyes. They surrender their stash, exchanging heroin for hope.
"There has been a thousand tears cried on this couch," Bashore said, easing into the brown leather sofa. "The families that come in and bring in their sons or daughters, you can see that they're at their rope's end and they don't know what to do or where to turn."
Thirty-two of them have turned to Bashore since Feb. 9, when the Nashville Police Department became the first law enforcement agency in North Carolina to offer drug rehabilitation assistance modeled after a Massachusetts cop's quest to treat heroin users as addicts rather than criminals.
"I know that we have saved individuals' lives, people who might well be dead right now from an overdose," Bashore said.
Through its Hope Initiative, the department allows users to bring their drugs and paraphernalia to the police station without fear of arrest. Instead of a trip to jail, clients are ferried to the Coastal Plain Hospital in Rocky Mount for detox, then referred to a long-term rehab facility or enrolled in an intensive outpatient program.
Town Manager Hank Raper approached Bashore with the idea shortly after he was hired last October. Raper wanted a police department that was proactive, not reactive, in its approach to drug abuse.
"For years, it's been a policing model when you see people suffering from drug addiction to treat it as a criminal issue," he explained. "You lock them up, you send them to jail, but then they get out of jail and what do they do? They come right back and start using again. It's a real recognition that methods of the past aren't really an effective solution, and we're trying an alternative way of providing assistance to the community."
As North Carolina grapples with a spike in heroin overdose deaths, Nashville is aggressively promoting the intervention program to area police agencies, sharing successes and struggles with colleagues and helping to draft model policies on a national level.
"I know there's probably still some skepticism out there from other law enforcement agencies that this is a health department issue or a social services issue," Raper said. "I think it's an all-of-the-above issue and everyone needs to play their part."
The Hope Initiative's first client walked into the Nashville Police Department on Feb. 19. Nearly five months later, the man remains clean and sober. Bashore helped him find a long-term rehab facility in Florida. Since starting the program, the client has found work, rented an apartment and bought his own pickup truck.
Of the 32 people referred to treatment, 29 were addicted to heroin or opioid painkillers, two were crack-cocaine users and one abused alcohol. Twelve are in long-term rehab facilities, and only three of the 32 are known to have relapsed since their initial intake.
"It's been highly successful so far," Raper said. "I think we're doing fantastic. We've been very busy since February having 32 people come in, it's been quite an endeavor."
Bashore or Lt. Joseph Corbett meets personally with each Hope Initiative client. The police chief's cellphone number is printed in brochures and on business cards promoting the program, and he's fielded his share of calls after hours.
"If they call me, then I'm coming," Bashore said. "You're helping those individuals, you're helping the community and you're saving lives. That's what we're supposed to do in law enforcement. That's part of our core function."
It isn't the occasional user or rebellious teenager who winds up on Bashore's couch. He sees the hard cases -- people who, for the most part, have used heroin or prescription painkillers daily for years on end.
"The average age is about 26, 27 years old and you have somebody that has broken a lot of the bonds that they have with their family," the chief explained. "They've ruined relationships. They've stolen everything they can get their hands on in the house. I've had parents tell me they're on the brink of losing their house. They can't afford the mortgage anymore because they've taken everything they had to try to help."
Advocates of intervention programs are working to dispel the notion that health departments or social services agencies should be providing access to rehab instead of police.
"The community doesn't care what box you put it in as a government," Raper said. "They care that you're providing them help. I don't think we can take an isolated approach and say 'Well, that doesn't really fit in my job description. That doesn't fit the way we typically do things.' I think you've just got to throw that out the window and go to people as they are and provide them the help that they need."
INTAKE TO RECOVERY
After helping 32 patients through the Hope Initiative, Nashville police have condensed and refined the intake process while still taking the time to listen to people's stories of addiction, loss and hope.
"We've got the process down to probably about 30 minutes," Bashore said. "If they have drugs or paraphernalia, they can turn it over to us -- no questions asked. We just destroy it. We don't ask them or interrogate them about where they got their drugs from or any of that."
When clients arrive, Bashore sends a group text message to a team of 37 community volunteers. The first person to respond will report to the police department. Volunteers become like sponsors or accountability partners for each client.
"They keep contact with them throughout the process and even after that to make sure they're on the right path and encourage them," Bashore said. "If they need to call somebody, they can."
Either Bashore, the volunteer or a client's family member will drive him or her to Coastal Plain Hospital for evaluation at the emergency department and admittance to a detox program there. Patients stay in detox for an average of five to seven days.
"Withdrawal symptoms usually start for an individual at the two-day mark," Bashore said. "They refer to it themselves as 'getting sick.' The withdrawal symptoms can be pretty painful, they're not pleasant, and so the detox process kind of helps them through that."
While Hope Initiative clients are shaking off the physical symptoms, Bashore is working the phones to place them in long-term rehab, which ranges from about nine months to two years. Some clients opt for outpatient treatment so they can return to work or repair family ties.
Nashville police have placed 12 clients in long-term programs -- seven in North Carolina and five in Florida. Going out-of-state is sometimes necessary due to a severe shortage of facilities here, Raper explained.
"We are playing our part to try to get people into those seats and those beds, but there is nowhere close to the number of beds needed to actually treat this problem," Raper said. "In the eastern part of the state, there is not a single long-term treatment facility that we can send someone to for heroin addiction."
The town of Nashville has purchased airfare and bus tickets for Hope Initiative clients and paid application fees ranging from $250 to $400 for long-term treatment, but it doesn't pay for the programs themselves. Fees can top $13,000 per month, and Bashore will pull any string he can to get a scholarship or find an opportunity for a client to pay his or her own way through models that offer job training and allow patients to work during their stay.
Raper said the town has spent less than $3,000 on the first 32 clients combined.
"We do not use any ad valorem taxation money for this," he said. "We just use the money we get from our drug prevention grant."
A scourge in the northeastern United States for years, heroin has gained popularity in the Tar Heel State, where many of its users found the drug cheaper and easier to obtain than opioid painkillers.
The Coastal Plain Hospital logged double-digit figures for heroin overdoses until 2015, when the number spiked to 532 in a single year.
"If you've got a thousand-percent increase here, it's not really something you can sweep under the rug," Raper said. "It's already here. It's not a matter of 'We'll address it when it gets here.' I think you're in denial if that's what you think."
The town manager noted that many users migrate to heroin after receiving legitimate prescriptions for opioids like hydrocodone, oxycodone, codeine and morphine.
People who abuse heroin also defy demographics -- with young and old, rich and poor, whites and minorities all developing a physical and psychological dependence on the substance.
"Children are addicted to heroin," Raper said. "Elderly senior citizens, 80, 90 years old, are hooked on heroin. Wealthy individuals, poor individuals. It's a cheap drug. For $10, you can buy a hit of heroin. That's really not unaffordable to anybody. If you want it bad enough, you can find 10 bucks."
The high number of overdoses prompted law enforcement agencies throughout the state to begin equipping officers with naloxone, an emergency drug that counteracts the life-threatening effects of heroin and opioids and can reduce an overdose.
Each of the Nashville Police Department's 16 sworn officers have received training on administering the medication through nasal injection and have two doses on hand at all times. Wilson police and Wilson County sheriff's deputies also carry naloxone kits.
Sometimes it takes an overdose or an extremely close call to shock users into reality, Raper said.
"Most of the people, until they've actually hit rock bottom, they just think they're invincible -- that they can beat it, nothing bad's going to happen to them, or they have another 70 or 80 years left on this earth, and what's the next five or 10?"
A NEW MODEL
Nashville town leaders credit Chief Leonard Campanello of the Gloucester Police Department in Massachusetts with laying the groundwork for the Hope Initiative.
In June 2015, Campanello decided his department would help addicts overcome barriers to therapeutic treatment in an effort to reduce heroin overdoses and drug-related property crimes. His Angel Initiative became a national model for community policing, and he later co-founded the Police-Assisted Addiction and Recovery Initiative, or PAARI, which counts the Nashville Police Department among its more than 100 members.
Raper brought the suburban Boston success story to the Nashville chief, who agreed that the model could work in eastern North Carolina.
"I think he was supportive of the concept and wanted to find out more about it," Raper said. "He did his own research and was intrigued about it and made some calls and we really got the ball rolling very quickly."
Stylized as the HOPE Initiative with chain links forming the capital letters and an anchor beneath the "P," the first word in the program's name is not an acronym, but it does represent Nashville's vision.
"It was simply about being able to provide hope for those individuals who have substance use disorder and the families that are suffering," Bashore said.
While the program represents a change in the way police interact with drug abusers, proponents stress that it isn't amnesty. Drugs seized in traffic stops and undercover investigations still result in an arrest.
"Our program is a voluntary program for people who recognize they have an addiction," Raper said. "If they want assistance in getting treatment, we are willing to do our part to help them go through that process. We're not here to police them and incarcerate them; we recognize that what they're suffering from is an illness and we want to treat it as such."
By becoming an early adopter, Nashville is on the front line of a national movement among law enforcement to offer substance abuse intervention. Bashore drove to the nation's capital on Wednesday to participate in a PAARI conference with about two-dozen other police chiefs.
While in Washington, PAARI members met with Michael Botticelli, director of the Office of National Drug Control Policy, along with Sens. Elizabeth Warren, Jeff Merkley and Dick Durbin.
"It was really nice for a place the size we are, recognizing where we fit into the scope of things, a place of 5,500 people had a seat at the table for a national solution for a problem," Raper said. "When you get in on the ground floor, you get to be a part of shaping where it goes. We're not going to back away from that opportunity or that responsibility."
SHARING THE SUCCESS
Only a handful of the Hope Initiative's first 32 clients have come to the Nashville Police Department from inside the 3 square miles of the town limits. The rest are from Rocky Mount, rural Nash County, Wilson and parts beyond.
To Bashore and Raper, that indicates there's an unmet need for substance abuse intervention in other eastern North Carolina jurisdictions.
"I really don't see a reason why every police department and sheriff's office in the state can't be providing some type of program like this, because what we're really doing is showing that the police department recognizes that there's a positive role we can play in the community to help people," Raper said. "And that's really what community policing is. You have to come to the members of the community as they are."
Bashore has fielded phone calls and emails from counterparts at other law enforcement agencies, met with state lawmakers, addressed a meeting of the N.C. Harm Reduction Coalition and given interviews to area newspapers and television stations in an effort to spread the word.
He'll also send the Nashville Police Department's action plan for the Hope Initiative to any city or town that requests it.
"It's not a trade secret," Bashore said. "The more, the merrier."
Raper said making the PAARI model successful and diminishing drug addiction on a nationwide scale ultimately depends on the number of agencies that choose to implement it.
"One law enforcement agency is not going to solve this problem," he said. "Even if every law enforcement agency had a program, that in itself is not going to solve the problem. It's much bigger than that, but I think every law enforcement agency needs to play a role in doing what it can to help address this problem."
Bashore said it's a scaleable model, and departments with more officers in cities and towns with larger populations may reach more people than his Hope Initiative can.
"I'm a small agency," he said. "An agency the size of Wilson, Rocky Mount, those are much larger, obviously, than the town of Nashville, so they have more resources and more individuals they could dedicate to it. I think it's in every agency's best interest to take a serious look at the program and see what they can do to assist those citizens in their jurisdictions."
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