Just beyond Maine Street: the invisibility of the opioid crisis at Bowdoin
November 22, 2019
Maine loses nearly a person per day to opioids. But on campus, students are largely insulated from the crisis, which hits Maine’s aging populations and manual laborers especially hard.
In Cumberland County, there were 74 overdoses during the first quarter of 2019, down from the previous quarter’s 86. Decreased death tolls are good news, but a greater percentage of these deaths are caused by fentanyl, a dangerous substance which is infiltrating the region at an alarming rate, explained Leah Bauer, medical director and psychiatrist at the Addiction Resource Center (ARC) at Midcoast Hospital. For many, addiction starts with a prescription written by a doctor but spirals out of control, leading to fentanyl, heroin and methamphetamine abuse.
The nationwide crisis wrought by opioid overprescription has sparked lawsuits against pharmaceutical giants traveling as high as the Supreme Court; a bipartisan coalition in Congress proposed a nationwide settlement around $48 billion.
But despite the magnitude of the crisis and its consequences, opioids have been a predominantly silent specter in Brunswick since the 1990s.
Some students are prescribed Oxycontin when they get their wisdom teeth removed. Others manage pain from serious athletic injuries with similar drugs.
Geno Ring, a licensed alcohol and drug counselor who has been contracted by the College for 14 years, believes that in Bowdoin’s insulated community, these cases seldom tumble into serious addictions. Yet for many, this is how a life hijacked by opioids begins. Feelings of safety and invincibility can be dangerous, and mind-altering substances should never be underestimated, explained Ring.
“‘We’re all smart, high-accomplishing, high-achieving people [here at Bowdoin]. So that will protect us from these drugs,’” said Ring. “The drugs have no idea who you are. They’re indifferent to your socioeconomic background, your IQ. Addiction is a disease of the brain, a neurological hijacking.”
Looking to learn more about the impact of the opioid crisis, Annie Rose ’20 and Nina Alvarado-Silverman ’19 designed an Alternative Winter Break (AWB) trip last year that centered on addiction and recovery. Participants visited local organizations that address addiction in their communities, from the ARC to Portland’s Preble Street Resource Center.
“I really do think we have a responsibility to engage with the local community and understand what it is that folks have had to overcome,” said Rose.
Bowdoin students are Brunswick citizens, too. For this reason, she believes that the often-invisible struggle playing out in our community should be part of conversations on campus.
Tam Phan ’21, who will lead this year’s iteration of the trip alongside Biz Sweeney ’21, also thinks these conversations are important.
“Bowdoin produces political leaders and prominent people in medicine. Teaching people about this, when they’re in positions of power, that could be really important,” she said.
Although surrounded by the bubble, some students do have personal connections to the opioid crisis.
Patrick Bloniasz ’22, grew up in New Hampshire next to a city nicknamed “Heroin Hollis.”
“A lot of people dealt with addiction,” he said. “I had a lot of friends from school who had that problem.”
Motivated by this connection, Bloniasz spent last summer as a research consultant looking into the effectiveness of various community efforts attempting to address the opioid epidemic. His findings echo the plea of professionals, from law enforcement to social service providers, who work with these issues firsthand: a bottom-up, community-integrated and holistic game plan is necessary.
“If you work from the top down, there’s huge holes in certain policies that people don’t see,” Bloniasz said. “The best approach to helping someone kick addiction is a holistic approach, meeting their social support needs.”
As for what students can do on campus, Bauer of ARC says that breaking the stigma surrounding addiction can begin by using correct terminology. As she explains, these are people with substance abuse disorder, not “addicts” or “junkies.”
“Stigma is multi-layered, multifaceted and certainly pervasive in this disorder,” she said. “It’s good people wanting to have productive lives who have had their brains hijacked from them.”
Who struggles with addiction?
“All walks of life. All,” said Brunswick Police Department (BPD) Commander of Patrol Tom Garrepy.
Opioid substance abuse disorder and its consequences impact everyone from the wealthiest members of the community to its most vulnerable, including the homeless individuals served by Tedford Housing, a Brunswick organization providing housing and homelessness prevention services.
Fourteen percent of Tedford Housing patrons self-report that they are also struggling with substance abuse disorder. Tedford Housing Director of Operations Giff Jamison said that this is likely a significant underestimate, as individuals who admit addiction often fear they will be denied essential services and face scorn and reprimand in the communities they belong to.
The impact of stigma complicates law enforcement and community efforts alike. In Brunswick, the presence of Route 1 and Interstate 295, highways that serve as major drug corridors, means the midcoast region is hit hard by the influx of out-of-state substances and their repercussions. The solution to mitigating the crisis is far from simple.
“I’d like to say it would just take heavy [police] enforcement on drug traffickers pushing the stuff, but it just seems like a never-ending battle,” said Garrepy.
“You take one off the street and there’s immediately another,” said BPD Detective Jared Verod. “I don’t think it’s any one specific thing. I think it’s a totality of things. It’s such a broad education and enforcement endeavor.”
In 2018, BPD officers began carrying Narcan, a medication used to prevent overdoses. Narcan has been a bone of political contention in Maine; former Governor Paul LePage sought to limit access while current Governor Janet Mills is earmarking significant funds to expand its availability.
Students and politicians alike clash over strategies for enforcement and treatment. Some claim solutions, such as the increased availability of Narcan, enable users and preclude recovery; others believe they save lives and mitigate risk. Bauer sees every dose of Narcan in the community as one more tool against the specter of overdose and wants “as much of it in the community as possible.”
When facing such a complex issue, Gareppy believes that stakeholders must work together.
“When I say stakeholder, that’s everyone from the hospital to the emergency services to colleges and businesses. We all have a stake in this because it could be tomorrow that I find out that one of my family members has an addiction,” Gareppy said.
Recovery and Treatment
Access to care is a persistent problem, even for those who overcome stigma to seek treatment. Many recovery programs are not covered by insurance and many individuals who are impacted are uninsured. Recent legislation has worked to lessen financial barriers to recovery, but the overcrowded recovery programs where applicants struggle to find a bed or schedule appointments with overworked clinicians reflect the magnitude of this epidemic.
The ARC at Midcoast Hospital is the exception to this rule. Bauer directs an innovative group-based recovery initiative that allows patients to be seen just a matter of days after checking into the system. One of their most prominent programs uses Buprenorphine, more widely known as Suboxone, to chemically assist recovery.
ARC was the first hospital in Maine to integrate Suboxone into the ER, beginning the process of recovery immediately after an individual suffers from an overdose.
But even assisted by a powerful tool like Suboxone, recovery is an individualized process with no guaranteed success. Addiction is often compounded by mental illness and socio-economic vulnerability, making it nearly impossible to disentangle the causal mechanism from the subsequent impacts. And often, individuals must first have their basic needs met before they can even think about getting clean.
“Housing is a stabilizing force for anybody, whether they’re experiencing substance use disorder or mental illness,” explained Jamison.
From summer research to service learning to decades of work in these fields, those working on the opioid crisis in and around Brunswick all concur that it begins and ends with community. They point to the good work happening in our neighborhood—just down the road at ARC, and just beyond Maine Street.
“The opposite of addiction isn’t sobriety,” said Rose. “It’s human connection.”
Those struggling with addiction, opioid or otherwise, or those concerned for a friend can reach out to the counseling center (207-725-3145), or contact Geno Ring to schedule a time to talk. For Bowdoin students, this service is confidential and free of charge.
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