“We're addressing the epidemic of opioid use
and abuse in a way law enforcement doesn't typically
address an issue,” stated Gloucester Police
Chief Lenard Campanello when discussing how the
Massachusetts town is handling the opioid crisis.
Since 2015, the police station in Gloucester has become a
safe space for people seeking help for substance use.
Anyone suffering with an addiction can walk into the
Gloucester Police Department (GPD) where existing staff
works to place them into treatment. Any drugs turned in
are properly disposed of without charges.
Gloucester has experienced amazing results from what is
known as their “ANGEL” program. Over
430 patients have been referred to treatment and
overnight incarceration costs have dropped 75 percent.
With a population of 29,000 and less than 40 miles from
Boston, Gloucester isn't considered rural by most
commonly-used definitions. However, the GDP's
achievements gave life to the Police Assisted Addiction and
Recovery Initiative (PARRI), which is a partnership
of over 100 police departments and 250 treatment
facilities across the U.S. Many of these affiliated
police departments are rural and mimic the ANGEL program
step-by-step. The National Rural Health
policy paper on the rural opioid crisis urges more
rural communities to explore the use of the Gloucester
model and other unprecedented programs to combat opioid
Small town life has been turned upside down by opioid
use, but across the nation, communities are implementing
concrete and innovative tactics to get the problem of
opioid drug abuse under control. It all just takes some
inspiration, a little teamwork, and thinking outside of
The Love of the Law
“We have partnered with treatment centers to
ensure that our patients receive the care and treatment
they deserve – not in days or weeks, but
immediately,” proclaims the Dixon (IL) Police
website. “All you have to do is come to the
police station or sheriff's department and ask for help.
We are here to do just that.”
Dixon is just one rural police department utilizing the
ANGEL program, and the news of its success is spreading
fast. In Creston, Ohio, the Second Chance Drug Initiative
takes its wording directly from Gloucester's ANGEL
program. Another rural police department inspired by
Gloucester, Middlebury Police Department in Vermont has
held disposal events for unused or expired medication for
the past three years. Now partnered with PARRI,
Middlebury, like many others, has expanded opioid
services to help those in need of treatment.
Campanello noted that his department and others try to
help people afflicted with the disease of addiction as
opposed to arresting and incarcerating drug users.
“Law enforcement can be a voice on the demand
side of the drug equation after we've been the strongest
voice on the supply side for a long time,” said
Campanello. “We haven't been accomplishing much
in terms of reducing addiction or reducing the number the
drug dealers out there.”
Aside from national success in urban and rural areas with
facilitating recovery for people suffering opioid
addiction, Campanello feels one of the best outcomes of
these programs happens at the local level.
“Treating the individual with passion, dignity,
professionalism and attempting to help first
—that's brought about a trust with police
departments in a demographic that didn't exist
before,” said Campanello. “That's
paid huge dividends for the public and the police in
terms of getting closer together to solve
When asked if these programs enable users, Campanello
stated law enforcement isn't in a position to judge. The
Chief said their role is to facilitate help where they
can and to hold people accountable when they have to, but
to never judge in either circumstance.
I think when scientifically and medically proven to be a
disease of the brain, enabling doesn't even have a point
in the conversation.
“How do you enable cancer? How do you enable
diabetes or heart disease?” asked Campanello.
“I think when scientifically and medically
proven to be a disease of the brain, enabling doesn't
even have a point in the conversation.”
It Takes a Village
Campanello and the GDP enacted the ANGEL program in a
response to what the public wanted in light of the opioid
epidemic. Other communities are catching on that one
entity can't snuff out the opioid problem alone, and that
successful programs will require numerous organizations
and engaged citizens.
“In one year, our community had 400 people show
up at our local ER needing detox or [who] were
overdosing,” stated Erie County Health
Commissioner Peter Schade. “How many more are
In the small mountain county of Alamosa, the home of
SLVAHEC, death from drug poisonings reached more than 20
per 100,000 people in 2014, according to a
report from the Centers for Disease Control and
Both organizations received a Rural Opioid Overdose
Reversal Grant, a program developed by the Federal Office
of Rural Health Policy. The grant program requires
awardees to create partnerships between entities such as
local emergency responders, health facilities, academic
organizations, fire departments, and law enforcement.
“Anyone from the community who gets trained and
certified can receive naloxone at one of our partnering
pharmacies,” said Freddie L. Jaquez, Executive
Director of SLVAHEC. “Naloxone through us is
free of charge.”
SLVAHEC and Erie County used the grants to train first
responders in their service regions and initiate training
in naloxone administration for anyone willing to learn.
Schade stated that naloxone has saved over 100 people in
the past year, and the educational events supported by
the grant have drawn over 1,000 people.
In line with its community focus, Erie County has
initiated a unification process where they help
newly-sober mothers reunite with their children. The
program may save money in foster care and family social
services, but the real payoff is keeping families
“When the mom is sober, she can focus on
helping her kids do better in school and build their life
the right way,” said Schade.
While naloxone is a vital piece in saving lives, the best
solution to preventing death is expanding treatment
intervention before an overdose can occur. Drug cocktails
continue to increase in potency and relying on naloxone
may be a gamble in the future.
“A lot of the marijuana here [in Ohio] is
tainted with heroin or fentanyl,” stated
Schade. “Young people in the Erie County
service area are now at risk of opioid addiction
accidentally though other substance use.”
The CDC found that fentanyl was the primary reason for
the exponential increase of overdose deaths in Ohio.
Schade wants to send the message home that drug dealers
are aggressively targeting new prospects for addiction
and the drugs are more powerful than ever.
“It's gotten to the point where our law
enforcement and responders are giving 2-4 doses of Narcan
to drag people out of an overdose. Heroin isn't just
heroin anymore. That's a very scary thought that Narcan
may not even be as effective as products become
stronger,” said Schade.
This sobering reality pushed the Erie County Health
Department to build a new medically-supervised detox
facility at their Federally Qualified Health Center.
Schade said that there was nowhere within an 80-mile
radius for patients to detox. He also noted how
heartbreaking it is to turn families away when they are
pleading for detox help with family members or
It's barbaric. Many people are detoxing on the jail floor
with four other people in their cell. We shouldn't be
treating our brothers and sisters that way.
“It's barbaric. Many people are detoxing on the
jail floor with four other people in their cell. We
shouldn't be treating our brothers and sisters that
way,” stated Schade.
Mike Dennis, Executive Director of the Tri-County Commission on Alcohol
and Drug Abuse, has also seen the dire need for
intervention in his rural South Carolina community. For
three-and-a-half years, the Dawn Center in Orangeburg has
offered buprenorphine, a medication used to treat
addiction, in its outpatient programs. Currently, the
center has 30 outpatients using the drug. Dennis said
that detox facilities weren't keeping patients long
enough to fully detox and recover, leaving them more
susceptible to overdose after being discharged.
“The longer we can get them engaged in
services, the greater the likelihood they are to
recover,” said Dennis. “It's a modest
investment when you think of clogged emergency rooms or
prisons that are nearly all state-funded, high-dollar
Patients receive tailored counseling and medical services
several times a week from the Dawn Center. Inpatient care
in South Carolina could cost a patient $15,000-$20,000
for a 30-day stay. According to Dennis, the Dawn Center
could treat patients for nearly two-years, if need be, at
half that price.
Staff work closely together with social service agencies
including vocational rehabilitation services and mental
health agencies to make sure every possible need is met
for people in treatment. Dennis also stated that, in
South Carolina, every county has basic outpatient
services contracted with the state's Department of Alcohol and
Other Drug Abuse Services. This policy assists with
treatment on demand, which is vital to intervention.
For folks that wake up one day and decide they need help,
they can just walk into our facilities, get seen by a
counselor, and start the recovery process.
“For folks that wake up one day and decide they
need help, they can just walk into our facilities, get
seen by a counselor, and start the recovery
process,” said Dennis.
Thanks to the Substance Abuse and Mental Health Services
Administration's buprenorphine waiver program, physicians
like the one at the Dawn Center are allowed to prescribe
the opioid use disorder treatment medication. However,
the waiver limits doctors to treating 30 patients with
the possibility of increasing the threshold to 100
patients after one year. Currently, the Department of
Health and Human Services is
working to raise the limit to 200 patients.
The waiver is also vital in prescribing Subutex, a brand
of buprenorphine used for pregnant women suffering from
opioid abuse. Dennis stated that they have treated women
who deliver happy, healthy babies. They stay out of
social services and do extremely well, according to
Nonetheless, too few doctors have this waiver. For many
years, substance misuse education has been an
afterthought for physicians in training. Dennis hopes to
create a statewide telehealth program so that partnering
counties without an authorized physician can access their
services for buprenorphine.
It's Our Battle
Numerous approaches are being used in rural areas across
the country to combat opioid abuse. But, many of the
successful programs are finding that collaboration is
essential for long-terms wins against opioid addiction.
Working efficiently together, we can move along the
system to make healthcare immediately available and
sustainable for every person who suffers from addiction
and wants care.
“With each profession comes a lot of compassion
fatigue. In both law enforcement and healthcare, we see a
lot terrible things over and over again and get numb to a
situation,” said Campanello. “I think
that we are able to inspire each other. Working
efficiently together, we can move along the system to
make healthcare immediately available and sustainable for
every person who suffers from addiction and wants
Dennis urges the medical community to train more in
dealing with substance abuse and treatment. The state
Medicaid agency is working to “lock patients
down” to particular pharmacies for better
opioid prescription management. Last month, the agency
enacted a requirement that all doctors prescribing
controlled substances must report each instance to
the state prescription drug monitoring program.
“If they can identify and refer folks to
treatment earlier from the private practices, emergency
rooms, and the FQHCs, then we're going to see better
results down the road,” stated Dennis.