Women on Cape Cod and Opioid Addiction
Compiled By
Helen Bresnahan
Commissioner, Cape
Cod & Islands Commission on the Status of Women
Edited By
Theresa M. Barbo,
M.A.
Chair, Cape Cod
& Islands Commission on the Status of Women
July 2015
Dear
Reader,
The mission of the
Cape Cod and Islands Commission on the Status of Women (CCICSW) is to provide a
permanent, effective voice for women across Barnstable, Dukes and Nantucket
Counties that facilitates and fosters community and inclusiveness among women.
The Commission stands for fundamental freedoms, basic human rights and the full
enjoyment of life for all women throughout their lives.
The Commission was
established in 2009 under a new law enacted to form the wider Massachusetts
Commission on the Status of Women, to which the CCICSW belongs and functions
under its guidance.
What this means in
the most practical sense of our mission is that our diverse roster of
Commissioners are out in the community pursuing various discussions and engagements
with people on issues about which we individually care. For my colleague,
Commissioner Helen Bresnahan, the issue of addiction resonated for this retired
schoolteacher. So Helen took it upon herself (Bravo!) to visit the Barnstable
County House of Correction in January 2015, which houses women on various drug
convictions, to hear their stories. Her brief report follows on the next page.
Mrs. Bresnahan’s
viewpoints, perspectives and opinions are her own in this report, and do not
represent an endorsement or, or a comprehensive review of this issue by, the
entire Cape Cod and Islands Commission on the Status of Women. All that said we
applaud our colleague’s expression of free speech and her genuine desire to do
right by this issue.
Theresa M. Barbo
Chair, CCICSW
SYNOPSIS COMPILED BY COMMISSIONER HELEN BRESNAHAN:
Women
use substances to cope with negative effects of anxiety, stress, family issues,
and depression, and if they cannot stop using drugs for benefit of care of
children, that speaks to the power of addiction. Everything else is secondary
to their substance of choice. Postpartum crises arise and exhibit a greater
need for prescription drugs. If these drugs are not available they will switch
to another drug addiction.
Currently
there is no detox hospital on Cape Cod that will accept a pregnant woman
addicted to opiates. For treatment, they must travel to Boston Medical Center
for care. In recovery, these individuals face unique challenges of their
partner ingesting drugs illegally, as well as the depression, shame, and
isolation and crushing guilt that accompanies addiction.
The numbers
continue to be alarming locally. At Cape Cod and Falmouth Hospitals alone
between December 2014 and January 2015, nine infants were born to addicted
mothers. If there is a generational addiction, the chances are greater that
there will be addiction in the family.
The
needs of young addicts are unique. For instance, adolescents require
transportation, a home, and a job. Even if one of those three items is
eliminated or disrupted, that adolescent loses all three.
Prevention Plan
Emphasizing Education & Treatment
In
my opinion the following has to occur:
1.
Develop an overall strategy to combat addiction
2.
Declare a public health emergency
3.
Provide education in the schools
4.
Provide space for support groups
5.
Reduce doctor shopping
6.
State provide inventory of resources (physical, literature)
7.
State monitor out-of-state ‘pill mills’
8.
Reduce jail recidivism
9.
Provide a toll free number for addicts and families who are seeking advice and
help
10.
Increase on-Cape treatment beds with family housing 11. Admit pregnant,
addicted women to detox hospitals
Treatment
1.
A thirty-day rehabilitation plan often results in relapse; can in-residence
treatments be longer?
2.
Reduce the stigma of addiction
3.
Apply multidisciplinary practices such as:
a.
Psychologist; and/or b. Psychiatrist;
c. one M.D. for all medical needs; d.
parenting counseling;
e. spiritual counseling;
f. drugs in treatment: Vivitrol,
suboxone, methadone
4.
Must
be long term life management
5.
Create
self-goals and mentor to return to work
6. Create vocational
goals and residential treatment programs
Know the Causes of Addiction
Behavioral
Family
experiences
a.
Most sensitive individuals
b.
May be dysfunctional
Neuroscience Brain
a.
Wearing down of prefrontal cortex (control mechanism)
b.
Reward system hijacked (motivation)
c.
Brain learns bypass tricks that are harmful
d.
Escalation of dopamine (pleasure) by doses (craving)
e.
Differences between recreational, using (liking)
f.
Environment of past creates a relapse (needles,pipes)
g.
Years later can bring on a relapse
Dependence
a.
Tolerance to drug with compulsion
b.
Psychological and physical (e.g. heroin diarrhea)
c.
Problems with relationships
d.
Neglect responsibilities (children)
e.
Lose job
**
My Experience with
Women in Rehabilitation at the Barnstable County House of Corrections:
As
I was seated in a conference room off the women’s cells, the counselor in
charge introduced me to the incarcerated women. In turn, the women gave their
first names. They signed in, as did I. In a circle of eight plus the counselor,
and with Special Deputy Sheriff Jeff Perry, we began an informal dialogue.
Initially
I had a hard time finding my voice to ask questions, but they were very easy to
interview.
“Why
are you here?” I asked. Most answered ‘because
I was caught with drugs my family did them, boyfriend, etc…’
“Will
you be looking forward to change from your addiction?” Yes, they all replied.
“How
will you change your addictive behaviors?”
My family will see I have changed, and
I will do something better, they said.
The
informal conversation continued with these women. I asked them ‘what started
them on drugs,’ and they answered that they often had nowhere to go.
I
asked them what advice they would give to someone just beginning the road to
addiction, and their answers were simple:
“Don’t take them.” “Get away.” “Make better friends.”
I
also wondered how did they know they were again in control of their drug use.
Again, their answers were surprisingly simple:
“Count to 10.” “Remember Jesus.”
As to what
triggered their drug use: challenges with work, depression, postpartum blues,
and peer pressure also contributed as key triggers. A desire by these women to
feel more successful was very clear.
Sadly, these women
knew that addiction is a life-long process with cravings for drugs able to pop
up at any time. It’s critical to learn to cope through positive mechanisms. The
women said after their jail terms are over, they recognized the need for
continued treatment. “We need beds. There are only six on Cape Cod and we hope
we can fill them, but behind us there are women who need more beds,” one woman
replied.
All the women said
they want jobs and job skills. Prior to entering jail, these women mostly
worked as cooks, waitresses, secretaries, and nurse’s aids. Some even produced
meth.
On
a hunch I asked, “How many of you have/ had ADD or ADHD?” ALL HANDS WENT UP.
This
interview took about an hour. They were happy to answer and I was happy to ask
with restraint out of respect for what I did not know of their past
experiences. No one got to jail the same way; each woman’s pathway was
different. Friendships looked like they were formed in jail. Some questions
were hard to answer for them, and obviously were too painful.
Ages
ranged from the 20’s through the 50’s although some women might have even been
older. They all wore green prison. I told them on return, I would wear green or
maybe their outfits. They laughed. Later I spoke to Mr. Perry. He liked the
questions and was surprised at the response to the ADD question.
Personal Note
In
writing this report, I discovered something about myself that I could not
avoid. On some level, I empathized with them and am very concerned about their
next life on the outside. Whenever I relate this report, I feel emotional
remorse. Even with my Guidance credentials, I know I could not mentor or
counsel them in the future.
I
call them “the magnificent seven” and I will remember them for all time.
Respectfully
submitted,
Helen
B.
Helen
Bresnahan Commissioner, CCICSW
April 2015
Professional Sources
Bartlett,
Cheryl, Cape Cod Healthcare
Casey-Lee, Diane, Cape Cod Council of Churches
Friedman, Robert, M.D.
Harik,
Vaira, Barnstable County Human Care Heavlin, Dr. Mothers Helping Mothers
Hunt,
Randy, Mass State Representative Mitrokostas, Patricia, Director of Prevention,
Gosnold Talbert, Jean, M.D. “Abuse in Pregnancy Task Force” Tamasi, Raymond,
Gosnold
Terry,
Reverand, Hyannis Federated Church Groups
Aids
Support Group of Cape Cod Angel House
Cleveland Clinic
“Learn to Cope” @ CCCC
