Arlington opioid graphic by Brynn O'ConnorPART ONE OF A FOUR-PART SERIES
YourArlington has spent the past 10 months speaking with police officials, health department employees and residents about drug abuse.
This four-part series explores how the town seeks to combat the opioid crisis through the help of federal government funding, town programs and policies -- and the aid of a community that cares.

UPDATED July 8: Arlington, population not quite 47,000, is one of hundreds of municipalities in the state and one of many thousands of communities throughout the country. In Arlington, as everywhere else in America, each life ruined by or lost to substance abuse takes a toll. Some addictions are obvious battles, others silent struggles. Every day throughout the United States, millions of people are using chemicals that are ruining their lives — sometimes even ending them.  

Opioids, a class of drugs meant to reduce pain and of great benefit when used as prescribed, sadly have too often instead become the cause of an ongoing epidemic throughout the nation. In 2022, 75 percent of drug overdose deaths nationwide involved an opioid. It can happen anywhere -- and it has happened in Arlington. 

One of several such tragic incidents occurred right here, nine years ago, in June 2015. The victim was just 21 years old.

Her death, in part, inspired the Town of Arlington to begin viewing addiction and overdose not as crimes but instead as evidence of a serious health issue that needs and deserves special attention.

“Here's a girl that we had an opportunity to maybe do something; try and think a little bit outside of the box, and we felt we kind of missed it,” said Capt. Richard Flynn, public information officer of the Arlington Police Department.

Whether it be the loss of a friend, a neighbor, a family member or a colleague, many residents in this town have been affected one way or another by this tragic epidemic. 

Now, the town is making strides to make sure fewer Arlingtonians have to say premature goodbyes and so that more community members feel supported and safe. And it starts with the town’s law enforcement. 

THE ARLINGTON OUTREACH INITIATIVE

The Arlington Outreach Initiative was formed in 2015. It is a police-assisted recovery program to combat opiate addiction in town. Information the APD collected in 2016.Members of the police department, including a staffed mental health clinician and recovery coach, have since embraced the initiative to extend a helping hand to suffering Arlingtonians.

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“We help the community, the quality of life here. We’re trying to solve a problem instead of just arresting people and keeping a vicious circle going." -- Capt. Richard Flynn
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According to records that YourArlington received from APD Data Analyst Danielle Smith, in 2015 there were close to 40 reports of opioid overdoses, including a handful of fatalities. As APD leaders saw it, a supply-and-demand situation was on their hands.

On the supply side of things, there would be no tolerance for the selling of opioids in this community. 

“I’m as hard on [sales of] drugs today as I was on day one," Flynn said. "There’s nothing good that comes from it, when people are selling narcotics in our neighborhood. We’re gonna go after those people. We’re going to try to arrest them and prosecute them."

On the demand side? For every seller prosecuted, officers find a list of customers who are struggling with opioid addiction and who need resources to recover. 


Local law enforcement realized that a new approach was needed to help residents. 

“Change is never easy,” said Flynn. “I may be amazed at what our officers are looking for that might help them out on the street, but if I slow down a second and think about it, I get it. It’s an ever-changing profession… the more we listen, the better we are. You just try to do the right thing.” 

He continued, “We help the community, the quality of life here. We’re trying to solve a problem instead of just arresting people and keeping a vicious circle going,” 

An overdose leads to a 911 call. Quite often, a police officer is the first person to help.

“You have to treat that person like they’re a human being. If they come back and they’re responsive, you’ve got to let them know it’s going to be OK . . .  we have resources. We’re going to get you help. You’re going to go to a hospital, but somebody will follow and help you,” Officer T.J. Kelly of the APD said. 

After the person has been taken to get medical assistance, the APD will file the required police report and try to collect contact information for those involved in the situation. At the core of the town’s outreach effort is establishing a connection, and usually, those connections start with Christina Valeri, the APD’s mental health clinician. 

According to Flynn, Arlington was one of the first communities in the commonwealth to bring this position on board to its police department. In 2022, there were 16 reported nonfatal reported overdose victims; that year, Valeri tried to connect with every one of them. 

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We try to meet people where they’re at. So, if someone’s not ready for their recovery journey, we don’t push them to do it." -- Christina Valeri, mental-health clinician with the Arlington Police Department
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She’ll try calling on the phone to establish herself as a trustworthy resource to the person or their family. Valeri is no stranger to being hung up on nor to listening to the near-endless sound of the phone ringing -- but that doesn’t stop her from offering help. Clinician Christina Valeri Clinician Christina Valeri /Courtesy APD

“We try to meet people where they’re at. So, if someone’s not ready for their recovery journey, we don’t push them to do it," Valeri said. “We never try to force our services on them -- but we will be very persistent, every single time.” 

 UNDERSTANDING NARCAN

Sometimes, creating a connection can be as simple as providing somebody with the lifesaving nasal spray Narcan. Flynn calls this the “handshake.” Those who are part of the initiative cannot stress enough the importance of understanding Narcan. 

With its active ingredient naloxone hydrochloride, naloxone is a life-saving medication proven to rapidly reverse an opioid-related overdose. According to the CDC, naloxone can be administered in two ways; as a nasal spray or as an injectable. The former method is commonly viewed as easier to do and therefore is the one the town makes available to residents. 

Officer T.J. KellyOfficer T. J. Kelly /Courtesy APDThe small contraption contains one dose of medicine –- one spray in each device. Instructions from the Narcan website as well as the Arlington Health Department say that the device should be inserted into either nostril of the person experiencing an overdose. Then the rescuer simply presses the plunger to release the Narcan. Narcan available locallyNarcan nasal spray is available from the Arlington Health Department.

Free Narcan kits are available for pickup at Arlington’s police station and at its health department. Members of the health department will even supply training courses to introduce residents to the tool and how it works, as well as to provide additional recovery resources. 

Kelly has been called to the scene of an overdose more than once; he's been able to administer the nasal spray and get somebody breathing again. 

“It’s a great tool," he said. "We have it in all our police cars; I carry some in my personal car. I always have it with me. We’ll leave Narcan [with the overdose victim or family] and say, 'When you’re ready to talk to us, give us a call.' ” 

Narcan efforts began roughly 10 years ago under then-Police Chief Fred Ryan. Flynn remembers his own naloxone training soon thereafter, in 2015, at which time he learned to administer the injectable medicine, before the nasal spray became the preferred method.

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I could imagine [the pandemic] may have affected some people; it affected our mental health program. There still are a lot of people dealing with the aftermath of Covid, readjusting. There are challenges out here." -- Capt. Flynn
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“We went and took a class. Literally on my way back I get a call from one of my lieutenants. He goes… ‘Cap, someone’s family, they’ve got a boy and he's really up against it. They need some help. They would really like some Narcan.’ ”

Richard FlynnCapt. Richard Flynn /  Courtesy APD

As Flynn says, just providing a loved one with tools can save a life. 

And the tools aren’t just naloxone. They include counseling services for the person using and/or their loved ones. It could be providing a new jacket during the winter -- or offering an overnight stay if someone feels unsafe. Officers will even drive somebody to a doctor’s appointment . . .  and maybe on the way back they’ll stop for a cup of coffee and to have a chat.

 “It's figuring out what is our way in to develop a little bit of trust and a little bit of a relationship,” Flynn said.

Within two years, reports of opioid overdoses in town dropped by more than half compared to when the Arlington Outreach Initiative began. Over more recent years, however, the reports rose and fell, following numbers throughout the state as it faces an increasing opioid crisis. 

 TRENDS: HARD TO IDENTIFY

In August 2023, YourArlington received data from the Arlington Police Department courtesy of data analyst Smith, which reported opioid overdoses to the town since the start of the outreach initiative, in 2015. 

Note: According to Smith and Flynn with the APD, state data differ from the town's. Most notably, Massachusetts cites more opioid-related deaths in Arlington in 2022 compared to the town's data; the state claimed 10 opioid-related fatalities, but the town recorded just six. Flynn says that the state-vs.-town discrepancies may be due to the state referring to somebody's "last known address" when determining residency for recording purposes, meaning that in some cases the overdose death may have occurred elsewhere.

Members of the APD say that patterns or trends in this data aren’t easy to pinpoint, as there are several everchanging factors when it comes to drug use. For example, people are continuously moving in and out of Arlington; the achartmount of Narcan distributed over recent years might be reducing the number of overdose calls the department receives; and the pandemic’s effect on mental health affected reports of drug use here as well as nationwide.

“I could imagine [the pandemic] may have affected some people; it affected our mental health program. There still are a lot of people dealing with the aftermath of Covid, readjusting. There are challenges out here,” Flynn said.

In Arlington, from 2019 through 2021, the town saw the total number of reported opioid overdoses gradually rise – from 22 deaths in 2019, to 28 in 2020, to 32 in 2021. Data from the CDC shows that drug overdoses nationwide increased 30 percent between the years 2019 and 2020. 

While cases of reported opioid use increased as the nation was recovering from the pandemic, death rates did not seem to spike. That was, until the year 2022.

FENTANYL: A COMPLICATING, FRIGHTENING FACTOR

In June 2023, the Massachusetts Department of Public Health released a report detailing recent opioid-related deaths in comparison to the state’s previous records. In 2022 the state confirmed that there were 2,310 confirmed opioid deaths, plus an additional 48 estimated opioid deaths, totaling approximately 2,358 who died that year from opioid use. Overall, the state found there that there was a 2.5-percent increase in opioid-related fatalities from 2021 to 2022. 

The Boston Globe reported that this rate of deadly overdoses is nearly one-third higher than the national average. WBUR reported that these numbers indicate that more than six people were dying each day in Massachusetts in 2022 due to opioid abuse. 

In Arlington that year, the town lost six people from opioids, a notable jump from just two fatalities the year before – and the most reported to the police since the start of the outreach intiative. 

According to Flynn, there’s adevastating factor that comes into play, which might explain this spike in fatality rates. 

“2022 wings out fentanyl, and that was a game-changer. It was a curveball to not only our program but [also] to everyone else out there,” Flynn said. “A very potent, synthetic narcotic that doesn’t take much at all to take a life. Across the board, when you look at the time fentanyl came into play, you’re gonna see increases throughout the country.” 15-milligram OxyContin pill. /Opiateaddictionresource.com

Fentanyl is powerful, and fatally so in the wrong hands. When it comes to opioids prescribed by doctors for pain relief, the common types are OxyContin, Vicodin and some others. For severe pain in patients, typically after undergoing surgery or experiencing cancer treatments, doctors sometimes will prescribe fentanyl. 

Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. When used properly by trained medical personnel in a clinical setting, fentanyl has numbing properties. Other effects include extreme happiness and sedation. However, after multiple uses recreationally, the brain can adapt to the drug, resulting in users becoming reliant on the opioid for pleasure or relief.

When people overdose on fentanyl, their breathing can stop.

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Substances are substances. They’re not morally right or wrong. No one is better than anyone else." -- Anna Martin, prevention services manager
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Throughout the United States, fentanyl was responsible for nearly 70 percent of opioid deaths in 2022. And in Massachusetts, fentanyl was present in 93 percent of the year’s opioid deaths. 

Studies have connected this increase in fentanyl presence to the decrease in opioid prescription rates, which was a product of national reduction efforts by the Food and Drug Administration. Studies also have attributed the increase of fentanyl presence in fatal opioid overdoses to the rate at which illegally made fentanyl is combined with other illicit drugs 

 Besides the pharmaceutical fentanyl, illegally made fentanyl is available for those who seek it, usually in the form of liquid or powder. The CDC says that illegally made fentanyl is often mixed with heroin, cocaine and methamphetamine, then made into pills deliberately manufactured to resemble prescription opioids. 

Why is fentanyl getting mixed into these drugs? Because of its potency: It takes very little to produce a high from fentanyl – making the synthetic a cheaper option for makers and dealers.

Tragically often, a person unintentionally overdoses from opiates that they thought were something else but which had been secretly mixed with fentanyl. The Recovery Research Institute reports that the substance related to the highest percent of unintentional drug overdose deaths were prescription opioids. 

The role fentanyl plays in the opioid crisis is adding more fuel to a fire that's already ablaze. The threat of residents using laced drugs is something law enforcement cannot shut off altogether, so the town is adopting perspectives to stop residents from taking that risk in the first place – starting with encouraging members of the public to change the way they view drug users.

DECREASING THE STIGMA

“Addiction is not a moral failing,” said Anna Martin, who served as the town's prevention services manager from May 2023 through June 2024.

In an email received in early July at YourArlington, Deputy Town Manager of Operations Christine Bongiorno wrote that Karen Koretsky has taken over the position of prevention services manager from Anna Martin. Koretsky began in this role June 24, 2024.

 “It is a condition that is both medical and psychological and deserves treatment and respect just like [what would be offered to] everyone else with an illness.” 

Martin was hired by the Arlington Department of Human Health and Services in May 2023. In her position, she works toward reducing substance abuse in town and providing support to those suffering with addiction. MartinAnna Martin presents a Narcan training session at the Arlington Health Department offices.

Years before, while studying chemistry in college, Martin was introduced to a different model of thinking in a course titled "Drug Discovery and Development," in which addiction was labeled as a disease. As Martin and others in the health department see it, mitigating the opioid crisis includes reworking public perception that sees addicts as strictly criminals, reminding residents in town that addiction comes in many forms. 

“Substances are substances. They’re not morally right or wrong. No one is better than anyone else,” Martin said. “If you asked me to stop drinking coffee cold turkey, there’s absolutely no way I could do that.”

The efforts taken and mindsets adopted by town employees center on a harm-reduction approach – the view that it is much more important to focus attention on saving a life than to strive for immediate abstinence. 

“One of my favorite quotes is ‘Dead people don’t recover.’ You want to give people tools to stay alive so they can hopefully recover in whatever capacity that may be,” Martin said.

Recent drug-reduction efforts in some other nations have included the establishment of supervised consumption sites (SCS). Although faced with opposition, some state authorities are advocating for these sites, saying that these would allow users to use substances under the supervision of staff who could intervene in the event of an overdose or other medical emergency. More than 10 countries have established SCS to combat drug crises. Much closer to home, Somerville is in the process of opening oneNarcanMartin shows exactly how to use Narcan spray.

On Dec. 13, the Massachusetts Department of Health released a report in support of overdose prevention centers and SCS. State DPH Commissioner Robert Goldstein wrote in a statement that these sites "can be lifelines, serving not only as places of intervention, but [also] as places of empathy, understanding and healing." So far in Arlington, the town health department is not ready to discuss this approach. 

According to the federal Substance Abuse and Mental Health Services Administration, by definition, harm reduction prioritizes prevention, treatment and recovery.

And one of the most valued recovery efforts within both Arlington’s health and police departments is the recovery coach, Tommy Caccavaro.

Most people recognize the inherent power of a lived experience. Some local residents have experienced the horrors of opioid abuse but have eventually made it through recovery. Approaches like the Arlington Outreach Initiative provide resources and understanding that can pull people out of addiction and save lives. Longtime town resident Caccavaro is living proof of this. But he almost wasn’t.


Part one of this series by Brynn O'Connor, assistant to the editor, was published Sunday, June 23. She also created the graph in this section showing overdoses as well as the series logo that begins all four parts of the series. It was updated July 2, to note that Martin is no longer prevention services manager, and July 8, to include brief information about Martin's successor as of the end of June -- Karen Koretsky.

In part two, YourArlington speaks at length with Recovery Coach Tommy Caccavaro about how he finally overcame his own addiction -- and how he uses what he’s learned from his past to make positive impacts on others' futures