A new kind of police patrol pushes treatment, not jail
Looking for alternatives to arrest, police departments are using their 24/7 presence and regular contact with drug users to refer them to treatment
By Paul Cuno-Booth
The Keene Sentinel
BRATTLEBORO — Detective Joshua Lynde and his team were cruising down Putney Road one morning in October when they saw the guy.
"Josh, what do you think about pulling over in that parking lot?" Justin Johnston asked inside the unmarked white SUV.
Lynde took the next right and swung around in front of a grocery store. A skinny man of perhaps 40 stood on the median by the parking lot entrance. He wore a gray sweatshirt and a Patriots cap, and greeted cars with a cardboard sign.
"STRUGGLING DAD OF 4," it read. "ANYTHING HELPS."
Lynde, Johnston and their partner Vanessa Santana stepped out of the car and started walking over.
"You're all right, buddy, not in any trouble or anything," Johnston called out.
Lynde hung back while Johnston and Santana chatted with the man. He said he'd lost his job because of COVID. Johnston ran through some local resources.
"Job opportunities would be awesome," the man said.
Johnston and Santana are not cops but recovery coaches, helping people climb out of addiction after being there themselves. They were accompanying Lynde as part of a two-year-old effort to connect struggling local residents with drug treatment and other resources, known as Project CARE.
It's a model that's catching on. Looking for alternatives to arrest, police departments in Brattleboro and elsewhere are using their 24/7 presence and regular contact with drug users to refer them to treatment. While the details vary, in general, these departments put the word out that just about anyone can walk up to an officer — or into the police station — and ask for help.
"Police are not treatment experts," said Sean P. Varano, a professor of criminal justice at Roger Williams University in Rhode Island who studied one such program. "But they can be facilitators of treatment."
A collaborative effort
The July 4th holiday was a bad one in 2017.
It began that morning, when Brattleboro police found a woman in her 30s barely breathing in an alley near Whetstone Brook. Thirty-five hours later, on the night of the 5th, police returned to the same area for an unconscious man whose lips were turning blue. Empty heroin packages were strewn about.
At least nine others had overdosed in between, in apartments, hotel rooms, a gas-station bathroom and a park. A few had taken cocaine, ecstasy or Molly, but most were high on heroin or fentanyl stamped with names like "Iron Man" and "Apex." One man passed out in the driver's seat of his parked vehicle, next to needles and an AK-47.
Even in a town struggling with substance use, the two-day spike stood out, prompting somber reflection at the next selectboard meeting. It was only the latest illustration of an ongoing problem that local leaders were already grappling with.
By then, Police Chief Michael Fitzgerald had convened a group that included the recovery organization Turning Point of Windham County — which Johnston and Santana belong to — as well as addiction-treatment providers and other stakeholders.
It was clear there were "organizations doing some really good work," Fitzgerald, who retired Friday, said. "But everybody was doing it in their silo. Like the police department was dealing with it from a law enforcement perspective, the hospital from the ER perspective." According to Fitzgerald, the group decided they could be more effective by collaborating.
What Project CARE would become wasn't clear until Fitzgerald got a call from an organization called the Police Assisted Addiction and Recovery Initiative.
PAARI promotes a model developed in Gloucester, Mass. In 2015, the police chief there — fed up with old approaches — declared that anyone suffering from addiction could walk into the police station and ask for help without fear of arrest. The idea soon spread.
With guidance from PAARI, the Brattleboro group came up with a version adapted to the local community and launched Project CARE in July 2018.
(Around that time, a different program inspired by PAARI was shutting down just across the Connecticut River. The Cheshire County Addiction Assistance Recovery Initiative, which sent recovery coaches to the hospital to meet with people who had overdosed, ended in 2018 after the state pulled funding.)
Project CARE seeks to connect with people on their own terms and offer help with immediate needs. That could be securing a spot in rehab, transporting them to treatment, handing out the overdose-reversal drug Narcan — or even just mentioning that Turning Point's downtown location has free coffee and warm places to hang out.
Police officers and Turning Point recovery coaches go out into the community together once or twice a week, sometimes joined by Groundworks Collaborative, a local nonprofit that works with people experiencing homelessness. They used to walk around downtown; during the pandemic they've visited hotels, where Vermont has put up people who would otherwise be homeless. Project CARE also tries to follow up with everyone who survives an overdose, to offer help.
Few people join Project CARE by walking into the police station itself. But they have called, approached officers on the street and shown up at Turning Point, organizers said.
The program doesn't force people into treatment or demand they stay sober. Organizers understand that people often won't be ready for that — but may accept other types of help that improve their well-being.
"There have been a lot of people that we've talked to that have said, 'Yeah, thanks, you know, I'm not really interested in treatment right now,' " said Lt. Adam Petlock, the Brattleboro Police Department's point person for the program. " 'But it's cool to know that you guys took the time to reach out to me. ... I didn't realize that we could call the police department if we needed help.' "
A much-needed boost
The SUV pulled into the next destination, a motel near the interstate. Lynde, Santana and Johnston walked around the parking lot looking for people. It was surrounded by rooms, like a concrete courtyard, and the weather was pleasant. But few people were out. The Project CARE team peered into a patch of woods in case someone was camping, marched up a flight of stairs, came back down. Every so often, someone would walk by or crack open a door.
The night before, police had arrested a man dealing drugs out of one of the rooms. Johnston guessed the disruption in supply had driven inhabitants elsewhere or kept them inside. "To be as blunt as possible, if they took the drug dealer out, that could be a reason we're not seeing as many people today," he said.
For Johnston, working with the cops is something of a reversal.
His family moved to Brattleboro when he was 9, part of a difficult childhood that later included time in foster care. He began using at an early age. "The defiance and anger, being rude and wanting to break rules really started coming out of me," he said. "I was really trying to deal with different emotions I couldn't understand."
Marijuana and hallucinogens gave way to cocaine and oxycodone, and finally heroin and crack. He started dealing, too. In December 2014, Johnston, by then in his late 20s, met a customer outside a Westminster gas station to sell them 50 bags of heroin for $350. The person was working with the Vermont State Police Drug Task Force. Johnston was sentenced to more than two years in federal prison.
"When I went to federal prison, I had to take a big look at my life," he said.
On release, he had a couple years sober. But he wasn't really in recovery, he says now — just "white-knuckling" and trying to get by. Then he started taking the medication Suboxone at the Brattleboro Retreat, a mental-health facility.
The daily doses kept his body's need for illicit opioids at bay, but also gave him something else. "I started off every day at the Retreat around counselors and different people who were asking me how I felt today and telling me 'good job,' " he said. "So I used that as, like, this boost."
Soon, he was helping to cook Turning Point's community meals, drawing on culinary training he'd done in prison. "That first day, people made me feel this confidence that I'd never felt before," he said.
Looking back, Johnston believes he lacked the support structures he needed as a kid to build life skills and self-confidence. And as he spiraled further into drug use, fewer and fewer people were there to catch him.
Occasionally an officer would say a kind word — "Hey, we're here for you." But he felt the police were often unsympathetic, and he was more interested in avoiding them. He never would have thought to ask them for help.
'I've gained so much'
When Gloucester, a city of 30,000, launched its program in 2015, a key question was whether anyone would actually show up, according to Varano, the Roger Williams professor. Would drug users trust police to get them help?
In many cases, the answer seemed to be yes. Hundreds of people went to Gloucester police in the first year, and most were placed in treatment, a group of Boston-based researchers reported in 2017. A study of a similar program in Brockton, Mass., counted more than 800 intakes of 523 different individuals in its first two years — though in a city of 95,000 where more than 45 percent of residents are Black, 78 percent of participants were white.
Varano, who co-authored the Brockton study, said he was struck that so many people turned up "in absolute crisis, and thought their best chances for hope were getting the help from the police."
In small-town Brattleboro, Project CARE had formally signed up 65 people between its founding in 2018 and late December, 48 of whom had engaged with treatment at some point, according to Petlock. The program reaches additional people through post-overdose follow-ups — about two dozen between January and August of last year.
Some question whether police should be involved in such efforts at all.
In a report issued Thursday, a committee conducting a broad review of community safety in Brattleboro noted that local treatment and recovery professionals differed on that point. Some worried about police extending their reach into social services, raised concerns about potential conflicts of interest and wanted more data on Project CARE's effectiveness, beyond how many enter treatment.
More broadly, according to the report, many people of color and members other historically marginalized groups in Brattleboro said a police presence makes them feel less safe, even outside of a law enforcement context — meaning they might be less likely to engage with a program that involves police. The report recommended an in-depth review of Project CARE's impact and suggested moving its funding out of the police department.
Project CARE organizers say collaboration with police is important to their work. Suzie Walker, Turning Point of Windham County's executive director, said it can help shift attitudes in both directions — showing people who use drugs they can go to the police, while giving officers a more nuanced view of addiction and recovery. "It's pretty rare that the police or first responders get to see that people actually do get well," she said. Fitzgerald believes the past few years have changed the culture on the force, familiarizing officers with local resources and making them more empathetic.
However successful, a referral program can't fix larger shortcomings in a region's treatment capabilities. The 2017 study found that the Gloucester program got people in the door, typically at a short-term detox. But they soon ran into the limitations of the broader treatment landscape, which the authors described as fragmented and focused on brief, acute care — even though addiction is a chronic disease that requires long-term attention.
Locally, some advocates said they'd like more residential treatment and long-term housing for people in recovery in Brattleboro. The community-safety report described a general shortage of "truly voluntary support related to mental health, substance use" and other needs. And the community just lost two outpatient treatment programs due to cuts at the Brattleboro Retreat, including the Suboxone program Johnston used early in his recovery.
Project CARE organizers say they work to bypass barriers. Volunteers have driven people to treatment in other parts of the state. The police department vouches for local residents who don't have the ID they need to start treatment. Project CARE stakeholders meet regularly to discuss how participants are doing.
For George Gravatt of Brattleboro, little bits of help — whether from Turning Point or others — have made a difference.
A Los Angeles native who developed a meth problem in his teens, he moved to Vermont several years ago and got sucked into heroin. He ended up homeless, unemployed and a "very well-known panhandler," as he put it.
Eventually, he went from jail to rehab to a sober-living home in Brattleboro — but had no way to haul his stuff there. He called up Turning Point, whose volunteers gave him a ride.
Now almost three years into recovery, Gravatt, 33, said he's working at a restaurant, learning bass guitar and serving as a recovery coach himself. He's a regular at Turning Point, which he said gave him a strong support network.
"I've gained so much," he said. "... There's material things, there's values — there's my self-respect, is the biggest thing that I cherish now."
Whether police-based referral programs like Project CARE actually reduce overdoses is an open question. David Rosenbloom, a professor of public health at Boston University who co-authored the Gloucester study, said there are anecdotal testimonials, but researchers haven't yet studied it rigorously.
"The definitive studies would be complicated — not impossible, but complicated," he said. "And I think will be done, should be done, and my guess is that when they are done we're going to see a positive effect."
Drug deaths continue to plague southeastern Vermont. Brattleboro police responded to 11 fatal overdoses in 2018 and 10 the next year. Across Windham County, deaths from opioid overdoses fell from 24 to 15, part of a statewide decline that still left the county with the highest per-capita death rate in Vermont.
Local officials acknowledge it's hard to discern how any one program affects those numbers, but say things could be worse without efforts like Project CARE. The town allocated it $16,000 last year to pay for transportation, recovery coaches and a program coordinator, a role Johnston took on.
The Project CARE team eventually found a few residents lingering outside their rooms at the motel. Johnston conferred with Lynde, who agreed a detective's presence might make them skittish. He headed back to the car.
On his rounds, Johnston has the energy of a friendly salesman or upbeat evangelist, finding a way to chat up every politely uninterested soul. He'll recall a personal connection, share snippets of his own story, sense what a person's dealing with and casually mention some organizations that could help.
Like any good salesman, he carries swag. Some of it is potentially life-saving, like overdose-reversing Narcan. And some of it's just swag — Jolly Ranchers, Turning Point T-shirts.
Santana approached a middle-aged woman smoking a cigarette, telling her they were from Turning Point. Thanks, she said, she wasn't interested. A bit later, Johnston reached into his backpack and asked if she wanted a T-shirt. She did.
It was a way in. They talked for 10 minutes or so.
Later, Johnston recapped their conversation. She was reluctant at first, he said. But then she remembered he had given her a ride once through Project CARE. She opened up, and at that point Johnston felt they could have talked for hours. But he also sensed she wasn't quite ready to sign up for services. So he told her they'd be back that Saturday. Could he stop by? She said he could.
"We're just trying to plant seeds," Johnston said. "Every single time, plant seeds."
(c)2021 The Keene Sentinel (Keene, N.H.)