The New York Times
The Vera Institute
"Last November, more than a year after the county stopped making arrests for unprescribed partial agonists, overdose fatalities had decreased by more than 50%. Burlington’s former Police Chief, Brandon del Pozo, reported no "negative consequences,” the specter thrown out by many of anti-harm reduction groups."
"Until we get this right, we’ll continue to suffer more needless deaths. In the meantime, the street presence of diverted subs may help many people to use fewer riskier drugs, and is nothing to fear."
"Krasner’s office said that the move was inspired by a similar policy in Chittenden County, Vt."
Madelyn Linsenmeir died of sepsis as a complication of opioid addiction on Oct. 7, 2018. Her family is from Burlington, and her sister Kate wrote a beautiful obituary for her. Madelyn was beautiful herself, and she left behind a very young son. Her image was so stirring, her death so tragic and her obituary so poignant that People Magazine covered it in addition to The Boston Globe and several other venues. This was in a year when over 50,000 people were going to die of opioid overdoses, and it occured to me that Maddie's death was a tragedy, but it shouldn't take the death of a beautiful white woman to get People magazine to pay attention to the opioid crisis for once. At eleven at night, I typed this Facebook post with my thumbs, in bed. I hesitated, then hit send. It went viral the moment it left my phone.
I have a problem with this obituary.
Born here in Burlington, Madelyn was the 30-year old mother of a toddler. She was beloved by her family. She became addicted to opioids when she was 16 after she tried Oxy at a party. When her addiction finally killed her last week, after she battled it for nearly half her life, a family member with a talent for expression wrote her the honest and moving obituary she truly deserved. It went viral. It's being read across the country. It's in People, the Globe, HuffPost, and the Daily News. My problem with it is that it's a much better obituary than the rest of us deserve.
Why did it take a grieving relative with a good literary sense to get people to pay attention for a moment and shed a tear when nearly a quarter of a million people have already died in the same way as Maddie as this epidemic grew?
Did readers think this was the first time a beautiful, young, beloved mother from a pastoral state got addicted to Oxy and died from the descent it wrought? And what about the rest of the victims, who weren't as beautiful and lived in downtrodden cities or the rust belt? They too had mothers who cried for them and blamed themselves. She died just like my wife's cousin Meredith died in Bethesda, herself a young mother, but if Maddie was a black guy from the Bronx found dead in his bathroom of an overdose, it wouldn't matter if the guy's obituary writer had won the Booker Prize, there wouldn't be a weepy article in People about it.
But if there had been, early enough on, and we acted swiftly, humanely, and accordingly, maybe Maddie would still be here. Make no mistake, no matter who you are or what you look like: Maddie's bell tolls for someone close to you, and maybe someone you love. Ask the cops and they will tell you: Maddie's death was nothing special at all. It happens all the time, to people no less loved and needed and human.
So Maddie, in death, has given us a final gift, thanks to her family's moving tribute to her: the gift of focusing our attention for a moment. Thank you, Maddie and family. This is what I'm tired of: Arguing with sheriffs about their deputies carrying Naloxone at national conferences. Arguing with corrections officials at home about getting all inmates who need it on medication-assisted treatment early on in their sentence and keeping them on it even after they leave. Getting mocked by reactionaries because I won't arrest desperate people for using non-prescribed addiction treatment meds.
If nothing else I will be able to be sanctimonious and know for certain I was doing the right thing. But the NYPD didn't raise me that way, and it's not what a city needs in a chief of police. It raised me to win: to protect and rescue people, and to vanquish threats, not just to be smug about being right. To get the Maddies of a city home.
The science is clear. We have medicines and protocols that work to effectively reduce the risks of death by overdose or other addiction-related causes. If you're ignoring or denying them, then I'll wonder if your tears for Maddie are crocodile tears. This spring, at the direction of our mayor, Miro Weinberger, Burlington police teamed up with Johns Hopkins, the American Health Initiative, and the Police Executive Research Forum to give police and city leaders things they could do, or advocate for, to reduce the nation's opioid addiction deaths.
They are based on science, and medicine, and they *will work* to lower the number of fatal overdoses and addiction-related deaths. And they're not especially police-like, which wasn't an accident because the police aren't going to stop the dying themselves. Here are some of the highlights and of our city's general strategy, which is a good one for the nation:
- Support and propagate needle exchanges (done in BTV);
- Give out buprenorphine at needle exchanges to basically any user who requests it (BTV is doing it);
- Give out buprenorphine at the emergency room to anyone who presents with an addiction and requests it (BTV doing it);
- Treat every prisoner who needs it with buprenorphine, methadone or vivitrol as best fits them (Vermont is at least trying);
- Stop arresting and prosecuting for simple misdemeanor-level possession of non-prescribed addiction treatment meds (our city's police & prosecutor policy);
- Stop requiring total abstinence in recovery housing by allowing people stabilized on addiction treatment meds to live in them (not even close);
- Equip users with the tools to test their drugs for fentanyl (Vermont is doing it);
- Create enough capacity to eliminate wait lists at treatment hubs (almost there in VT);
- Train primary care doctors to treat addiction and prescribe addiction meds (making progress in VT);
- Return the opioid prescribing rate to pre-epidemic levels (on the way in VT);
- Recognize addiction as a chronic disease and that abstinence-based therapy only works a small percent of the time, for certain people (old stigmas die hard);
- Saturate communities with Naloxone (done in Vermont)
Maddie's gone. She can't feel your sorrow. But others are next. Some aren't beautiful. Others look nothing like you. Some are like Maddie's twin, and have little children too. They are all human beings and they need our help. Go. Get to work. We still need to earn the feelings her obituary inspired in us. We should have felt them years ago.
In the wake of the obituary and the response, I had the opportunity to discuss addiction, stigma and drug policy reform not only on MSNBC (link to the segment here), but on WBUR Boston with Beth Macy, the author of Dopesick, Maddie's sister Kate, and On Point's host David Folkenflick
In 2018, I collaborated with the Johns Hopkins School of Public Health and the Police Executive Research Forum on a science and evidence-based approach to policing's role in reducing the effects of the opioid epidemic. The platform lays out ten standards of care the police can adopt and advocate for to save lives.
David and I were backyard neighbors in a small village on the Hudson River north of New York City. I was a cop, and he was in recovery from a heroin addiction. What we learned from each other would profoundly shape our journeys. He's a frequent writer about drug use, recovery and relapse: