Tuesday, October 6, 2015

Women on Cape Cod and Opioid Addiction

 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


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
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
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
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