A Bridge Over Troubled Water

October 11, 2023

By Courtney Wise

In other news: The FDA encourages the development of medical treatments for cocaine and meth addiction. JFK’s nephew leads the charge to renew the former president’s vision for a nation in which people with mental illness “need no longer be alien to our affections or beyond the help of our communities.” Plus: A young skateboarding legend uses his gift to help people achieve sobriety. 

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“He’s a dab of glue in a broken city. Can he hold it together?”– A day in the life of an Portland, Oregon security guard on the frontlines of the opioid crisis

Portland security guard Michael Bock can’t even clock into work before having to respond to a crisis. His first on a day that reporter Eli Saslow and photographer Erin Schaff of the New York Times shadowed him was on the road to his 12-hour shift for Ecehlon, a private company with more than 75 guards who patrol 400 local businesses around the clock. Its guards do more than “human scarecrow” work, Bock said. They build relationships with the unhoused on the streets they patrol, offering food and supplies to people battling addiction and mental illness, even working to reverse overdoses and de-escalating their episodes of psychosis when first responders like police, fire and EMT are unavailable.

On this day, as Bock drove into downtown just before sunrise, he saw a man chasing someone with a hatchet over an apparent drug theft. His verbal requests to “please settle down” gone unheeded, Bock dialed 911 for police assistance. But dialing a dispatcher equipped with just 8 of the 17 officers needed to respond to the record number of 911 calls it receives for the area proved futile. Per usual, Bock was left with only his fortitude, ingenuity, compassion, and 2006 minivan to diffuse the situation.

With the physique of a sumo wrestler and expertise in jujitsu, Bock is built for the job. He also patrols armed with a gun and pepper spray. But the mentality he brings to work is his most valuable tool. “Love is the devotion to the well-being of others without regard to the cost” is the adage that drives him. It’s the most reliable thing he’s got in a city with a first responder system the mayor decries as “20 years behind the ball and critically understaffed.” It’s what drives him to check on the overdose victims nodding out near a deceased comrade who didn’t survive his last taste of fentanyl. Dozens of passersby stepped over the man’s body during morning rush hour before one stopped to see if he was still alive. “It’s rinse-and-repeat at this point,” said the medical examiner. (You can read the entire article here.)

Postscript: Eugene, Oregon’s lauded mobile crisis street team CAHOOTS was moved from the police department to the fire department this June. In Portland, a request for funding for the Portland Street Response team was nixed this August. [Due to an editing mistake, not an error from the newsletter writer, an earlier version of this newsletter was amended to say incorrectly that the mobile crisis team CAHOOTS was operating in Portland. CAHOOTS in based in and operates in Eugene, Oregon.]

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FDA encourages researchers to develop medicinal treatments for cocaine and meth addiction

The drug buprenorphine, approved to curb opioid cravings by the Food and Drug Administration, has been an enormous boon to physicians treating opioid addiction. At present, there is no medication approved to treat addiction to cocaine, methamphetamine or prescription stimulants. However, the FDA is seeking to change that. Last week, the agency issued guidance to encourage the development of “drugs and biologics” to address this gap in addiction medicine.

Though many are aware of the nation’s overdose crisis due to fentanyl and other potent opioids, stimulant abuse has also risen in recent years. A growing number of drug deaths are from a combination of opioids and stimulants, or stimulants alone, STAT News reports. 

In its announcement, the FDA said that certain medications could be eligible for fast-tracked approval due to the urgency of the stimulant addiction crisis. The agency also suggested it is open to clinical trials that may not end in complete abstinence from drug use – the most common datapoint used to demonstrate treatment efficacy. The position is shared by a number of scientists and public health officials, who believe getting the most high-risk people to significantly reduce their drug use is invaluable, even if it is not total cessation.

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In other news…

Patrick J. Kennedy seeks to renew his uncle JFK’s vision of mental health care for all who need it: Week’s before his assassination, President John F. Kennedy signed the Community Mental Health Act into law. His hope was that it would enable Americans with mental illness and intellectual disabilities to “no longer be alien to our affections or beyond the help of our communities” by providing them quality care beyond the asylum. Though JFK’s vision seemed to fade after his death, his nephew Patrick J. Kennedy is working to bring it back into focus, reports the Washington Post. 

Last week, Kennedy announced the launch of a public-private movement called Alignment for Progress, which calls for a 90-90-90 strategy to tackle mental illness. Ambitiously, it seeks for 90 percent of citizens to be screened for mental illness and substance use disorder; 90 percent of those screened to receive evidence-based support; and 90 percent of those served to have manageable symptoms, all by 2033. “It is a scandal that this rich nation has so many of its fellow citizens dying like dogs on the streets. It should be an indictment of all of us and our political system,” Kennedy said at last week’s launch. “This is not the purview of the mental health community any longer. This is the purview of all of us.” (Kennedy is also an advisory board member for MindSite News.)

Skateboarding to fight addiction in San Diego: Brandon Turner has been a skateboarding phenom since middle school, gaining international acclaim and sponsorships at age 13. But the fast success also opened access to a fast life he couldn’t quite handle. “I did start drinking early on, before I was 18, so that played a part legally. I started getting DUIs, started getting drunk in public, started getting county jail time. And then eventually — long story short— ended me landing in prison,” Brandon Turner told San Diego’s NBC 7. But after achieving sobriety in 2016, Turner sought to help others struggling with mental health and addictions. His journey inspired him to open West Side Recovery, a treatment center aimed at helping those who seek relief from substance use disorder.

“Getting help is not weakness, it’s power,” Turner told NBC. “And there are resources out there. Most of us, when we struggle, we think we’re the only ones going through the problems. And that’s just not the truth. It’s an illusion.” In addition to traditional treatment, participants can dive into activities to boost their mental health – including skateboarding with Turner twice a week in San Diego. “Skateboarding, to me, is one of the best lessons in life because it’s constant failure,” Turner said. “Like with skateboarding, just like life, you’re going to fall every single day, and the way you learn is how you pick yourself back up and your support system and people teaching you. So I use that analogy to help people with recovery.”

Sending encouragement to friends in recovery through the mail: There’s nothing like getting mail that’s meant to make you smile, and a new initiative in Colorado is designed to encourage those in substance use recovery and those on their way. Through the state’s Recovery Cards Project, residents of Colorado can send and receive greetings cards to encourage and celebrate their recovery at absolutely no cost. And there’s a digital option for friends outside of Colorado, too.

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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