Hampden DA Plans a Multi-front Battle Against Opioids

Mapping Out a Strategy

Hampden County District Attorney Anthony Gulluni says the ongoing opioid crisis is a function of supply and demand. In short, there is no shortage of either. And the situation won’t improve until that changes dramatically. Reducing both is the broad goal, and he says the key is partnerships — between law enforcement, the medical community, lawmakers, and other constituencies.

Hampden County District Attorney Anthony Gulluni is rather proud of the large map of the region he represents that now dominates one wall of his office in the Hall of Justice on State Street.

He found the item, circa 1857, on eBay, paid $40 for it — it’s a replica, not an original — and then plunked down more than 30 times that amount (his own money) to have it matted and framed.

“It’s sort of a gift to myself,” said Gulluni, who said he often finds himself looking at the map and noting the many forms of progress that have visited the region over the past 159 years.

But that term certainly wouldn’t be applied to the opioid crisis facing his territory — and the other 13 counties in the Bay State, and the entire country, for that matter.

In fact, it likely represents the biggest law-enforcement issue — and one of the deepest healthcare crises — in the Commonwealth and this region since his map was drawn.

“Historically, this is as bad as it’s ever been,” he said, referring to drugs and the many different tolls they take on society. “We had the crack epidemic in the late ’80s, but this is far worse, on many levels. Drugs have always been an issue, but it’s now reached a fever pitch.”

To map out strategies to address the crisis, Gulluni’s office is forming a task force comprised of law enforcement personnel, healthcare providers, elected officials, and others. These are the parties that will have to work together to not only conceptualize a strategy and its specific components, but secure the money to pay for them and then carry them out.

As he talked about the task force and this crisis in general, Gulluni acknowledged what many have said in various forums across the nation — that this is not a problem that the country or his county can arrest its way out of. But arrests can, and must, be a part of that equation. A big part.

Arrests like the one made in Springfield’s South End in early January that took more than 8,000 bags of lethal ‘Hollywood’ heroin off the street, probably saving many lives in the process (officials attribute at least six fatal overdoses to heroin bearing that stamp). And arrests like the one of Ludlow doctor Fernando Jayma, who was indicted late last year on 41 charges, including illegally prescribing oxycodone and other drugs and also making false Medicaid claims.

“We can’t arrest our way to a resolution of this problem, but we have to keep making arrests to take heroin off the streets and keep it from the people who are addicted,” Gulluni noted.

But the DA noted that this fight will have a number of fronts, including treatment of those currently addicted to opioids and educational efforts aimed at keeping others from becoming addicted.

And while saving lives and stemming addiction are the overriding goals of this initiative, the opioid crisis is a quality-of-life issue for everyone living in this county, said Gulluni, adding that, by his estimation, roughly 50% of the crimes committed in his jurisdiction are related in some way to drugs and, quite often, opioids.

This includes crimes related directly to those distributing and selling those drugs, but also those committed by individuals who will seemingly do anything to obtain the money needed to acquire them. And those committed by individuals impacted mentally, emotionally, and physically by those drugs.

“Addiction drives a lot of people’s crimes in terms of breaking and entering charges, trespassing, shoplifting, all those things,” he explained. “But there’s also domestic violence and other crimes that relate to the breakdown in people’s ability to deal with other people, the stress that addiction causes, and how it affects people’s well-being and their relationships with spouses and others.”

For this issue and its focus on law, BusinessWest talked at length with Gulluni about his ‘all hands on deck’ campaign against opioid abuse, and how it exemplifies the battle being waged across the region and across the country.

A Bitter Pill

When asked if he thought the opioid crisis in this region had peaked, Gulluni offered a contemplative “I really hope so” that spoke volumes about this crisis, how far it extends, and, yes, the uncertainty about whether any kind of corner has been turned despite a mountain of press on the subject and calls for action at the local, state, and national levels.

And when queried about when and how it will become evident that real progress has been made, he said this will be borne out by numbers — such as those concerning everything from arrests to fatal overdoses — but perhaps more importantly by fewer uses of phrases too often heard in cities and towns today.

“We’ll know when there are fewer mothers, fewer brothers, and fewer friends coming to me and saying, ‘I can’t believe it was my son,’ or ‘I can’t believe it was me who’s become addicted and it started with a prescription from my doctor,’” he said. “When we hear fewer stories like that, fewer stories of woe, tragedy, and death, that will be a clear indication of progress, and it’s one I look forward to.”

Getting to that day — and he didn’t want to speculate on how far away it is — will require a concentrated, collaborative effort, Gulluni told BusinessWest, one that will involve law-enforcement agencies, the healthcare community, the court system, community activists, and government leaders, who will be called upon to provide the legislation and financial resources to get the job done.

And, as mentioned, it will be a multi-faceted initiative, one focused on everything from curbing the supplies of lethal heroin to providing adequate numbers of beds for those trying to recover from addiction, to changing the way doctors prescribe narcotic painkillers.

Adding to the challenge in Hampden County is the fact that Gulluni’s office is already the busiest in the state by most measures, but has a fraction of the staffing that other DA’s offices have secured.

“We dispose of, in many years, the most Superior Court indictments, our District Court is extraordinarily busy — if you aggregate our numbers, we’re the busiest district, inclusive of Boston, Worcester, and Middlesex County, in the Commonwealth,” he explained. “We have 63 assistant district attorneys, Boston has about 140, Middlesex has 130, Worcester has about 95. So, with about half the staff of some districts, we have the same case load, or a bigger one.”

Gullini is lobbying state officials to enlarge his staff, and, in the meantime, he’s deploying the troops he has in ways that might bring the region closer to that day he described earlier.

These broad efforts might be described as efforts to dramatically curb both supply and demand for opioids.

Indeed, as he returned to the subject of arrests and convictions when it comes to those distributing and selling heroin, like that aforementioned batch with the ‘Hollywood’ stamp, Gulluni said that, while the supply of such drugs is seemingly inexhaustible, the seizures do make a difference.

“In terms of the overall supply of heroin in Western Mass. and Hampden County, those 8,200 packets were a drop in the bucket,” he said of the South End seizure, adding quickly that Western Mass. has become a kind of distribution hub for the drug. “And it has practically no effect on people’s access to heroin. But it’s significant nonetheless.

“And to understand that significance, you have to look at it from the context of how that particular heroin was killing people,” he went on. “Taking 8,200 bags of the ‘Hollywood’-stamped heroin out of circulation is significant; through the hard work of the Springfield Police Department and its narcotics group, in that case, a number of lives were saved as a result of that bust. Those bags would have found their way into any number of people’s hands — people suffering from addiction — and they would have used it, with possibly fatal consequences.”

While the South End bust certainly saved lives, the supply of heroin remains a huge issue, he said, adding that untold amounts of the almost ridiculously cheap drug flow into the region every day.

And by cheap, he means $3 or $4 a bag, with most users needing perhaps three of four a day to satisfy their cravings (at the extreme end, it could be a dozen or more). In Vermont, though, the price is much higher ($10 to $12 a bag due to supply-and-demand issues), which is in turn fueling a surge in cases where entrepreneurial criminals buy heroin at low prices in this state and then try to profit by crossing the border and selling it there. But that’s another story — or at least another disturbing aspect of this one.

“It’s a cheap habit, and that’s why we’re seeing this crisis reach this level,” said Gulluni, adding that heroin has become a very affordable alternative to the much-higher-priced prescription painkillers that many addicts began their unfortunate journeys with.

Prescription for Progress

And this brings us to another front in this campaign — stemming the tide in the number of prescriptions of addictive pain killers.

The arrest of Jayma was one manifestation of this effort, said Gulluni, adding that this was the first such arrest during his administration, which began just over a year ago, and likely not the last. Indeed, while he’s not sure how widespread such abuse is, he knows this is not exactly an isolated incident.

“The so-called pill mills — they’re out there,” he explained, adding that he hopes Jayma’s arrest sends a strong message and becomes an actual deterrent.

“I hope it was a strong statement to everybody, including the prescribing community, that there are certain limits by which you have to abide, based on both your professional ethics and the laws of this Commonwealth and the federal government,” he said. “If you’re doing things that are irresponsible or unlawful, whether you’re a doctor or not, you’re going to be arrested.”

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That arrest is part of the ‘curbing demand’ aspect of this fight, said the DA, adding that it is as important as the supply side, and perhaps even moreso, because without demand, there is no need for supply.

And it’s an example of how those involved with stemming this crisis must deal with the present and the future at the same time.

Regarding the former, efforts are focused on educating and treating those currently addicted, and not incarcerating them, said Gulluni, adding that jail time is generally for those who sell or traffic in drugs or those who profit from their use.

Elaborating, he said those arrested for possession of such drugs are, in most cases, given probation. And there is additional focus now on making sure this probation involves a setting where there is treatment for the addiction.

As for the latter, the future, Gulluni said attention must be directed toward the young people that might someday become addicted if they’re not encouraged to start down and stay on a different path.

“We’ve got to engage with young people; we have to engage with people who are at the stage where they’re beginning to use drugs,” he explained. “In terms of prevention and education, we need to get out in front on this issue for the future.”

Already, the DA’s office is engaged with programs to get opioid addicts and those who treat addiction in front of different types of audiences to “tell the stories,” as Gulluni put it, concerning what happened to them — and what could happen to others.

“We’re presenting groups of people — young people, parents, educators — with the information concerning how this affects people’s lives, how it starts,” he told BusinessWest. “We need people to say, ‘no, thank you; I don’t want 100 oxycodone pills because I had a tooth pulled.’ This is how this stuff starts.

“We need to get some of this out of the stream of commerce,” he went on, adding that legislation is being considered that would limit the numbers of potentially addictive painkillers that may be prescribed and the conditions they may be prescribed for.

Such efforts will require partnerships, he continued, adding that steps to limit prescriptions of this nature require the cooperation of the medical community, and represent just one example of how that constituency must work with law enforcement to stem the tide.

Many such partnerships will be needed, he said in conclusion, because of the deep-rooted nature of this problem and the simple yet indisputable laws of supply and demand.

Challenging Road

A quick look at Gulluni’s prized map reveals just how much Hampden County has changed since 1857.

Missing from this snapshot are countless roads, bridges, dams, reservoirs, colleges, airports, and parks — all of which have contributed mightily to the current landscape.

As has the ongoing opioid crisis, which, of course, doesn’t show up on any map or limit itself to any borders — real or imagined.

It represents history, and not the kind that society will look back fondly on, like a map drawn 159 years ago. And it will take an historic effort to relegate it to the past tense.

The state’s youngest and newest district attorney is ready and willing to make such history, and he’s not wasting any time in that effort.

George O’Brien can be reached at [email protected]