Substance abuse forum in Sharon: Young, old misuse drugs

Although drugs such as heroin or cocaine make better headlines, alcohol remains the most-abused drug. Dr. Jared Zelman, an emergency room physician at Sharon Hospital, said, flatly, "50 percent of trauma cases involve alcohol."

And "TJ" said in response to a question from a parent that his best guess was that "a majority" of high school students regularly get drunk on weekends — an alarming idea in terms of public safety.

"Kids drive recklessly anyway," he said. "Mix that with hormones and alcohol..."

Skip Kosciusko, captain of the ambulance squad in Cornwall, said parents can help deter drunk driving by teens. "Make an escape plan with your child," he advised. "One way to handle it is this: A call for a ride at two in the morning should be met with a ‘thank you.’"

Drugs such as heroin have made significant inroads in the area, Bailey said, citing the appearance of high-quality heroin now being produced in Colombia, rather than Asia or the Middle East.

"It’s much purer than before," he said. "Kids can snort it and avoid using needles."

And cocaine, whether in the form of powder or crack, is hardly uncommon, although Capowich said that cocaine activity is highly regionalized.

Bailey, whose investigations straddle state and national borders, said the Dutchess Task Force concentrates on mid-level dealers, and in trying to disrupt the supply.

And there are, generally, two types of dealers: those associated with gangs and freelancers out to make a quick dollar. "The first thing I want to know is does this guy use the product?" said Bailey.

John Hamilton, an expert on substance abuse treatment, delivered a quick synopsis of available treatment modes and emphasized that there is no single approach to the addicted individual, except this:

"We must always treat the individual with dignity and respect."

He ran through a lengthy list of treatment modes, describing which models best fit which clients.

Mountainside, for instance, is a "short-term" intensive facility best suited to people who are no longer contemplating addressing their addiction but taking action.

Kosciusko echoed this sentiment, saying that parents, first responders, or anyone in touch with the active alcoholic or addict must learn to separate the behaviors from the person.

"It’s tough sometimes," he continued. "I am mortified about letting first responders go in until the troopers have secured the scene." Capowich, referring to an incident in which a teenage girl in the midst of a heroin overdose was also in possession of a knife, added, " Our responsibility is public safety, our priority is to get the person to the hospital. But it doesn’t always look good, with three big guys taking on one girl."

No ‘accident’

Zelman said that emergency room terminology no longer includes the phrase "motor vehicle accident."

"We call it a ‘motor vehicle collision,’ because that’s what it is.

"These aren’t accidents. If someone drinks over six beers and puts his fist through the window, is that an accident? No. It’s predictable and preventable."

But reaching the patient is tricky. "Insurance policies have alcohol exclusion clauses, which result in the patient lying and refusing testing.

"And if someone is drunk or high, and maybe belligerent or weepy, is that the time for a ‘teachable moment’? No.

"But later on, when they’re coming down and we’re sewing them up, we might say something like ‘Gee, do you think your alcohol use might have had something to do with this?’"

Emergency room doctors have another quandary: What to do when someone complains of pain, yet the doctor suspects they are seeking drugs?

"Doctors don’t want to be taken advantage of," said Zelman. "I am going to be a little suspicious of an acute dental problem on a weekend evening, when the person is from out of town, and people need to realize that.

"I don’t want to be a social policeman, but there’s a point where I am not going to give out a lot of pain medication."

Kosciusko added a plug for participation in 12-step groups as the best way to keep an addict in recovery. "I have a life today that is unbelievable" thanks to his involvement with such programs.

Jim Hutchinson of Sharon Hospital, one of the evening’s organizers and the emcee, concluded the program by asking the audience if they thought it would be worthwhile to have additional events. The answer was an overwhelming "yes."