I am attending the Fairbanks Symposium on Impact of Opioids over the next few days. I will publish some live-tweets throughout the next three days in this thread.
“Day One: Starting the Conversation.”
#fbxopioid #Day1
“Day One: Starting the Conversation.”
#fbxopioid #Day1
Reverend Shirley Lee gave the opening prayer as Venerable Anna Frank was unable to attend. #fbxopioid #Day1
During his speech, Fairbanks City Mayor David Pruhs emphasized this will probably be the *first* symposium, possibly of many. #fbxopioid #Day1
Amber Vaska, Director of TCC, summarized efforts to address drug and addiction issues, as well as the cycle of trauma present for many homeless people and incarcerated people, and TCC’s efforts to both break the cycle of trauma and enter the cycle of healing. #fbxopioid #Day1
*TCC Executive Director Amber Vaska, excuse me.
Melissa Charlie, FNA Deputy Director, discussed the funding and efforts in Fairbanks to expand access to culturally appropriate treatments and methods to address opioid use disorders and stimulant use disorders and expand services. #fbxopioid #Day1
Former Fairbanks City Mayor Jim Matherly was unable to attend due to knee surgery. However, his representative emphasized what he had wished to speak: that opioid addiction can happen to anyone, and that Matherly’s daughter also dealt with opioid addiction. #fbxopioid #Day1
Emcee sharing about personal impacts of opioid addiction, use, abuse, and the death of family members. #fbxopioid #Day1
Fentanyl is the newest in a line of highly addictive substances that have impacted our community and breaking silence and stigma is one of the only ways to begin the community-wide healing process. #fbxopioid #Day1
Audience polls about thoughts on homelessness, re-entry, et cetera. Discussion on how definitions of homelessness create access barriers (such as living out of your car disqualifying you from certain resources, even though you ARE homeless). #fbxopioid #Day1
Break finishing up.
QR Codes posted around the room all go to different websites, but are unlabeled, and one doesn’t quite work correctly. I will copy-paste the link list below. #fbxopioid #Day1
QR Codes posted around the room all go to different websites, but are unlabeled, and one doesn’t quite work correctly. I will copy-paste the link list below. #fbxopioid #Day1
1/ QR code links #fbxopioid #Day1
namifairbanks.org (QR doesn’t quite work, this is their corrected website.)
namifairbanks.org (QR doesn’t quite work, this is their corrected website.)
Hashtag for symposium has been announced as #fbxopioids. I will now be switching from the #fbxopioid hashtag I had created to the pluralized version. #Day1 #fbxopioids
“Boots on the Ground” Panel will be starting soon. I have also signed up to try some of the healing techniques offered to attendees, so will break from summarizing when my turn comes up. #fbxopioids #Day1
MC discusses purpose of panel: how opioids effect first responders’ jobs on daily basis. Intros: FPD Chief Dupree, PO Church, FWPD Chief Kearns, Sarah Koogle Director AK Behavioral Health, Dr. Mark Simon MC (Golden Heart Emerg Serv), Asst. Fire Chief Coccaro FFD #fbxopioids #Day1
FFD Asst. Chief Coccaro discusses previous paramedic & medical examiner experience in lower 48 (I believe they said North Carolina). Says opioids are national problem & touches all demographics, “richest of richest to poorest of poorest & everything in-between” #fbxopioids #Day1
FFD Asst Chief Coccaro says FBX population suffers from multiple addiction issues. Not as bad as other states, but “tomorrow that can change” and spikes/ebbs and flows go according to what is mixed in with substances. #fbxopioids #Day1
Dr. Simon says local trends in ER are transitioning away from pain pills to heroin in Fairbanks community. Meth use is also seen commonly alongside opioids and/or heroin, and meth complicates everything due to effects on individuals and their decision making. #fbxopioids #Day1
Dr. Simon states that “diseases and illnesses of affluence” (substance abuse, obesity, diabetes, and mental illness) are becoming more common in Fairbanks and are more widespread. #fbxopioids #Day1
PO Church says “offenders must be cleared by medical” and be supervised before they can be/are incarcerated. Medical does “absolute best to make sure somebody is at least comfortable enough to detox.” Cannot be sent to halfway house while going though detox… #fbxopioids #Day1
PO Church continued: says detox seems to be taking longer. FCC (Fairbanks Correctional Center) also provides substance abuse screening, “almost nobody has beds available” across town. #fbxopioids #Day1
FWPD Chief Kearns says problems in community are reflected on base as well. (Fort Wainwright) #fbxopioids #Day1
Sarah Koogle says Mobile Clinic hasn’t seen increase, but patients also bounce back and fourth between resources on streets. #fbxopioids #Day1
Fairbanks PD Chief Ron Dupee says not as much heroin seen lately. Most of what PF seeing is locally manufactured (fentanyl & fentanyl fakes) or manufactured in lower 48. More are creeping into Alaska & increase in opioid derivative overdoses #fbxopioids #Day1
FPD Chief Dupee cont: says PD doesn’t see cases saved by narcan/naolaxin because they aren’t reported to pd. #fbxopioids #Day1
Dr. Simon describes what detoxing off of overdose looks like & what happens to person’s body. When people take substance, body gets used to some (like alcohol & nicotine.) Causes physical & mental effects, most substances have overlapping effects. #fbxopioids #Day1
Dr. Simon continues: Pain, discomfort, aches, diarrhea, sweating, shaking as common opioid effects & withdrawal effects. Describes gradual increase in substances to get effect & person becomes dependent over time, will suffer effects if use is stopped. #fbxopioids #Day1
FFD Asst Chief Coccaro says EMS has become “kinder, gentler EMS over time” & changes in training over time leading to better patient treatment & outcome. #fbxopioids #Day1
FWPD Chief Kearns says treatment has greatly changed over years overlapping with law enforcement treatment, “we used to just throw them in jail.” Says military response has switched more to medical focus than legal response. #fbxopioids #Day1
PO Church says things have changed in last five years, but “revolving door” of incarceration, and some officers just “check out” after talking to same person five times. Doesn’t “think we get trained well enough” on how to deal with recidivism in drug use/abuse #fbxopioids #Day1
FPD Chief Dupee says from police side perspective hasn’t changed re: legality, but service options have changed (like Crisis Now). FPD has also implemented Arbinger Institute training. arbinger.com/state-and-loca… #fbxopioids #Day1
FPD Chief Dupee says focus on community aspect has shifted since he took over as chief, police meet with NAACP, TCC, FNA, and Denakkanaaga every two weeks. Crisis Now has taken work off shoulders of police & FCC. #fbxopioids #Day1
FPD Chief Pupee discusses recent fur hat making with Denakkanaaga elders as way for officers to partner with and get to know elders & vice versa and share stories. Idea is that they are wearing something to remind them they are part of this community. #fbxopioids #Day1
FWPD Chief Kearns says military reluctant to use available army services because they are worried they will lose clearance etc. Partnered with Fairbanks Wellness Coalition to help soldiers & family reach services in town (and vice-versa).
#fbxopioids #Day1
#fbxopioids #Day1
FWPD Chief Kearns talks about care bags & information passed out on base due to partnering with FBX Wellness & others, summer will have more classes & initiatives put in place. Meet w/FPD every two weeks to discuss initiatives. #fbxopioids #Day1
Sarah Koogle discusses mobile operations, relationships & trust built over 2 1/2 years have resulted in better care & outcome. #fbxopioids #Day1
PO Church would like to see more pre-covid activities start up again at FCC. Yoga, dogs visiting & fostering while incarcerated, and more. #fbxopioids #Day1
Dr. Simon says compassion fatigue happens to all categories of EMS providers. World has gotten faster but institutes still move slowly. “Drugs are powerful and easy to get and they’re not going away.”#fbxopioids #Day1
Dr. Simon says emerging trends & concerns for opioid use are positive role incarceration can play, medicine & incarceration are tools that have powerful impact but aren’t enough. Need long term support & hopes more medication will emerge with longer effects. #fbxopioids #Day1
Sarah Koogle thankful for AK Mental Health Trust & Crisis Now. “Peer support can be practically anywhere” #fbxopioids #Day1
FFD Asst Chief Coccaro says peer support groups and mobile response team are positives and wants FFD to be integrated into support teams more to reach further to community as a team. Community opportunities for ride alongs are possible (after HIPPA Compliance) #fbxopioids #Day1
FPD Chief Dupee says powder form brought into state that’s then made into pill is common. Look for anything pill-like that doesn’t look normal. Signs: burned tinfoil pieces, bindle (folded piece of paper), orange caps from needles, pill presses, small baggies #fbxopioids #Day1
FPD Chief Dupee also states FPD does not have staffing to allow for ride alongs at this time. #fbxopioids #Day1
PO Church asks public to be patient with FCC and says that majority of staff treat others with same respect they are given. #fbxopioids #Day1
FWPD Chief Kearns says he was treating 15 overdoses a day (just narcan administration) in lower 48. #fbxopioids #Day1
FFD Asst Fire Chief Coccaro believes it is so much more doable to end crisis in community. #fbxopioids #Day1
Sarah Koogle says last year Mobile Support team was able to divert 737 calls from Law Enforcement or ER. #fbxopioids #Day1
Audience Q’s: Tools - Convert soda cans to smoke marijuana with, apple with bath salts, light bulbs converted for meth use. #fbxopioids #Day1
Audience Q’s - What is “no wrong door” approach? Sarah Koogle says Phoenix AZ great. Someone high can’t be legally treated, people shuffled around & rejected from services. Instead, this approach treats people for mental health & substance abuse where seek it. #fbxopioids #Day1
FCC says longer term classes aren’t a viable option due to type of facility (largely pre-trial, people moved sometimes week-to-week). So programs like literacy are prioritized, do not have online access to facilitate degree seeking students. #fbxopioids #Day1
FCC: Vocational training is also restricted. #fbxopioids #Day1
FPD Chief Dupee says have hard conversations with teens & young people, “One pill can kill,” says watch Dead on Arrival (documentary). #fbxopioids #Day1
TCC Amber Vaska says some rural communities don’t have tribal officers, mental health services— often left to tribal chief. Can enforce codes on all Alaska Natives for Civil Authority but are not trained. #fbxopioids #Day1
City Recovery Board member Linda says about 40 people attend meetings Tuesday nights at 6 PM. Has found it helpful & encouraging as mother of child with addiction issues. #fbxopioids #Day1
Public can get narcan at City Hall, FFD, hospital… #fbxopioids #Day1
Panel says stories of overdose by touching fentanyl most likely not true. #fbxopioids #Day1
FNSB has Prevention & Intervention specialists and they also collaborate with nurses to help prevent opioid abuse among students. Looking into online programs & use “Operation Prevent” within schools, hoping to expand program. #fbxopioids #Day1 operationprevention.com
Lunch finishing up, next panel will be “Breaking the Stigma” #fbxopioids #Day1
I am live-tweeting summary of discussion so those who could not attend and/or did not know of the symposium may have opportunity to learn (& possibly attend in the future). Inspired by @ANCDEADBEAT’s live-tweeting & how useful that is for Anchorage community. #fbxopioids #Day1
While very different from council meeting, heroin, meth, & opioids are so widespread in Fairbanks I very much feel that narcan/naoloxene should be included in med kits of all Fairbanks businesses & proper administration taught. #fbxopioids #Day1
I hope this running summary will be useful for someone in the future & for attendees who also had to leave early or can only attend one day/part of symposium. #fbxopioids #Day1
Ah, excuse me, I made a mistake. Next is “Funder’s Panel” at 1:15! #fbxopioids #Day1
Emcee mentioned purple is the color of opioid awareness, thus the color scheme of conference goods & printing.
syilx.org/wellness/our-p…
#fbxopioids #Day1
syilx.org/wellness/our-p…
#fbxopioids #Day1
Power outage! Will make Funders’ Panel unique for sure. #fbxopioids #Day1
Intros: Daniel Delfino from Alaskan Housing Finance Corporation. Some state & some federal programs, over 20 statewide programs within organization. Various programs devoted to renovating, building, rent help, and much more. #fbxopioids #Day1
Dan Delfino AKHFC continued: mortgage refinancing and help to local orgs also given. #fbxopioids #Day1
Intros: Travis Welch, Alaska Mental Health Trust Authority. Discusses history of trust from statehood, 1 million acres of land granted from state in beginning. Supports patients with disabilities, mental health issues, dementia, et cetera. #fbxopioids #Day1
David Welch intro continued: Provide funding for various trustees, work with Crisis Now and others, various programs to advocate for persons with mental health issues, disability, substance abuse, and more. #fbxopioids #Day1
Intros: Amanda Woody from Department of Behavioral Health. State program #fbxopioids #Day1
Intros: Bob Doehl from Rasmuson Foundation, private organization. Endowment gives grants from private foundation to work with all Alaskans. He specifically works with Housing and Homelessness coalition. #fbxopioids #Day1
Intros: Brian Wilson, Director of Alaska Coalition on Housing and Homelessness. Small 501 LLC, works with other organizations, is “continuum of care” organization. HUD defined geographic area they oversee is everywhere outside of Anchorage!! #fbxopioids #Day1
Intros: Brian Wilson continued— Youth Homelessness, Fairbanks Rescue, and more are grant recipients. Oversee all client data for all of the state in partnership with Anchorage Coalition. Also works with advocacy groups to try to make best use of limited funds. #fbxopioids #Day1
Intros: Man who didn’t give his name (later intro’d as Christopher) & woman named Stacy Williamson are here as Department of Corrections Representatives. #fbxopioids #Day1
Daniel Delfino of AKHFC discusses rental vouchers for people coming out of corrections, but most programs are about building or funding housing rather than reentry programs specifically. #fbxopioids #Day1
Delfino continues- programs are integrated, housing development reps will direct people to appropriate resources but they don’t serve a designated population in one building. #fbxopioids #Day1
Travis Welch: AK Mental Health Trust provides funding to those most at risk for recidivism. Funding goes to cover gap periods while waiting for Social Sec or AKHFC funds to kick in. Provides 4.5 million to Crisis Now per year. #fbxopioids #Day1
Travis Welch of AK Mental Health Trust states also provides funding for Careline in Fairbanks and soon-to-be-open care center in Kotzebue. Gives approx 39 million in grants per year across state. #fbxopioids #Day1
Amanda Woody from Div of Behavioral Health is focused on Reducing Recidivism Program today (though Division is extensive). Provide funding for case managers. 9 month programs that are short, specialized, and intense. #fbxopioids #Day1
Ms. Woody continues: True North is who receives reentry grant in Fairbanks. Partners for Progress in Anchorage also receives funding. #fbxopioids #Day1
Bob Doehl from Rasmuson Foundation clarifies they provide specialized grants but not direct funding. Generally focus on housing affordability & access. #fbxopioids #Day1
Brian Wilson of AK Coalition on Housing and Homelessness: discusses difficulty applying for funding & cannot earmark funds for specific funding (unless specified by grant itself). Can prioritize length of time of homelessness & other vulnerability factors. #fbxopioids #Day1
Wilson Continues: funds 23 programs across state. Mission is ending homelessness with positive outcome for individuals. While not specific to opioids or re-entry, there are many reasons someone falls into homelessness & houselessness. #fbxopioids #Day1
DOC reps: look at allocating funding to high-risk of recidivism. Also tries to educate incarcerated population on resources that are available to them. Certain grants must be applied for while incarcerated, such as 2nd Chance Act Grant. #fbxopioids #Day1 bja.ojp.gov/taxonomy/term/…
Q: What is most innovative project you’re funding/most excited about? #fbxopioids #Day1
Delfino, AKHFC: Designed program around end user so people can apply for rent help on their phones. “If it takes so long to get through…program that people give up, the program might as well not exist.” “You need a decoder ring to follow some of the language.” #fbxopioids #Day1
Brian Wilson AK Coalition on Housing: CrisisNow & behavioral health emergency funding not done through criminal justice system. “It’s a game-changer because it’s moving away from that model.” #fbxopioids #Day1
Wilson continues: “[Standard national] Dispatchers are great, but not trained to deescalate or handle mental health crisis.” says CrisisNow gets you “someone to talk to, someone to help, and somewhere to go” that does not involve institutionalization. #fbxopioids #Day1
Wilson continues: Has seen people be in emergency waiting rooms for as long as two weeks. Sometimes PD will drive around entire shift trying to find help for person in crisis. Crisis centers change that so that Law Enf Ofcrs aren’t in charge of behavioral health #fbxopioids #Day1
Wilson: “No wrong door” approach is what’s missing in Fairbanks. #fbxopioids #Day1
Woody: Individual Placement and Support (IPS) for people with substance abuse issues, places Employment Support Specialists to support clients preferences and interests, and provides peer support. “Employment is public health support intervention.” #fbxopioids #Day1
Doehl (Rasmuson Foundation): Resource Center— “one stop shopping” for support. Job training, behavior health support, maximizing support options for individual success. #fbxopioids #Day1
Wilson (AK Coalition on Housing & Homelessness) - used to be that tribal orgs could not apply for certain funding. Laws expanded to allow tribally designated housing institutions, starting to break down institutional racism that is still extremely widespread. #fbxopioids #Day1
Christopher & Stacy DOC: “Re-entry starts the day of incarceration.” Beginning communication & incorporating ideas to create face in community is “unfortunately more of an innovative practice” among government entities. #fbxopioids #Day1
Audience Q’s: How to assure safety of care providers that must accept clients regardless of violence or intoxication? #fbxopioids #Day1
Safety answer: peer support specialists, adequate staffing, asks to direct question to Thursday panel at 10 AM. #fbxopioids #Day1
Mike (panel MC) with regards to recidivism, says “everybody’s doing the best they can with what they have.” It’s a worldwide problem, recidivism IS dropping says Marsha (overall MC). #fbxopioids #Day1
Wilson states “Recidivism has dropped to 59%.” #fbxopioids #Day1
Eviction as a barrier to housing help: Delfino says there may still be resources & they do work with people who have eviction history; asks people to reach out to AKHFC. #fbxopioids #Day1
Q to Travis Welch (AK Mental Health Trust) asking about vet services & dementia services: directed to VA for vet help & Colette at NAMI, Alzheimer’s is covered by Kelda & contact info is on trust website. #fbxopioids #Day1
Regards to re-entry help with DoBH- Woody (DoBH): Evidence based interventions are at forefront of policy “good data is the basis of assistance.” #fbxopioids #Day1
DOC Reentry Delfino: Federal programs probably can’t do much, state *might* not be able to do much, but there may be resources you don’t know are available unless you contact AKHFC who can work with you. “There’s a line in the sand, but you can move it.” #fbxopioids #Day1
Welch (AK Mental Health Trust): private funding can be used to help secure other funding. #fbxopioids #Day1
Q: DOC - are you excited about TCC partnership? “Yes.” #fbxopioids #Day1
Q: Do you help fund projects in small villages? Doehl (Rasmuson): “Yes, limit is on project’s ability to succeed.” #fbxopioids #Day1
Q. Is 59% recidivism rate something to brag about compared to other states/countries? Marsha Oss (Emcee) : “Yes. Rates were at 69-72% in 2017. Still highest in nation (depending on numbers examined), but dropping & have dropped 10 points in 5 years.” #fbxopioids #Day1
Marsha Oss (overall Emcee, Fairbanks Reentry Coordinator Opening Blessing): emphasizes large area complicates recidivism. If can help someone without reoffending or PTRP (Petition to Revoke Probation— a probation violation), that’s huge. #fbxopioids #Day1
Closing thoughts & thank yous from panel: Requests to have community get involved, different systems must work together to be successful & it is impressive, invitations to reach out to various orgs & org reps. Hope about future due to work of various people. #fbxopioids #Day1
Break before today’s final presentation. Alaska Fentanyl Response Presentation and Nalaxone Kit Building Activity starts at 3:15. #fbxopioids #Day1
Came in to Naoloxene seminar late due to healing session signed up for earlier. Feel a little strange. Documentary playing, I believe it is “Dead on Arrival.” #fbxopioids #Day1
I hope the fentanyl documentary is not overly distressing for folks who have lost family, friends, loved ones. I think it must be at least to some degree, how could it not be? Some sniffles & stressed rocking from participants in room. I hope folks will be okay. #fbxopioids #Day1
I wish it was easier to know how to support folks for whom, inevitably, this will stir up pain. I’m not sure how that support is possible amongst strangers. I hope they are here with friends & coworkers. Perhaps they can do more. #fbxopioids #Day1
I have been to events where counsellors were present & it was actually *extremely* damaging. Depends on the counsellor(s) no doubt, but sometimes things that seem supportive can be unhelpful if proper screening & followup isn’t involved. But I digress. #fbxopioids #Day1 
(Art by Arch Budzar archbudzar.com)
Presenter Sandy Snodgrass’ son, Bruce, died at 22 less than 40 feet from a drive through in Anchorage. He had a relapse and collapsed almost instantly due to fentanyl. murkowski.senate.gov/press/release/… #fbxopioids #Day1
Snodgrass says she knows all of the parents in the video and they work tirelessly. “Talk to your kids, talk to your nephews, talk to anyone you can talk to anyone you can talk to, and carry naoloxene.” #fbxopioids #Day1
Naoloxene training video— Call 911, how to recognize an overdose, administration instructions. Naoloxene only works on opioids. Support back of the head, put in nose until fingers touch nostrils, hit plunger. Each is one dose, do not leave after administering. #fbxopioids #Day1
Can administer multiple doses, will not harm you/them. Takes 3-5 minutes for someone to start coming out of overdose, depends on what they took. With fentanyl it can take several doses if no response in short time. #fbxopioids #Day1
City of Fairbanks (City Hall) is a Project Hope distributor, as is FNA. Standard dose/old dose of naoloxene is 4 MG, these kits each dose is 8 MG due to increased incidences of fentanyl overdose. dhss.alaska.gov/health/osmap/P… #fbxopioids #Day1
FCC (Fairbanks Correctional Center) distributes narcan/naoloxene kits as part of re-entry. Inmates can request it upon release and they will be given one, but they have to ask for it. They can also request one from medical & it will be put in their belongings. #fbxopioids #Day1
Each kit contains an instruction sheet that also lists signs of an overdose, a face shield, rubber gloves, two doses of 8 mg kloxxado (Naloxone HCL) —these do expire & list their expiry dates, post overdose recovery information, & TreatMent Connection info. #fbxopioids #Day1
Pouch also has QR code and website information for anonymously reporting usage to Project hope. health.alaska.gov/dph/director/p… #fbxopioids #Day1
“Signs of a Heroin or Opioid Overdose - Any of the following are signs of an overdose.” health.alaska.gov/dph/Director/P… #fbxopioids #Day1
Instructions for administering naloxone. See health.alaska.gov/dph/Director/P… for more information. #fbxopioids #Day1
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