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Amy Aparicio Clark is executive director of the Aetna Foundation, the charitable arm of CVS Health. In 2019, the foundation awarded a $1 million grant to fund the Law Enforcement Overdose Intervention Program in Winchester.

WINCHESTER — Two years after the $1 million Law Enforcement Overdose Intervention Program began, one person has graduated and 16 have been terminated.

The program, which serves people in Winchester as well as Clarke and Frederick counties, hoped to serve up to 150 clients. So far, it has served 41.

That might not seem like a lot of bang for the buck, but Lauren McCauley, program case manager, noted that between January and June 2022, eight clients are scheduled to graduate from the Winchester-based program. But she said the numbers don’t tell the whole story. The road to recovery is often filled with detours, and McCauley said the program has adjusted to reduce terminations and better address the needs of clients.

“Recovery’s not easy and it’s not a one-size-fits-all thing. It’s different for everybody. They have different needs, they have different histories, and they have different ways to process things,” she said. “We have the same structure and rules for everybody, but we also take into account everybody’s individuality and their needs.”

There are currently eight men and six women ages 19 to 40 in the program. Graduates typically spend about 15 months in the five-phase program, which includes individual counseling and group therapy as well as help finding food, housing and jobs. There is also a community service component. It has included serving meals at the Winchester Rescue Mission and volunteering at the Shenandoah Valley Equine Rescue Network.

Clients work with program staff eight to 10 hours per week. The program includes regular drug testing and monitoring, but there is less monitoring as clients progress through the program. McCauley said all of the terminations occurred in the first two phases of the program with most in the first phase.

The program has sought to be an antidote to the nearly decade-long nationwide opioid epidemic. Over the last decade, at least 259 people have fatally overdosed in the Lord Fairfax Health District, which encompasses Winchester as well as Clarke, Frederick, Page, Shenandoah and Warren counties. Hundreds more have survived overdoses, primarily due to the overdose antidote naloxone.

Realizing the epidemic needed to be treated medically as well as criminally, local leaders sought new ways to combat it. So the announcement of the three-year, $1 million grant from Aetna Foundation, the charitable wing of the pharmaceutical retailer CVS Health, was made with much fanfare. Representatives at the announcement included Aetna/CVS officials, members of the Northern Shenandoah Valley Substance Abuse Coalition — which created and oversees the program — as well as officials from the Virginia Department of Health and Human Services, the Virginia Department of Public Safety and Homeland Security, and state police.

Program changes

The idea for the program was when given the option of being charged with drug possession or joining the program, many overdose victims would choose the program. And the threat of the drug possession charges would incentivize clients to stay in the program,

But on July 1 of last year, the overdose immunity law took effect. It eliminated charging overdose victims with drug possession. The law was written to encourage people to call 911 about overdoses, but program supporters said it had an unintended consequence: there was longer an incentive for victims to seek treatment or stay in the program.

So the program has pivoted from being voluntary to mandatory for new clients. Shortly after the law changed, the program started accepting clients selected by the Virginia Department of Probation and Parole District 11, which is responsible for probationers in Winchester as well Clarke, Frederick, Shenandoah and Warren counties. Eleven of the 14 clients are probationers.

While the probationers in the program have had drug relapses, not all are overdose victims. And McCauley said they are not considered as high a risk of relapsing as defendants in the Northwestern Regional Adult Drug Treatment Court, another local alternative to incarceration program.

Termination from the intervention program is a probation revocation, which usually means jail time for clients. Five of the 16 terminations have come since the switch, including three this year. While relapses or other program violations can trigger terminations, the goal is to help clients find the stability necessary for maintaining sobriety.

“We come at it from a team approach working together with probation and it’s been really beneficial, but we’re all there to advocate for the clients,” McCauley said. “It’s not like, ‘You messed up. You’ve got to go back to jail.’”

As part of the change, Caitlin Dutrow, a probation and parole officer, was added to the intervention team. While they were initially apprehensive, Dutrow said clients she’s referred to the program tell her it’s helping.

“We’re really hoping this is a program that can help them to address their addiction long term and change their life for the long term once they get off probation,” Dutrow said. “We try to exhaust all options before they would be terminated.”

Besides McCauley, the program’s original team consisted of Detective Michael T. Upham, then a Winchester police officer and member of the Northwest Virginia Regional Drug and Gang Task Force, and Haley Brockway, a certified peer recovery specialist. Peers are people in long-term recovery trained to mentor drug users new to recovery. Upham, who now works for the Frederick County Sheriff’s Office, left in December of last year. Brockway departed in June.

The team now consists of Dutrow, McCauley, task force member and Winchester Detective Bryan T. Derryberry and Cady Shaffer, a peer recovery specialist. In October, Shaffer began visiting overdose victims with a member of the Northwestern Regional Drug and Gang Task Force to encourage them to get treatment.

McCauley said the program has evolved since its inception and is making a difference for clients.

“We’re helping clients build structure in their lives that maybe they didn’t have before,” she said. “Building a healthy, happy life, that’s everybody’s goal.”

The foundation awards between $7 million and $9 million grants annually to 45-60 organizations, according to Amy Aparicio Clark, foundation executive director. While the Aetna grant was designed to helped reduce the opioid epidemic, CVS has been accused of contributing to it.

Last month, a federal jury in Ohio found CVS, Walgreens and Walmart recklessly sold prescription pills. The companies are appealing the verdict. The lawsuit is one of thousands filed by local governments including in Clarke and Frederick counties and Winchester. The three recently announced settlements. Winchester and Frederick County will each receive about $2.5 million over 18 years. Clarke County will get about $500,000.

Clark said she couldn’t comment on the lawsuits but said Aetna frequently communicates with coalition and program members. She said the foundation is satisfied with the program’s progress despite the graduation/termination ratio. Clark said staff has been “incredibly resourceful” in keeping the program going during the coronavirus pandemic, which has made getting treatment harder and caused opioid deaths to skyrocket locally and nationally. Clark said staff couldn’t have predicted the law change or the pandemic.

“The key for us is that they’re in dialogue with the foundation so that we’re not blindsided by a number that is much lower than the target they set at the beginning,” she said. “Despite graduations being one of the metrics, there are still other metrics that we would consider significant and that is the quality of services folks in the program are receiving which is very high.”

The grant is scheduled to expire in the spring, but Clark said it’s common for grantees to get extensions when they are unable to meet goals due to unforeseen circumstances. She said it’s premature to say whether Aetna will renew the grant for another $1 million, but the foundation remains supportive of the program. Clark said it has an innovative approach and has reduced the stigma surrounding addiction and recovery.

— Contact Evan Goodenow at egoodenow@winchesterstar.com

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