SANTA FE, N.M. — Lupe Salazar’s son went to jail for his first DWI 14 years ago.
He did time for a mistake, Salazar admits, but she said he came out of jail with track marks on his arm, clear evidence of heroin abuse. On Thursday, he was transported from the Rio Arriba County jail in Tierra Amarilla to the Central New Mexico prison in Los Lunas for violating parole, continuing the spiral he fell into just over a dozen years ago.
Salazar made the trip to Tierra Amarilla from her Española home Thursday, but her 32-year-old son was gone and on his way to state prison by the time she got there. She said his drug habit started when he went to jail when he was 18 and now she is left to care for his 2-year-old daughter.
“It started a snowball effect and grew out of control,” Salazar said. “My son gets out of jail, and sometimes he lasts a week or maybe a month, but he always goes back.
“I do the time, too, it’s just behind a different wall. It just saddens me that I couldn’t get him the help he needed and deserved.”
Lauren Reichelt, director of the Rio Arriba County Health and Human Services Department, is starting a program aimed at helping people like Salazar’s son avoid the tragic revolving door of going in and out of jail. A pilot version of the Opiate Use Reduction network will begin operations August, with 10 test subjects who will be chosen by judges at Española Magistrate Court and state District Court.
Reichelt said the program will provide addicts with assistance, from inpatient detox in the county jail to transitional housing to outpatient treatment, requiring a network of health care providers and others to work together.
“The worst public policy we ever made regarding drugs was to criminalize them,” Reichelt argues. “It funnels a lot of resources incorrectly into our corrections system. It makes it much harder for treatment providers when someone is a convicted felon. They lose access to things that can help them, and it makes it way harder to live a normal life.”
The program is also a means to curb drug deaths in the county. Rio Arriba has the highest rate of heroin overdose deaths in the country, according to the most recent data from the Center for Disease Control and Prevention. There were 78.4 overdose deaths for every 100,000 residents in the county between 2010 and 2014, compared with 24.3 statewide and 13.8 in the U.S. per 100,000 residents in that same span, according to Health Department data.
Reichelt said she wants to get eligible people enrolled in Medicaid once they’re booked into the county jail, with treatment continuing after release. Inmates who are at a high risk of using again will be given naloxone, an injection or nasal spray that reverses opioid overdoses, while others may qualify for more extensive treatment.
She said judges will use a risk assessment tool, which has yet to be decided on, to determine who can best utilize the services. The assessment works by asking the user a series of questions and outputs a score, similar to a personality test.
“What we’re really looking for is who is most likely to benefit from treatment,” Reichelt said. “They’ll pick people who they think will be successful and will use the services.”
Giving an inmate naxolone, typically known by the brand name Narcan, upon release can have a profound impact, she said. Rio Arriba County Sheriff James Lujan said people’s drug tolerance goes down when they’re in jail, and they get out and use the same dosages they were used to taking before getting locked up, sometimes with fatal consequences.
“They come out and think they can start back up where they left off, and they shoot up and end up dying,” Lujan said. “We’re trying to keep from sending them home without something to fall back on.”
Reichelt will also train the sheriff’s office on how to administer naloxone next week and all deputies will be equipped with the antidote. Lujan said deputies are the first to arrive at an overdose call and often have to clear the scene before medics can get to work, putting them in a position to take life-saving measures when seconds matter. He said his department responded to three overdose calls this week and two of those people didn’t make it.
“The best bet is to get Narcan to them (overdose patients) sooner, before the medics get there,” Lujan said. “The main function of our job is to protect and serve. It’s our responsibility to save them if we can.”
Thanks to new state legislation passed in March, naloxone is now in the hands of a lot more people. House Bill 277 and Senate Bill 262 essentially allow for anyone to carry an opioid “antagonist” to reverse overdoses. The new statutes also greatly expanded who can distribute naxolone. Before, only someone licensed by federal, state or local government was permitted to provide the drugs.
Tiffany Wynn, the executive director of the Santa Fe Mountain Center, which provides harm reduction services for Santa Fe and Rio Arriba counties, said the center went from distributing Narcan two days a week to five days a week, without the previous requirement that a nurse handle the drug.
She said the organization, which uses outdoor adventures to provide therapeutic services, probably went from reversing 12 overdoses a week to 12 overdoses a day and that anyone who knows or is around an opiate addict should carry naxolone with them.
“This legislation has been a godsend,” said Dave Koppa, the Mountain Center’s harm reduction center program manager. “That is helping people by getting naloxone to the community. The intent is to get it in the hands of everybody and expand the access.”
Sheriff Lujan believes a lot of the people his deputies arrest for drug crimes want out of the addiction cycle, suggesting the Opiate Use Reduction network can be a success if people use it. “If we show them that we can get them the help, then I think they can follow through with it,” he said.
“It’s a multi-faceted issue,” Koppa said. “Fixing it is going to take a village. What Lauren (Reichelt) is trying to do is coordinate care and make sure that care happens. I think we helped make a dent in it, but there’s a lot more work to be done.”
Lupe Salazar believes change will occur when people change a drug culture that now seems normal in Española and other parts of Rio Arriba.
She recently founded Barrios Unidos in Chimayó, a nonprofit organization that will provide peer counseling and other services to drug addicts, and she says the first open house will be in October. She regrets not being able to help her own son, but she now dedicates a lot of time helping other mothers to not know the disease of addiction.
“It’s not uncommon for addiction to be generational,” Salazar said. “We’ve had addiction in the Valley for many years and shame on us if we don’t try to work together as a community to fix it. I really feel that we can nip this epidemic, and it’s not going to be an overnight process, but I think the first step is admitting we have a problem.”