There has been a lot of coverage in the media recently, at the local, state, and national levels,  about the scourge of opiate addiction-whether the addiction is to a street drug like heroin or to highly addictive, opioid based prescription pain medications.

This scourge is taking a devastating toll on individuals, families, and entire communities. Sadly, Gloucester has not been spared that harsh reality.

What is interesting about Gloucester is the problem is not a new one in “Fishtown”. In fact, the problem in Gloucester dates back almost fifty years to the late 1960’s, when Gloucester’s working class young men who could not avoid the draft began coming home from Vietnam – more than a few of them addicted to heroin.

I recall sitting in my office at NUVA at 100 Main Street in the mid 1990’s with a recovering heroin addict who was enrolling in a program to assist him with obtaining his medications for his HIV-Disease.

It was he who educated me about the role his generation’s service in Vietnam played in the entrenchment of the heroin problem on the “island”.

The son of a hard working, Italian fishing family, this man did not have the means to go to college. He had planned to make his living from the sea, as his father and grandfather had done before him, but the draft and Vietnam intervened in devastating and life changing ways.

Talking with this man, who died not too long thereafter as a result of complications from AIDS, opened my eyes as a social services professional as to just how interwoven seemingly unrelated events and issues really are.

In his own journey of recovery, he had begun to make the connections between his life growing up in Gloucester, where life as the son of a fisherman was good but often hard. Harvesting the sea was, he made clear to me, a tough way to make a living and, as a result, many who do so work hard and play hard.

He came to see the inter-generational pattern of substance abuse within his own family, where the men of the older generations often drank hard after a tough stint fishing at sea. His family, he assured me, was not at all atypical.

When he was drafted and sent to Vietnam, substance use/abuse was a common phenomenon and the availability of cheap heroin became just another way to cope with the high stress of war – much the same way throwing back a few too many beers or shots at Mitch’s or the old Depot was a way for the older generations to deal with the stresses of working the sea.

That opiate based “coping” mechanism, as dangerous and deceitful as it was, followed more than a few of those young soldiers home to Gloucester.

In the 1980’s, a young Gloucester Times reporter named Sean Murphy, working with long time Gloucester educator and community activist Phil Salzman, pulled the curtain back and exposed the extent of the heroin problem in “Fishtown”.

The breaking of that story resulted in the CBS news magazine “Sixty Minutes” coming over the bridge to do a feature on the heroin scourge in “America’s Oldest Sea Port”.

The demographics of the problem were both astounding and frightening.

Gloucester, at that time, had, per capita, more heroin addicts within its city limits than the Big Apple.

The community did not respond positively to either the story or the reality and scope of the problem . In fact, many people were angry at Murphy and Salzman for what, in their eyes, was nothing but an attempt to damage Gloucester’s reputation by bringing the problem to light.

At the same time Gloucester’s heroin problem was making both local and national news, another scourge was emerging in America. I am, of course, referring to the AIDS epidemic.

Initially and erroneously written off as a “gay plague”, it was becoming clear by the time the story about Gloucester’s heroin problem broke that AIDS was caused by a blood borne pathogen impacting a growing number of people far beyond the gay community – including injection drug users.

By the late 1980’s, several gay men in Gloucester who were living with AIDS began working with their friends and the growing number of holistic health practicioners making Cape Ann their home to form what became known as the North Shore AIDS Health Project.

At the same time, Ron Morin, who was the executive director of NUVA,  then the city’s leading out patient substance abuse treatment provider, recognized that HIV/AIDS was likely to become an issue in Gloucester among the city’s local injection drug using population and their sexual partners.

NUVA worked with the Massachusetts Department of Public Health to obtain funding for an HIV counseling and testing program, case management services, and a prevention, education, and outreach program.

Shortly thereafter, the VNA of the North Shore received funding for a home care program for people living with HIV, and a variety of other social service agencies on Cape Ann, including  Child Development Programs, Addison Gilbert Hospital, Action, Inc., representatives from the school department, to name just a few, joined with NUVA and the Health Project to form the Cape Ann AIDS Task Force. The task force provided a forum for providers to better coordinate and plan  responses to the myriad needs emerging from a public health crisis that linked the diseases of addiction and HIV in a truly unsettling way.

Within a few short years, that kind of cooperation and collaboration had Gloucester being held up as an example by the state for other communities in Massachusetts to emulate.

That kind of collaboration and cooperation also played no small part in preventing the dual epidemics of HIV and addiction from having a much bigger impact  on Gloucester than they have.

Today, the dual scourges of HIV and opiate addiction are still very much with us, both in Gloucester and across the country.

As a result, there are those who argue funding for programs like those in Gloucester was and is a waste of tax payers’ money.

To those people I pose this question, “Can you imagine what Gloucester might look like today if those programs and the services they provided had not been funded and never existed, as the dual crises of AIDS and addiction came together in a truly unholy alliance on the ‘island'”.

It is a relevant question for several reasons, not the least of which is the fact Gov. Charlie Baker has proposed cutting funding for programs that serve people struggling with both HIV and addiction while at the same time claiming the opioid addiction epidemic is one of his top priorities.

But beyond that, there is growing evidence  the escalating opioid addiction crisis has reignited the spread of HIV among people trapped in the addiction cycle to a degree not seen in more than a decade.

Nowhere is that more evident than in a rural Indiana county reeling from opioid addiction. Since December, public health officials have diagnosed over 80 people in the county as HIV positive. All of them are either opioid addicts who also share needles or the sex partners of people who do.

That explosion of new HIV diagnoses in so short a time has local, state, and federal public health authorities scrambling to intervene on numerous fronts.

The federal Centers for Disease Control are concerned the strains of virus being spread are likely to be ones that have been exposed to anti-retroviral medications for years, increasing the likelihood those strains within a new host will be resistant to the medications that slowed the progression of the disease in the original host.

Translation, the opioid epidemic could well be  fueling a new epidemic of HIV infections already resistant to medications that have been such godsends to so many for so long.

I share all this because people should know about Gloucester’s leadership role through the years  in the fight against two of the most serious public health crises the US has ever faced and continues to face today.

That leadership role is something to be heralded and respected, not belittled by those who think trying to address these types of issues is a waste of time and money or somehow an affront to Gloucester’s reputation and the reputations of its residents.

Nothing, absolutely nothing, could be further from the truth.

 

Mike Cook, Gloucester and Provincetown

 

 

 

Mike Cook  is a long time liberal and gay rights activist who saw the uniqueness of Gloucester from the first moment he drove over the bridge during his move from Cambridge to Cape Ann in 1991 to run NUVA’s AIDS education and services programs.