This is the third story in a series sharing different perspectives about how the current opiate crisis affects our town and ways people with ties to Hingham are reaching out to others to provide support and help to those who are fighting substance use disorder.
July 21, 2019 by Carol Britton Meyer
While working as a labor and delivery nurse at Boston Medical Center when she first began her career, Hutch Warden — who grew up and lives in Hingham — had pregnant women who were suffering from substance use disorder under her care.
Witnessing their struggles motivated her to want to do more than help them deliver healthy children, as important a role as that is.
“As their delivery nurse I only saw them for a short time, and I wanted to do more,” she said. “I became motivated toward helping them start their [road to] recovery.”
Warden’s desire became a reality when she was able to move to an outpatient setting at Boston Medical Center as a case manager, working with pregnant women struggling with addiction through the Project RESPECT (Recovery, Empowerment, Social Services, Prenatal care, Education, Community and Treatment) program. Project RESPECT provides a unique service of comprehensive obstetric and substance use disorder treatment for pregnant women and their newborns in Massachusetts.
Realizing she needed more education in this area in order to be as effective as possible, Warden went back to school to earn her nurse practitioner license and went on to attend the Massachusetts General Hospital Institute for Health Professionals. “I was fortunate that I was allowed to tailor my curriculum to addiction issues, learning about different levels of care,” Warden said.
Following graduation, Warden returned to Project Respect as an addiction nurse practitioner. She was with BMC for about 12 years in all.
Last April Warden accepted a position at a community health center in Fall River for the purpose of starting a Suboxone clinic. Suboxone is the brand name for a prescription medication used in treating individuals addicted to opioids — illegal or prescription — that blocks the opiate receptors and reduces the urge to use drugs.
“Suboxone is not a dangerous drug if it’s working and it’s being prescribed and used correctly until the individual is ready to take the next step in his or her recovery. There’s no euphoria,” she said. “It’s used to counter out-of-control addiction. A lot of people are doing well with medication-assisted treatment, but there’s sometimes a stigma attached so they don’t talk about it.”
There are also other medication-assisted treatments available such as methadone and Vivatrol.
The Fall River center, HealthFirst, provides addiction care that is integrated into an overall health system, “something not being offered in our community.” Warden is the program director for the Opioid Addiction Recovery program there.
“There are people in Hingham who are actively using and others who are in remission. We need to do a better job at offering treatment — not shaming people but rather, talking about [substance use disorder]. Sometimes [people struggling with addiction and their family members and friends] sweep it under the carpet, sometimes until they die.”
Warden has treated people from all walks of life, including nurses and lawyers. “They don’t talk about it because they’re afraid of being ostracized,” she said. “Part of my mission is to educate people to the fact that addiction is a disease — a malfunctioning of the brain. Using drugs is often an impairment in a person’s ability to make rational choices and to follow through with them.
“We know that the initial bad choice [to use drugs] sparks something in the person’s brain that chemically changes its structure,” Warden said. “When they first try drugs some people say, ‘This is terrible’ and don’t use again while others think, ‘This feeling is something I’ve been looking for my entire life,’ which can lead down that rabbit hole.”
Because of all these factors, Warden said it’s important to talk to kids in school and to have conversations at home about the dangers of using drugs,”which isn’t an easy subject to talk about, she said. “I’m petrified that this could happen to one of my four children. It has happened in our family.”
There should be no stigma or shame attached to substance use disorder, which is a more commonly used term for addiction these days, than if someone had some other type of disease. “If someone died of complications from diabetes we would talk about it,” she said. “That’s what we need to change,” because people sometimes don’t feel comfortable talking about someone dying of an overdose because of the stigma often attached to overdose deaths.
When someone poses the question, “How do you work with this population?” Warden responds, “I treat my patients the same way I would want my family members to be treated,” she said. “I have never felt more appreciated than I do working with people struggling with addiction. It’s important to treat people with human decency and kindness. After all, this is someone’s child [regardless of his or her age] I’m working with. I love doing what I do. This is my life career.”
For those who don’t yet understand the effects of the current opioid crisis on Hingham and the surrounding area, Warden pointed out, “When you’re walking or driving down Massachusetts Avenue [the part referred to as ‘Methadone Mile’], some of the people we see are from our own communities — Hingham, Hull, Quincy, and other places —who are active in their addiction in the communities in which they live and also there [Mass. Ave]. This isn’t a Boston-only problem. It’s in our communities.”
Warden noted some startling statistics — in the United States an average of 130 people die from overdoses every day while on average, as many Americans die in one year of an opioid overdose as died in the 10-year Vietnam War.
There’s no perfect way to recover. “Suboxone is not the magic pill we all would like it to be,” Warden said, “nor is Alcoholics Anonymous. It’s a combination of treatments” that can lead to recovery. “Just as with cancer, you don’t sit and watch and wait, you explore all [recovery] options.”
Warden reiterated, “We know this is a lifelong disease that doesn’t go away. Sobriety is never owned — it’s rented, and rent is due every day.”
Recovery is “a series of slow changes. It takes a long time to heal the brain,” Warden said. “In the meantime a smell or sound can trigger the desire for drugs. If I can make a difference in helping them overcome those triggers, then I am doing my job. This is a really exciting opportunity to continue doing what I love.”