One Square Mile: Opioids In New Bedford's Fishing Industry

Feb 8, 2018

(This the second part of a two-part story. Read part one here.) 

Andrew Dillon has had a front row seat to the opioid epidemic in New Bedford. His diner is a favorite for local fishermen.

Sometimes he sees customers come in so high they can barely stay awake. 

“You know you’ll have people coming in and, unfortunately, they’ll be nodding out while they’re eating,’’ he said. “So you have to have one of the waitresses go over and kind of tap them a little bit. You don’t want to make a scene, you know what I mean? You don’t want to see other customers to see what’s going on.”

Dillon is more apt to offer a customer advice show than show him the door.

“It’s not only fishermen,’’ he said. “There was one guy, he was a mechanic, auto body guy and he’s just a mess. He’ll stay clean for a while and then you see him the next time he’s in there and it’s like, oh man. It’s sad, that’s for sure.”

Just over a mile from a mile from Dillon’s diner and New Bedford’s waterfront, there’s a treatment center for opioid addiction. Cars pack a rutted parking lot outside a squat a-frame that houses the center, called Clean Slate. 

Inside, patients wait in metal chairs for their names to be called. Dr. Arnold Hill, a psychiatrist and former U.S. Army Colonel, is the clinic’s medical director.

“Having grown up in the largest scallop port in Canada, as a child, there was always problems among the fishermen with addiction,’’ he said. “In those days it was alcohol...So New Bedford, it turns out, is a modern version of this and now has significant opiate problem in its scallop fishermen.”

The clinic treats nearly 800 patients a week. Most are on buprenorphine, better known by its brand name, Suboxone, a medication that blunts opioid cravings. But almost none of them are fishermen.

Hill says he thinks he knows why.  

“Suboxone or methadone treatment is not structured for this type of employment,’’ he said, “where you’re essentially at sea for two weeks and then in port for two weeks.”

That’s because at this clinic new patients are required to come in every week.  

So Hill designed a treatment program for scallop and ground fishermen. 

The program allows fishermen to check in before and after they leave port. Clinic staff can monitor the boats returning to port to make sure their patients visit the clinic within three days of docking.

Hill calls his program The Poseidon Project. It’s modeled on a program developed in the U.S. during the 1970s to treat alcohol abuse among commercial airline pilots. That program, he said, has had great success.

“The success of the program for pilots, apart from monitoring with breath and urine tests, has been counseling and AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) meetings on a very, very regular basis,’’ Hill said. “The recovery rate for pilots is 75 percent, versus the average population somewhere around 30 (percent).”

In other words, the pilots in the program recover at twice the rate of the general population – and three out of four don’t relapse.

It remains to be seen whether the treatment will be as effective for fisherman as it has been for pilots. Hill is trying to figure out how to get the word out so fishermen will enroll. 

Drew, the fisherman who became addicted to Oxycontin after a back injury, says he got help for his addiction from a doctor back home in Maine.

“I just told my doctor, I said: when I get them I’m like abusing them,’’ he said. “And like I feel, if I don’t have them I can’t even get out of bed and I feel sick.” 

His doctor prescribed methadone and, later, Suboxone, to treat his addiction and the pain from his old injuries.  

“I just take it once a day,’’ he said. “I take eight milligrams a day. It’s a film now, I just go in and put it under my tongue. I usually do in the morning.”

And he’s able to work with a ground fishing crew out of New Bedford. He said he told his captain he’s in recovery -- but he mostly keeps it to himself. 

“I never talked about it to anybody or anything,’’ he said. “I just don’t know how they’re going to react to it, you know? That I’m on the Suboxone.”

People in the treatment field say the reluctance to talk about addiction -- especially in the fishing industry -- is part of the challenge. And the first step to erasing the stigma of addiction, they say, is breaking the silence.