QUINCY — The day after her son overdosed on a near-fatal mix of heroin and fentanyl, there was a knock on the door. Two plainclothes police officers and two health workers had arrived unannounced, in the dark of the evening, and the distraught woman could only imagine what they wanted.
They wanted to help.
“It was a miracle,” recalled the mother of five, who asked not to be identified. “I was trying to save my son’s life, and I was desperate.”
Fifteen months later, her son Shawn, 27, remains drug-free, the longest such stretch in a torturous decade of opioid abuse. She credits that cold call, a cornerstone of Quincy’s nationally recognized campaign to reduce overdose deaths, with rescuing her child.
For the last three years, a team of Quincy police and health workers has visited overdose survivors and their families, mostly within one or two days after an overdose. They offer options for counseling and treatment, and they bring naloxone, the overdose-reversing drug commonly known as Narcan.
They also bring a clear message that the wrenching, complicated journey from the horrors of substance abuse does not have to be borne alone. That message is almost always welcomed, and often with tears.
“Part of the reason they get emotional is because they know we care,” said police Lieutenant Rob Bina. “You feel like you made a difference, that you made a connection. And they feel like they have a lifeline.”
The direct outreach is part of a multipronged approach in Quincy, emulated by many other communities, that appears to be making strides in the opioid fight.
Overdoses in Quincy plummeted 35.5 percent overall from 2017 to 2018, and drug-related deaths fell 24 percent, according to police. That decline followed a steady, alarming climb during the four previous years, when overdoses in this city of 100,000 people more than tripled, from 105 to 361.
“It’s amazing,” said Lieutenant Detective Patrick Glynn, who heads the Police Department’s narcotics unit.
Opioid abuse continues to ravage hundreds of families here, and workers on the front lines predict the fight will last for generations. But after years of mounting deaths, something positive appears to be happening — not only in Quincy, but in many hard-hit communities across Massachusetts.
Overdose deaths in Norfolk County, which includes Quincy, dropped 20 percent, to 170, in 2017 — the largest decline of any Massachusetts county that recorded more than 40 overdose fatalities that year, according to the state Department of Public Health.
Middlesex County, with a state-high 357 overdose deaths in 2017, dropped 11 percent from the previous year, while drug fatalities in Barnstable County dropped 17 percent, according to state figures.
Statewide, confirmed and suspected overdose deaths fell 6 percent between 2016 and 2018.
“Our numbers have been dropping precipitously over the last three years,” Norfolk District Attorney Michael Morrissey said. “I’m cautiously optimistic we’re going in the right direction.”
Morrissey noted that, in 2018, fatal overdoses fell an additional 17.6 percent in cases investigated by State Police attached to his office. That figure does not include residents who died in hospitals after overdoses — data that will be part of a statewide report on overdoses, expected in May, that is broken down by county.
Given that authorities and health workers have deployed so many different strategies, it is unknown why, exactly, the number of fatal overdoses has begun to drop.
Perhaps, people simply are using smarter strategies to reduce the risk of overdose, taking precautions such as keeping naloxone available and not using drugs when alone.
Those on the front lines also are hopeful that public education about opioids, including warnings about the spread of the lethal painkiller fentanyl, is finally making inroads.
And some point to visits in Quincy and elsewhere by police and clinic workers at the homes of overdose survivors.
“We know we’ll never get to the finish line,” Glynn said. “But as we go down the field, we’re helping a lot of families and saving people.”
The falling death toll provides a guarded measure of optimism after a yearslong effort that put Quincy at the forefront of the opioid fight. In 2010, the city became the first community in the country to train and supply its police officers with naloxone, a move that would be replicated across the state.
Today, Glynn estimates that 75 percent of all police departments in Massachusetts, as well as departments in 45 states, now carry Narcan, the brand name for naloxone.
“They’ve changed the way people look at police,” Morrissey said of Quincy’s efforts. “The city also has a long history of having some great people who cared about mental health and substance abuse issues.”
Police in Norwood, another community in Norfolk County, took early notice of Quincy’s use of Narcan and followed suit.
“What Quincy did was cutting edge, and Norwood saw the benefit of it,” said Peter Kelly Jr., the deputy police chief in Norwood, whose officers also reach out to survivors and their families to connect them with treatment.
In Quincy alone, nearly 1,000 overdoses have been reversed with Narcan since its introduction there. The city’s police also teach the public how to administer the drug.
“We’re not trading our handcuffs for Narcan,” Glynn said. “But we look at a humanistic approach. We put a face to a name. It’s a family member — a brother, sister, parent, even a grandparent.”
That’s the mind-set that led police and staffers from the Manet Community Health Center to Shawn’s mother. Years ago, Glynn said, police were conflicted about carrying Narcan, which sometimes is administered by police multiple times, only hours apart, to the same person.
That hesitation has faded, Glynn said, particularly after police began losing some of their own children to overdoses.
“Now, most police look at it as a medical problem, a terminal illness almost,” said Bina, the Quincy police lieutenant. “Relapse is a part of recovery. If you look at it that way, you don’t get frustrated.”
That approach helps Quincy officers such as Matt Miller, who has teamed with Manet health workers to visit the homes of hundreds of overdose victims. At the height of the opioid crisis, Miller was making a dozen and more visits a week.
The team, which travels in unmarked cars and out of uniform, presents options for treatment instead of ultimatums, Glynn said.
“We talk with them about being safe,” said Kim Kroeger, Manet program director. “It’s planting the seed. We don’t have a lot of people right then and there who want to go to treatment.”
Shawn and his mother said that the team followed up its first visit by checking in every week by phone and that Manet arranged for monthly medication, which has eliminated his hunger for heroin.
“I needed their help. I couldn’t have done this all on my own,” Shawn’s mother said. “It made all the difference in the world.”
Michael Botticelli, the former director of the state Bureau of Substance Abuse Services at the DPH, worked with Glynn and other Quincy officials before being appointed the White House drug czar under President Barack Obama.
“Basically, this is an all-hands-on-deck issue. Everybody at the community level has a role to play — parents, community players, employers,” said Botticelli, who is now executive director of the Grayken Center for Addiction at Boston Medical Center.
Quincy’s declining overdose numbers “show that these kinds of strategies are having an effect. It also shows we still have a long way to go,” he added.
The city’s police realize the road ahead is difficult. Overdoses are down, but arrests involving cocaine and methamphetamines are rising.
Glynn likened the city’s ever-evolving strategy to an accordion, constantly changing shape to find the right notes. “It keeps on stretching out. It’s not stationary,” he said.
In a small home a mile from police headquarters, Shawn and his mother said they are grateful that, after years of searching, help finally arrived on their doorstep one winter night.
“It made me strong,” Shawn’s mother said, turning toward her son on the living room couch.
“I love him with all my heart, and I knew he was good,” she said quietly. “I now have my life back, and I see that my son has his life back, too.”
Brian MacQuarrie can be reached at firstname.lastname@example.org.