Van Wagner: A Lawyer’s Personal Stare-Down with the Opiate Epidemic, Part 2

Ed. Note: This is part two of a guest post by Madison, Wisconsin, criminal defense lawyer Christopher Van Wagner. You can find part one here.

When we learned of the death of our 29-year-old daughter, Mollie, to an opiate overdose, time stood still. But one thing was clear to me, something I had actually said to Mollie at one time as she slowly killed herself by addictions, walking away from every treatment effort: we would tell the truth in her obituary and to anyone who asked. We would not shy way from the truth, and we would do so without shame or stigma.

We had talked openly about addictions for a decade, due largely to her struggles and those of our family. Addiction is indeed a family disease. But it is a disease despite the stigma which many still attach. So we published a candid, baring and honest obituary. We even included the story of how her rescue pit bull, Jocko, stayed with her for 36 hours after her instant death. The obit had the same effect as many viral ones about “nice” people dying from opiate overdose: tears and too many questions.

But those were not our real goal. SHG correctly noted here recently that this sort of story leads to viral clicks, immediate tears, and zero real change. (Mollie died a few weeks before that SHG post, btw.) So if we did get folks’ attention through the honest obit, well, then we wanted to try to do more to prevent the next sad story. You see, in the four years before her death, on not one but two occasions, a Madison PD program putting naloxone in the hands of every single MPD officer (who often arrive before EMT’s) had successfully resuscitated Mollie, sparing her from certain death.  Twice.

Our appreciation for that police-conceived and executed initiative left us with gratitude beyond words, both for the extra time we had with Mollie and the extra time she had to fight on. So we simply asked (in her obit) that in lieu of flowers, people donate to the local MPD naloxone program. In this way, maybe, just maybe, another heroin-addicted young person would also get more time. And unlike our Mollie, they might live long enough to turn their life around. Their family might be spared this incalculable, unending pain.

Mollie Clare Van Wagner, 1989-2018

The shocking contrast of her honest obit and her striking picture (a gorgeous, smart, talented young woman in her prime set against the reason for her death) hit all the same chords locally as those that have gone viral nationally. But it also pointed local folks’ attention to our town’s problem and to one way to help. What did they do? They opened up their pocketbooks and gave, and gave, and gave, for more naloxone.  In fact, as a result, to date, over $13,000 has poured into the MPD in her honor. Each dose of nasal naloxone costs MPD just $35, but it has a 4-month shelf life, so one cannot Costco it like paper goods. And it gave the MPD extra resources to save even more lives.

The MPD is now also able to do more than planned as a result of the humbling response to the story and the request for funding.  MPD had recently taken its naloxone-based first-responder effort (this, readers, is the POLICE department, mind you, not the public health folks) to a new level with its brand new Madison Area Recovery Initiative (“MARI”).  This program is new and evolving, and it is completely the brainchild of a very progressive police department and its truly compassionate chief, Mike Koval.

The MARI team now takes the person saved by naloxone to the ER, and they sit with her. When the addict is ready for discharge, she faces a possible felony opiate possession charge and a jailing (or at least a very prompt court date). She is then handed a MARI brochure explaining that she can avoid jail, courts and charges if she calls immediately for an assessment (totally free of charge), and if she goes to that assessment (that same week, it is hoped), and if she enters and completes an intensive 6-month long treatment program designed specifically for opiate addicts. All costs are covered, including getting her in to a doctor for such things as suboxone, methadone or – hopefully – Vivitrol (the new and very effective opiate receptor blocker that has actually shown real promise in this area). If she chooses not to do those things (again, all funded in full), then she will face felony charging, conviction and incarceration.

This is the first such police level program I’ve found, although my research is hardly exhaustive. But it hits and seeks to help the overdosing person at the moment she may be both most willing and most vulnerable: when she was all but dead and brought back to life.  So far, over 90% of those who have made the assessment appointment have also started the intensive, drug-testing based program. There is hope that some substantial number of addicts may make it through; some already have. The program may become a model of “best police practices” if it succeeds; MPD and Chief Koval deserve high praise for seeing this for what it is:  a disease, addiction, that needs help, not punishment and stigma.

And more good has also come out of this request. MPD is flush with the donations, which continue to come in due to a conscious effort by the “odd couple,” Chief Koval and the Defense Lawyer, to continue to discuss Mollie’s story and the MPD’s MARI program. (Here is a link to the Chief’s blog post on this effort, as well as an embedded link to the podcast on which he had me share Mollie’s story and the appeal for more help.)

Now, “Mollie’s money” has allowed MPD to expand the program to include an outreach team consisting of a treatment person and an officer. They visit the addict and her family in the next 24-48 hours, they bring info on more help, they make sure the addicted person makes the appointment and attends it, and – get this – they actually give the family two full nasal doses of naloxone (along with hands-on instructions on use). Someone may yet succeed by Mollie’s death.

As an aside, I have also learned much about another father, Gary Mendell, who in 2011 experienced the same loss of a child to opiate addiction and mental health struggles, and who as a highly successful entrepreneur set out to find national and local solutions. He founded and runs Shatterproof.org, and it is having much success one step at a time. I have given myself to help him, as well. I encourage anyone facing an opiate addiction in their work or life to visit that page. There is help there. And they will soon start a page devoted to best police practices, while looking at MPD’s MARI initiative as one good model.

So, through our decisions, as well as the work of Shatterproof, while many readers of brutally candid obits such as Mollie’s will turn the page or click the mouse in tears, some may be educated and motivated to help who never before knew they could or should.

Our grief will be a hole in our hearts forever; our lives are forever altered in saddening ways. But as a defense lawyer accustomed to responding daily in the midst of tragedy, chaos and a vortex of emotions with words of help and hope, I simply could not sit idly by and do nothing. Mollie is gone, our memories painful and raw. But someone is going to die tonight in Madison of an overdose, so why wait until tomorrow?

People have called this brave; it is not. It is what you and I do daily, really, even if it is a lot tougher to think clearly about strategy through personal sorrow. But we each do it every day, in some way. I am, after all, a defense lawyer and must step into the breach. I could have remained a pensioner for life (an AUSA has a nice gig) but I chose this life instead. Mollie did the same for many as she struggled herself, as we have learned time and time again from her grieving friends. And so we try.

11 thoughts on “Van Wagner: A Lawyer’s Personal Stare-Down with the Opiate Epidemic, Part 2

  1. Richard Kopf

    Mr. Van Wagner,

    Thank you for writing this two-part gut-punch post. I am terribly sorry for your loss but very glad you shared Mollie’s story with us.

    All the best.

    Richard Kopf
    Senior United States District Judge

    Reply
  2. OtherJay

    Thank you for bringing some hope to others facing the same tragic circumstances your family faced. Thank you for posting this.

    Reply
  3. Kathleen Casey

    The MARI program is practical intervention needed everywhere, just about. My sympathy for you and your family in your season of grief.

    Reply
  4. Terence Roberts

    The real deal for MARI is the choice given to the addict. When I quit smoking 40 years ago (after 35 years of cigarettes) it was because I was so disgusted with the habit that I was at a low point. I have always believed there is a low point for every habit user when permanent quitting is possible. MARI holds that same hope.
    My sympathy to you for your loss, my admiration for your efforts.
    Terence Roberts
    Law Prof (Ret.)

    Reply
    1. B. McLeod

      I have heard that called “bottoming out” or “hitting bottom.” I know some folks who have survived addiction, and knew some who did not. This has been with us in various iterations for a long time, and is a dreadful business. One thing that is clear is that Draconian punishments have not solved the problem.

      Reply
  5. Fubar

    Thank you, Mr. Van Wagner, for sharing both your grief and your insights here.

    Please accept my condolences for your loss of your beloved daughter Mollie Clare.

    I congratulate you for both your insight and your ongoing effort to support the MARI initiative. It is a step in the right direction.

    Politically cultivated ignorance and misinformation tantamount to superstition about drugs, and about opiate drugs in particular, has driven American and world-wide drug policy since the 19th century. The consequence of that comfortable ignorance is measured in lives lost and lives ruined by prohibition laws.

    I thought I had seen the ugliest prohibitionist “reasoning” when I worked with illegal needle exchanges to prevent propagation of HIV a couple decades ago. I was wrong.

    Chemically, opiate overdose is a simple problem, to which administration of naloxone is a simple and effective solution.

    Politically, prohibitionist superstition still reigns to make opiate overdose a complicated problem without simple solution. The FDA currently prohibits naloxone without prescription, although many states have rejected that requirement, with varying requirements of their own.

    More than half the states permit police to carry naloxone. All should.

    May MARI flourish, propagate, and engender even more widespread availability of naloxone and other life-saving opiate antagonists.

    Reply
  6. Nigel Declan

    Thank you for sharing your daughter’s story and my deepest sympathies for your loss. That you are working to spare other children and other parents the same fate is courageous and noble beyond words.

    Reply
  7. B. McLeod

    We can try what we can try. If it were Tuesday Talk rules, I would post the Joan Baez version of “Lonesome Valley.”

    * * *

    “There is a road, that leads to glory,
    Through a valley, far away,
    Nobody else can walk it for you,
    No, they can only point the way.”

    * * *

    Reply
  8. Anonymous

    As someone who struggled with my own opiate addiction a decade or more ago I wanted to share my sympathy (I’ve lost friends this way too) but also a few comments that seemed relevant.

    First, I’d like to add my praise to the practice of passing out the nalaxone widely and it needs to go to users as well as police. The policy of doing this (they charged for it but no script needed) not only saved my life but a number of friends as well.

    Second, my understanding is that buprenorphine has a better track record than approaches like Vivitriol. Opiate agonists like buprenorphine or fentanyl derivitives that bind strongly enough can cut through the blockade and even worse it leaves the user (after it wears off) with absolutely no tolerance (some addicts voluntarily use it to reset) making usage much more tempting not to mention depressive side effects. The buprenorphine ceiling effect and partial agonist property prevents maintained users from getting any opiate high and turns the addiction into a pressure to stay on the treatment giving them time to fix the psych issues that lead them to addiction. Having said this in a setting where one can compel patients to take the drug every month for 6 months but can’t fund long term psychiatric care the considerations may go the other way.

    Reply

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