Discarded needles on sidewalks. Heroin sales in parking lots. Obituaries for young people who died suddenly.

On the Vineyard the opioid crisis that is sweeping the country has crept in like some stealth invader, dark and insidious and living in the shadows.

If the Island is to meet this growing threat, it must be brought squarely into the open.

The Vineyard has always prided itself on being a place several steps removed from the social ills of the mainland. People don’t lock their doors. Children can safely walk or ride their bikes home from school, or take the bus into town or to the library by themselves. The landscape is beautiful; the environment is unpolluted. Neighbors look out for each other. Small-town friendliness prevails. We’re lucky to live in such a place.

But the true story of Martha’s Vineyard has its own long chapter on mental illness and addiction. Dr. Milton Mazer, the Island’s first psychiatrist, documented the problem four decades ago in his book People and Predicaments, compiled from his own series of case studies on the Island in the 1960s and 1970s. In that era, the prevailing substance abuse problem on the Island involved alcohol.

These days, the drugs of choice — heroin and other opioids — are far more pernicious. The road to addiction often begins innocently, with drugs prescribed for pain associated with injury. Addicted to painkillers, users drift to heroin as a cheap, readily available substitute. Once hooked on heroin, addicts find themselves in the grip of a habit extremely hard to break.

In the last few months alone, the deaths of several Islanders have been linked to heroin. In the weekly docket for the Edgartown district court, a police report offered a vivid glimpse into a heroin deal that was interrupted before it went down. The incident involved young adults whose names are known in the community and took place in a grocery store parking lot in the busy State Road commercial district in Vineyard Haven. It was not an isolated incident.

Around the Island dealers are selling and opioid addicts are using, many of them still in or just past their teenage years. Heroin overdoses are rapidly becoming commonplace. Sometimes the overdoses are fatal and sometimes not thanks to Narcan, the overdose reversal drug now carried by every emergency responder.

A recent gripping HBO documentary followed eight young heroin addicts Cape Cod, just a short distance across the Sound. Watching the film, the people sounded and felt familiar, as if they lived down the street. That’s because they do.

Today alcoholism — once denied and hidden as a shameful subject — has lost much of its stigma, with treatment now widely available through 12-step programs and other community support systems.

By contrast, heroin addiction still carries an enormous stigma, even as the underlying causes are the same, the medical community bears some responsibility for fueling it and the difficulty of kicking it is well documented. People are ashamed to admit that they have a child, friend or loved one who is using heroin or who may have died from an overdose.

Far from being immune to the national opioid crisis, Martha’s Vineyard may be more susceptible than many communities for the same reasons Dr. Mazer identified alcoholism as a major threat forty years ago, including isolation and economic seasonality.

Members of the Vineyard’s mental health and law enforcement communities have already taken important steps to address the problem, but it's time for the larger community to bring heroin use on the Vineyard out of the shadows and into the open. As those in the recovery community know, the first step to solving a problem is admitting you have one.

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