On the heels of the recent report by the Rural Scholars about addiction on Martha’s Vineyard, the Chilmark selectmen held a wide-ranging discussion last week about what can be done to stem the problem.

The two-week Rural Scholars study by graduate students at the University of Massachusetts painted a limited picture of substance abuse issues on the Island. The study found a somewhat tangled network of Island services for people dealing with addiction, and recommended improvements in treatment, prevention and collection of data. A dedicated addiction specialist to manage long-term recovery and better coordination among services, possibly through the Martha’s Vineyard Drug Task Force, are among the recommendations.

Appearing before the selectmen at their regular meeting, town health agent Marina Lent, police chief Brian Cioffi and Tri-town deputy chief Matthew Montanile spoke in passionate terms about the opioid crisis and efforts to guide addicts toward recovery despite limited resources on the Island.

Ms. Lent has led a recent effort to collect Islandwide data related to substance abuse, and will chair a substance abuse disorder subcommittee being set up by the Dukes County Health Council.

“We found that one of the most important things about the work that we’ve been doing in the last year here has been the nexus between law enforcement, corrections, the hospital and therapists,” Ms. Lent told the selectmen. “People who come for treatment are the tip of the iceberg,” she added, stressing the role of law enforcement in helping to gauge the problem and intervene when necessary. “The only crack we get at the iceberg below is when they get in trouble.”

Chief Cioffi noted the recent attention surrounding the Gloucester police department, which has launched a program offering treatment as an alternative to arrest for addicts who surrender their drugs and paraphernalia and seek help at the station. “That program has been going on with addicts of narcotics and stuff on Martha’s Vineyard for as long as I’ve been working,” he said.

Anyone arrested for drugs or alcohol in Chilmark gets a brief assessment, Chief Cioffi said, and the department offers to connect that person with services such as a recovery coach or an off-Island detox center. He underlined the fact that Martha’s Vineyard has no such facility. “That’s something that needs to be fixed,” he said. “And we have addressed this time and time again.”

The Martha’s Vineyard Hospital had planned to open a building known as the Red House as a short-term stabilization unit for addicts in withdrawal, but the project stalled during a change in management at the hospital. Selectmen agreed to write a letter to hospital president and chief executive officer Joe Woodin inquiring about where things stand. Mr. Woodin took the helm at the hospital six months ago.

Health and safety leaders said police and Tri-Town Ambulance usually respond together in cases involving acute intoxication, although emergency medical services play a limited role. Deputy Tri-Town chief Montanile said his work typically ends at the emergency room as a matter of protocol, noting that federal HIPPA laws protecting patient privacy prevent the ambulance service from sharing information. “It’s hard for us to get any follow through as to what happens to that person afterwards,” Mr. Montanile said. He said the hospital’s one room for psychiatric and substance abuse patients is always full. “There is somebody always in there, sometimes for three or four days before they can get off the Island,” he said.

Mr. Montanile said he hasn’t seen any opioid-use cases since the end of winter, but he didn’t expect the lull to last much longer. “[Last year] there was a bad streak from January to April, where I probably had 10 different calls involving some kind of opiates,” he said. “But since the summer’s come around, people are busy, people are working. There is not as much down time. I think once the winter starts again you’re going to see it escalate.”