Opioid forum sheds light on epidemic
On November 4, members of the Cranston Interfaith Clergy Association gathered with several local parishioners as Michelle McKenzie, Diego Arene-Morley and Lisa Castore presented an information session about opioid addiction, overdose and recovery in Rhode Island.
The faith-based leaders were there to help start a conversation about supporting those in crisis and the role that faith-based organizations can play in that support, with education about the addiction and overdose epidemic being the first step. The speakers represented Rhode Island Communities for Addiction Recovery Efforts (RICARES) and Faith Infused Recovery Efforts (FIRE), which is RICARE’s Interfaith recovery network and Preventing Overdose Naloxone Intervention (PONI).
Reverend Andrea Castner-Wyatt welcomed guests to the event, which was held at St. David’s on-the-Hill Episcopal Church.
McKenzie, a board member for RICARES and a researcher at Brown University and Miriam Hospital gave a comprehensive overview of opioid addiction and overdose and spoke to the critical role that faith communities can play in prevention, recovery and helping those who are struggling.
“Rhode Island has experienced among the nation’s highest rates of opioid overdoses,” she said, noting that the state ranks in the top five highest states when it comes to overdoses. She gave examples of prescription drugs and street drugs classified as opioids.
She also gave a roadmap of how and why the country is in the midst of such an epidemic, given that opiates drugs have been in existence for centuries.
“In the mid-90s there was a dramatic increase in the medical practice of the prescription of opioids for aggressive use for chronic and acute pain. There was unprecedented marketing and emphasis on opioids for everyday pain,” she said. “Opioids have been around forever and are a very effective pain reliever but they have risks and there wasn’t a recognition of the risks involved. They are effective to relieve pain, they’re in cough medicine and also effective for severe diarrhea, but they’re only effective under certain conditions and if those conditions aren’t followed, they’re not effective.”
She stated that opioids are not great for chronic pain and can actually make people more sensitive to pain and are only effective if used for a short period of time.
“You develop a tolerance to them, the more you use, the more you need to use to be effective,” McKenzie said. “If you take Percocet for a broken arm for a week and then you don’t take it anymore, your body rebels and is expecting you to take it. You will experience withdrawal symptoms. It gives comfort, it gives relaxation, and if you take it exactly as prescribed for a short period of time, the vast majority of people won’t have a problem. But many factors play into that, including family history of addiction and untreated mental health issues. Pain medications make you feel better, feel good and you’re more prone to having problems. Those conditions can give rise to misuse.”
Attendees described times both past and present when they’d been prescribed opioid medications for pain after such things as a surgery, and the difference between those who had been prescribed large amounts years ago, versus those who had been prescribed very controlled amounts currently, were obvious, illustrating the current crackdown on the over-prescribing of opioid drugs.
“Opioids do have a place, but we’re also looking at other alternatives, we want people talking to their physicians about managing their pain with over the counter drugs and things like cold compresses and only using opioids as a last resort,” she said.
McKenzie also explained the national movement of Count It, Lock It, Drop It, and said that it is designed to give patients a greater awareness of knowing how many pills they’ve been prescribed, keeping them locked away to avoid others misusing them, and then dropping them at a medication drop off site such as those seen at pharmacies like Walgreens and CVS nationwide.
She gave overdose statistics for Rhode Island and noted that the 323 overdoses in 2017 was high, and yet for the first time was a decrease from the year before, when there were 336 overdoses. She explained that many have turned to other means of getting their opioids, such as using street drugs like heroin, now that there has been a decrease in prescribed opioid drugs.
“In 2012 that drug was often heroin, but in 2015 it was fentanyl,” she said.
Several types of treatment and support were discussed, including Medication Assisted Treatment, which she noted was the best evidence-based treatment for addiction, and uses prescribed amounts of Methadone or Suboxone and Vivitrol to control withdrawal symptoms and help addicts beat their addiction.
However, she explained that because of the stigma that exists surrounding addiction, many professionals are struggling with addiction and are afraid to come forward to their physicians, especially in a small state such as Rhode Island, where everyone knows everyone everywhere, including at the state’s largest insurer, Blue Cross Blue Shield.
“Therefore they will get their MAT drugs off the streets or from friends or family members in order to self-treat their withdrawal symptoms,” McKenzie said. “I’m talking about people who might be doctors, lawyers and judges.” The importance of people feeling involved and supported in their faith-based communities was discussed at length and it was noted that people who feel involved in their faith, who are living to their fullest potential are often successful, and that faith-based communities are critical in supporting those who are struggling.
Arene-Morley described multiple pathways to recovery for individuals who are trying to overcome their addictions. Moderation management, abstinence recovery and medication assisted recovery were three of those pathways described.
“Part of the de-stigmatizing process is more about what does wellness look like for you. Wellness is self-defined,” he said.
“People find their pathways to recovery and what meets their needs, but spirituality is a critically important part of meeting the needs of people,” said McKenzie. “The faith-based community is critical to that support.”
Rabbi Jeffrey Goldwasser of Cranston’s Temple Sinai also acknowledged the challenges faced in the suburban communities. “Many of us are serving in churches and synagogues that are predominantly white, upper class,” he said. “Our parishioners may be suffering silently, but yet still functioning at some level and maybe haven’t reached rock bottom.”
All clergy present agreed that opening up the lines of communication and creating an environment where support can take place was a goal, and also a challenge. The discussion of living in “nice,” suburban communities were the discussion of such issues was still stigmatized took place and was seen as a challenge to be still overcome. Ideas for how to open those conversations were shared and included faith-based leaders continuing to get together to share ideas and resources as well as faith-based organizations opening their doors to those in need on a regular basis.
McKenzie noted that of the things needed for successful recovery, including housing and food security, unconditional support from family and friends, and feeling meaningful purpose and self-care, faith communities can help with that purpose and self-care as well as in the unconditional support.
At the end of the forum, a demonstration of how to administer Naloxone and how to recognize and prevent an overdose were presented and those who wished to take PONI bags containing Naloxone for muscular administration by syringe, were able to do so. Guests at the forum were also referred to preventoverdoseri.org for more information as well as psnri.org for FIRE training registration.