Perspectives

Community Voices

There are a decent amount of voices, big and small, that fight for the end of addictions and loss of life due to opioids.  One huge repository of information, and a collection of agencies, grassroots organizations, and methadone clinics can all be found under the website Maryland ROTA, or Rural Opioid Technical Assistance.  It observes and lists known organizations and such under a user-friendly UI, along with searching certain parts or all of Maryland, especially focusing on parts of the shore where my immediate community is located.

( Click the picture above to get sent to the search of organizations/clinics, etc. )

More specifically, testimonies from more grassroots groups such as the WoCos (Worcester County Warriors Against Opiate Addiction) were formed to help immediate members of the communities who couldn't afford the expensive treatments/rehabs, or who just didn't have the knowledge to not only fight addiction but to help out and spot those who are beginning the signs of addiction or are worsening.  Such one of these testimonies is from the co-founder of the WoCos Heidi McNeeley, who said the following:

“We wanted to help get the conversation started in Worcester County and dispel the stigma surrounding addiction,” McNeeley said. “As mothers of children with addiction, we wanted to make it apparent that addiction transcends everything. It has nothing to do with parenting or the environment in which they were raised. We wanted to normalize the conversation, so people could talk about it.”

Opioids aren't the only heath injustice that cases some form of scrutiny, resistance from the community, or had it's fair share of uphill battles. For instance, there was, and in certain instances, still is some social inequities in the quality of life that deaf people get, the community inequities in the health care of different racial and indigenous people, and those have high rates of crime and violence in their communities, such as inner-city neighborhoods.

Familiar Challenges

To start off with, I'll be showing some examples and strong moments from a short film called The Silent Child. In a brief explanation, it's about a family, who's youngest is deaf, hires an interpreter or mentor to help her out. Unfortunately, most members of the family, especially the mother, makes consistent ignorant comments about their knowledge of deafness, and unfortunately ends with the nanny being fired and the child placed into a school with no special care for her disability.

 Watch below for context, and to follow along for specifically pointed out time-marks

• At around 1:30: The older man (father figure of the house) is quoted by saying "Thanks for helping us out, we have quite low expectations. We just wanted her to be a little bit more confident in time to school." This dramatically ignores the issue at hand that they just want 'passable' teachings without setting her up to be as successful as the other children. It also seems selfish, like focusing on themselves rather than the disability their daughter has. This can be seen in people who are addicted to opioids getting not just quality treatment, but treatment from people who has genuine care for their well-being.
  
• Around and after 2:40: The mother tries to take the remote away from Libby, the deaf girl, in trying to get her attention.  Thoughtlessly, the mother then says to the interpreter "She can be very difficult, we don't even know what's wrong with her." Blaming the child instead of her unwillingness to understand her daughter. This can easily be equated to blaming people for their addictions to opioids when they are incredibly addictive both by design and psychologically to alleviate the pain.
  
• At around 9:50: Instead of being open to have the family being more inclusive for Libby's overall happiness and ways to communicate, the mother deflects the interpreter's advice and defaults to "I'm just wondering if we should focus more on the lip-reading, rather than on sign language?" Trying to take the easy road, and not the recommended road that could have a more significant impact on Libby's happiness. Comments like this remind me of "Oh just quit opioids" or "Just take the lesser drugs."
  
• Around 19:10: "90% of deaf children are born to hearing parents. Over 78% of deaf children attend mainstream schools with no specialist support in place." Startling statistics such as these can only be if people didn't think it was so common, or perhaps 'mundane' in a sense that deafness isn't necessarily linked by genetics or that they thought all deaf people can get the help they need.  On the flip side: "In Maryland, nearly 90% of drug overdose deaths involved opioids in 2018; a total of 2,087 deaths (a rate of 33.7)."
  

( Just as a disclaimer, some of the criticisms that I've seen/heard were actually in some AA and NA meetings that I've attended as part of a class assignment in my community college, so I can anecdotally confirm some of the views that people without first-hand knowledge have)
Check out some of the sources below, especially the statistic quote on fatalities among opioid users

Criticisms of AAs ( HERE ) Journal on if addiction is a choice or disease ( HERE )
Site of quoted statistics of opioid fatalities ( HERE )

In a second example is a trailer to an upcoming documentary called The People's Retort. Here, it shows the optimism and desire to achieve something better in an otherwise hopeless cycle of suffering in the inner-city community of Delaware. As someone who was born and raised in Baltimore, I have real, first-handed experience of suffering in unfortunate circumstances that are mostly not really the people's fault, but the leaders that do nothing to help them.

• Around 0:50: "It's research for power. 500 and 20 surveys, multiple interviews, extensive field observations from the street corners of Wilmington. There has not been one research project in the state's history that has data like this." To link this with opioids, the website shared before, Maryland ROTA, satisfies and challenges all other organizations to follow in their footsteps.
• Around 1:20: "These people do actually care for their communities, they want a better life."  To see the desire that people with opioids truly care, I want to turn attention to just one of many testimonies in the video below:
  

• (Back to the The People's Retort video) Around 1:55: "People that sell drugs... they are very smart, but you can't even get a job so... how do you even survive?" In a place so desolate of opportunities and upward mobility, it's not really any wonder why some may have turned to drugs in order to get by life's every day challenges. For addiction, even the costs of these powerful drugs have some people turn to incredibly risky alternatives such as taking mixtures of drugs or buying them off the streets, risking their lives just to get by on the hold on addiction.
• 2:16: "There's a lot of people doing things that they don't wanna do, just to get by"   To understand just how destructive and ruinous the addiction can go to the extreme to get their fixes, an article points out that: "Some addicts are chasing their high using an easier, legal but still dangerous method: by ingesting large amounts of an anti-diarrhea drug, loperamide. Some addicts are taking as many as 500 pills a day of the medication, which is also widely known by its brand name, Imodium."
  

The extremes of getting Opioids ( HERE ) Testimonies on the CDC's site ( HERE )

As my third and final example, I'll be highlight some key quotes from a video that focuses on several startling claims and inequities found in the healthcare system.

• 0:55 mark: "Sheena Fontaine was a youth in CFS care when she was murdered, put in a garbage bag and dumped in the Red River."   Some forms of horrifying treatment from healthcare can see seen also in the opioid end.  Between 2016 and 2018, five people have died from overdosing on opioids through the deliberate action of a doctor who continued to handing over said drugs in woefully unethical places such as a closed Radio Shack and as brazen as a still-functioning Dunkin' Donuts. (Source below)
• Around 2:05: "A First Nations person living with diabetes is 18 times more likely than a non First Nations person to have part of their leg cut off." (First Persons referring to Native/Indigenous people) To compare with: "NAS or NOWS (Neonatal Abstinence Syndrom / Neonatal Opioid Withdrawal Syndrome) may occur when a woman uses opioids during pregnancy.  The highest rates were reported among American Indian/Alaska Native (15.9 per 1,000 births) and White Non-Hispanic (10.5 per 1,000 births) individuals."
• 3:35: Talking about the case of Bryan Sinclair and the injustice he faced with the healthcare system: "An indigenous man who was referred to the emergency room by a community physician. He waited 34 hours to receive care, vomiting on himself and with other ER visitors asking nurses and security guards to help him. When they finally checked on him they found that he had been dead for several hours of an untreated but completely treatable bladder infection."   Negligence also runs rampart in opioid-addicted people, most of which are not at the fault of themselves. Doctors have been known to either over-prescribe or even vouch underhanded means of continuously supply people with the drugs, while also purposely giving stronger opioids for those who don't need it.
• 15:30: "Staying true to your principles, doing what you say you're going to do, sharing the hard truths, not by sugarcoating but with kindness."  For those currently suffering or are recovering from the addiction of opioids, the road will be hard and long, but with persistence, will, and love and care from a strong and readily available network of family, friends and other loved ones, one can also stay true to their path to become addiction-free.

( Below is a short video of a testimony to a road of recovery ) ( Click picture for video )

New York Doctor kills 5 people with over-prescribing Opioids ( HERE )
Drugabuse.gov statistics on NAS/NOWS ( HERE )
Another negligence story and how easy it is ( HERE )
Withdraw - What you need to know ( HERE )

You're not alone. Help is here

Here are ten resources, communities, organizations and other interest groups that have direct/indirect relationship to bettering the community over opioids, and other similar issues:

1. Hudson Health Services, Inc.  This addiction treatment provider, based in Salisbury, has multiple treatment settings, including halfway housing, withdrawal management, partial hospitalization, residential treatment, recovery housing, peer support, and group support.
2. Wicomico County Local Behavioral Health Authority (LBHA). The LBHA is responsible for planning, managing, and monitoring publicly-funded behavioral health services within the county, including treatment and rehabilitation services for persons with mental health or substance use disorders. The LBHA also provides education, training, and advocacy services.
3. Non-Emergency Medical Transportation (NEMT).  NEMT is available for recipients who have no other means of getting to their medical appointments. Transportation services are subject to limitations.
4. Wicomico County Health Department.  The Wicomico County Health Department provides information and services for substance use disorder treatment, including methadone administration and PEER services for triage to treatment.
5. Recovery Resource Center.  Free addiction services (including 40+ twelve step meetings weekly). The Recovery Resource Center is also a safe station for people who wish to seek treatment.
6. Community Outreach Addictions Team (COAT).   Peer support specialists partnered with local law enforcement assists people into treatment by offering phone and in-person support, connections to local resources, and follow up assistance.
7. Focus Point Behavioral Health (multiple locations).  Focus Point Behavioral Health provides the full spectrum of behavioral health services for all populations, including: intensive outpatient substance abuse treatment, outpatient services, medication-assisted treatment (MAT), psychiatric rehabilitation program (PRP) for adults and adolescents, mental health therapy, supportive employment services, and DUI/DWI education. We offer counseling, therapy, and mental health services for adults, children, adolescents, and families.
8. BNJ Health Services (multiple locations).  This is an outpatient opioid treatment program with several locations in Maryland. They offer detox and inpatient services and use medication-assisted treatment for opioid use disorder including methadone, Subutex, and others. Their treatment program may also incorporate family members to provide wraparound support.
9. Balanced Life Counseling Services LLC.   They offer a variety of substance use disorder treatment options including inpatient, outpatient, detox, group and individual therapy, methadone and Subutex therapy.
10. Opioid Intervention Team (OIT).  Opioid Intervention Teams (OITs) are set up in each of Maryland’s 24 jurisdictions and led by the emergency manager and health officer. They are multi-agency coordination bodies that coordinate with the community, and complement and integrate with the statewide opioid response effort.
    

A hypothetical organization

Here's an example of what my hypothetical organization could look like:

Name: Project PainFree
Mission: To free Americans from opioid addiction.
Vision: To see that over the course in years, not decades, that we amass the greatest database and call to action to stop opioid addiction and deaths once and for all.
Goal statement: To one day disband as we are a non-profit organization aiming to eliminate the choke hold of opioid addiction in all communities big and small, rich and poor, in every corner of America.

About: We are a non-profit organization striving to spread awareness of opioid addictions and how dangerous and destructive they are, through a vast collection of scholarly research, field researches in local communities, and an active stance against the crisis by bringing awareness to those responsible. Through establishing a network of community leaders and groups, of all walks of life, creeds, experiences and stories, our voices shall unite to bring addiction down so we may free our neighbors, our loved ones, our fellow Americans out from opioid addiction.

Stakeholders would be, of course, those who are addicted to such drugs, the NAs and other local healthcare organizations and grassroots origins who are also directly or indirectly involved in the same goal, the local and greater communities of America, and the researchers who put themselves on the front line to collect and establish a wealth of knowledge so that we can best exercise what are the best possible solutions for each community, not just a blanket 'resolution / one size fits all' fix.

In smaller communities, it all starts with accessing the family and hosting / co-partnering with popular events. If we develop good faith in communities small, word will spread that we support more than just resolving addiction, but also remaining addiction free for the rest of their lives. We will make sure to access all kinds of voices, church leaders, urban centers, and much more.

Initiatives: To outsource to NAs, and to establish a strong internet presence. This will involve getting big enough to outsource for additional manpower and the technology needed to support such an ambition, and also to gain the trust from those currently effected by opioids to tell their story, while keeping their anonymity should they desire to do so.

---

To advocate for health equity, we wish to first focus on the most vulnerable and susceptible communities and parts of the communities who are most at risk of addiction. Although the bar is set up, we will look into the other factors either contributing to the addiction, or what elements are impacting speed, quality, and access to recovery or recovery options.  One such example is by examining the vulnerability index of Worcester County, we can see that transportation and housing is the biggest vulnerability, which may lead people to having an increase difficult time in reaching the necessary healthcare places or other places critical to their recovery.  Through this, we aim to de-stigmatize the victims of opioid addictions so that the community can be more forward and willing to assistance those who most need it.

---

Here are some of the more local efforts and field researches and efforts in fighting opioids that I have loosely based my organization off on:

Opioids in the Workplace: Click here
The Rehabilitation Department & University of Maryland Eastern Shore Response to the Opioid Crisis: Click here