Addressing Local Concerns
Dear Woonsocket City Councilors,
This week, CCA convened a meeting with the RI Department of Health (RIDOH) and Aids Care Ocean State (ACOS). Our primary objective was to get to the bottom of what was occurring in terms of needle distribution, as well as to address whether needles were being delivered directly to encampments.
By way of clarification, the Needle Exchange program is managed by the RI Department of Health and is part of the Governor’s Overdose Task Force whose strategies are focused on Prevention, Treatment, Rescue, and Recovery for persons with opioid addiction. To better understand this strategic approach to managing the State’s opioid crisis, I would urge you to visit: https://health.ri.gov/addiction-overdose/drug-overdose-prevention-program
Through its prevention initiatives, the RI Department of Health contracts with various health and human services organizations to carry out specific functions. Community Care Alliance is one organization that RIDOH contracts with to provide a range of harm reduction actions, such as outreach and engagement, as well as the distribution Naloxone or Narcan, wound kits, and clean needles. In addition, RIDOH contracts with AIDS Care Ocean State (ACOS) to distribute clean needles throughout Rhode Island, including Woonsocket. The method for distribution has been for individuals to contact ACOS and make a direct request for needles to be delivered to their private home. As a result of this meeting, we learned that similar requests had been made to Aids Care from individuals in local encampments, the result of which was the delivery of an abundance of needles.
Upon learning that needles were being distributed directly to encampments without local coordination, and to address local concerns being raised about public safety related to an excess of discarded needles in the community, we urged ACOS and the Department of Health to discontinue these distributions while we worked together to find solutions.
Both the RI Dept of Health and ACOS representatives readily agreed to a new, more coordinated effort. This will include the following:
- All local unhoused individuals must come to Community Care Alliance’s Safe Haven program at 245 Main St. to request clean needles. This is a 1:1 approach whereby unhoused individual’s must bring in their dirty needles in exchange for clean ones. We are now closely tracking any needles distributed, which are limited and based on what is returned. There are two advantages to this process, first, there will be no further bulk distributions to encampments. Second, CCA staff will have an opportunity to determine whether any unhoused individuals are ready to take the next step toward recovery, which would entail detox, treatment, transition to recovery housing and ongoing outpatient and other support services.
- AIDS Care Ocean State will continue deliveries to private residences; however, these recipients must also return their dirty needles. If dirty needles are not returned, ACOS will limit their distribution only to those individuals that are complying with the process. The feedback we have received from Aids Care Ocean State is that historically they have collected more dirty needles from individuals in private residences.
- Community Care Alliance staff and Aids Care Ocean State will coordinate with Woonsocket City Administration to assist in cleaning sites with dirty needles. CCA outreach staff has, in fact, been directly involved in these cleanups for several weeks at the request of Mayor Beauchamp.
- Community Care Alliance will work with the Dept of Health to identify additional resources that can support this effort.
- Community Care Alliance, Aids Care Ocean State, the RI Dept of Health and the City’s Human Services Director will meet on an ongoing basis to monitor the changes outlined and whether further corrective action needs to occur.
It is important to clarify a few facts relevant to the opioid crisis in Woonsocket and other communities throughout Rhode Island.
- First, Harm Reduction Saves Lives. The Governor’s Task Force emphasized Harm Reduction as a key action strategy for addressing opioid addiction for the reason that lives are saved by this approach.
- The primary objective in employing Harm Reduction is to keep individuals with addiction alive long enough to facilitate their eventual recovery. A primary example of this practice has been the scores of people that have been revived from death due to Naloxone being administered by Rescue personnel, Police Officers, Human Services staff and ordinary citizens.
- Needle exchange programs benefit public health. This evidence-based practice reduces the likelihood of individuals contracting HIV/AIDS and Hepatitis C, and without these strategies, we would be witnessing greater strain on the City’s rescue/emergency/medical infrastructure, as well as the already strained healthcare system in Rhode Island.
- The facts speak for themselves—the rate of death by opioid overdose in Rhode Island and Woonsocket has declined since these practices have been implemented.
- Opioid addiction must be viewed from the perspective of the Public Health crisis that it is and why the State through the Governor’s Opioid Task Force has taken a deliberate, systematic approach to addressing the problem.
In addition to the above considerations, it is important to understand that other factors, such as social determinants of health impact public health concerns like opioid addiction. These often include:
- An ability to address one’s basic needs (i.e. food, shelter, clothing etc.)
- Affordable housing.
- Access to healthcare to address one’s physical and psychological concerns.
- Employment and the ability to earn a livable wage.
- Ongoing, longstanding trauma and mental illness that many unhoused individuals are struggling with. Opioid use is one means of psychologically blunting the suffering that occurs with this population whose daily living situations are traumatic in themselves.
- Access to other resources to address disabling conditions (i.e. Assisted Living, Nursing Home Care, Recovery and Supported Housing).
- Reliable transportation.
Opioid addiction and homelessness are complex problems that require structural solutions, as well as an individual commitment to recovery. What we and other healthcare providers have learned is that there are no simple solutions. I frequently think about a former 1980’s Woonsocket hero by the name of Paul Dempster, who understood suffering and foresaw the complexity of homelessness—that there was no “silver bullet”. He also understood that many of the social problems we continue to deal with are structural in nature and require policy leadership. Moreover, to assist individuals and families to exit addiction, poverty, mental illness and other concerns, two ingredients are critical. First, that they be viewed and treated with dignity. And second, that a comprehensive and collaborative service approach among non-profits and government must occur.
Community Care Alliance seeks to work with our partners in government and other local organizations to strengthen all Woonsocket residents.
Respectfully,
Benedict F. Lessing, Jr. MSW
President/CEO
Community Care Alliance