Last week Evergreen Health hosted two events for International Overdose Awareness Day (Aug. 31), where we asked members of the community to join us in remembrance of those we’ve lost, to learn about what an overdose is and how to prevent it, and to learn about how to combat the opioid epidemic.
What are opioids? Opioids are medications that relieve pain. They reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus. Medications that fall within this class include hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs.
We heard powerful voices during these conversations; Evergreen’s staff told stories of clients that we’ve lost and helped, clients themselves told stories of loss and hope, community members came to recall the vitality of their loved ones before the epidemic took them, and political leaders joined us to listen and discuss the first steps our government is taking to stop this growing epidemic.
Many members of the community came to remember their loved ones and warn against denial; asking the audience to not fall victim to the falsely belief that the epidemic won’t affect you personally. In Erie County alone, the epidemic claims roughly 10 lives a week, stealing potential from our community, clawing back population gains, and leaving dozens of family members in grief at the loss of their mother, father, son, daughter, best friends – the list goes on. The sudden, and fast paced loss of life, prompted Eire County Executive Mark Poloncarz to address the issue:
“We’re averaging about 10 deaths a week of Erie County residents as a result of the opiate epidemic,” Poloncarz said. “I want you to think about this, folks. It took a lot of years for Erie County to start seeing population gain after the drops in the late 1980s, 1990s and 2000. Finally, the population came back.”
Source: This op-ed originally appeared in The Buffalo News, and was written by Emma Fabian, Evergreen Health’s Director of Substance User Health Policy.
By Emma Fabian
Each morning I pick up a newspaper or log on to peruse online articles, and many of the headlines are about substance use. To be fair, it’s my professional responsibility to stay well versed on the topic, so I am particularly drawn to these stories. But I have a feeling that most Western New Yorkers these days would have to actually work to be unaware of the lack of treatment beds, the trend of heroin laced with deadly fentanyl or the stretches of days wherein Erie County lost 11 and 23 people.
These epidemic proportions are enough to make some wonder: is the world becoming increasingly unstable or do we just have more mechanisms for noticing instabilities that have been around for a long time?
This country has not historically confronted drug use effectively; most drug policies have failed and adversely affected marginalized communities and people of color. Couple that with the tragic number of lives lost in Western New York recently, and it’s not surprising people read headlines perplexedly.
In the face of this opiate crisis, Western New York and communities across the country have the opportunity – responsibility, really – to adopt the kind of paradigm shift that led to decreased HIV/AIDS transmissions during the 1980s and 1990s and helped people live longer, healthier lives. A shift of this magnitude involves addressing programming, policy and public opinion. This country did not get through the height of the HIV crisis by perpetuating the same types of traditional treatments despite low outcomes, refusing to fund alternative types of care and stigmatizing individuals as moral failures.
In actuality, we are already on a path toward a more effective response to substance use here. Harm reduction, substance use treatment that reduces the negative consequences associated with drug use, is becoming more recognized as a viable option. Every day at Evergreen Health, staff and participants demonstrate how harm reduction can help change and save lives. The agency is home to a large syringe exchange program and recently received funding from the state Department of Health to implement a substance user health hub. This, in and of itself, is a big step forward for the community. Furthermore, Erie County has developed a productive task force addressing the opiate epidemic.
If stakeholders in our community continue to think outside the box and forget cookie-cutter mentalities, we will get through, as we have before.
Today at 6 p.m., Evergreen Health will lead a public event at 67 Prospect Ave. to remember clients and community members who have passed away from overdoses and raise awareness about services many may not know about.
Emma Fabian is director of substance user health policy at Evergreen Health of Buffalo.
Are you a substance user or know someone who is? We’re here to talk if you need us. Learn more and contact us by clicking here or calling us at 716.845.0172.
I wanted to write this, not only because I still struggle with the right words to use each time I disclose, but also for others to read and understand the thought process someone has when disclosing his HIV status. Hopefully it will help others with their own, personal disclosure, either through inspiration or by simply being a link that is shared with others to help start the conversation.
So there’s something I want to discuss with you before we take whatever this is to the next level. I wanted to bring it up right away, but I thought I would first see where this is going. It’s not an easy topic to bring up, but here goes. I’m HIV-positive. I’m healthy, on medication and have been undetectable for years. It’s not a huge deal to me, but I fully understand that it may be to you. Or maybe you already know all you need to know about HIV, and you are up to date on information. I don’t know what you are thinking at this moment after reading this, but here’s how I’m feeling.
Right now, I’m feeling a sense of relief. Disclosing is obviously not an easy task, especially when it comes to something as stigmatized as HIV. I’m feeling relief because I told you what I needed to tell you and on my own accord. If you had asked me, I would have told you, but it would have been a lot more difficult because I am not yet programmed to verbalize my carefully thought out monologue about my positive status. But now that a sense of relief has kicked in, I’m also beginning to feel anxiety and fear.
I’m asking myself, “What if this news is a deal breaker?” I mean, it very well could be. And just so you know, if it is, I’m not going to be upset because you wouldn’t be the first person to reject me because of my status. But if you are going to reject me, I’d like to know exactly why. Because if it’s due to a lack of knowledge and information about the topic, then I’m more than willing to share what I know, which happens to be a lot.
You know, when I first was diagnosed, I had my moments of darkness when all I wanted to do was grieve and forget about the rest of my life. I think I deserved that time, as I needed to put myself back together after my world came to a halt. But when I was ready, I took the time to become somewhat of an expert on this virus that is going to be a part of my life for the foreseeable future. I realized that knowing everything there is to know about HIV … and more was to my benefit, not only because some of what I learned is vital to me staying healthy and alive, but because the more I knew, the more empowered I felt.
I have put up a bit of a guard since finding out, and it’s mostly for my protection and sanity, because even with all the amazing advancements out there and news of new forms of protection, HIV is still a highly stigmatized disease. But every day when I wake up, I honestly don’t think about it anymore. At night before bed, I’m fortunate to have just one pill to take before passing out. To me, that pill could easily be a cholesterol medication, or an allergy pill or even an aspirin. I realize the importance of that one pill, as it’s keeping me healthy and allowing me to live a normal life, but each night when I take it, I don’t think too much about it. The only time I am really slapped in the face with reality is when it comes to sex, and having to disclose my status. That’s the moment when all those initial feelings of being scared, ashamed and alone set in again, the same way they did after I was diagnosed, even if just for a brief moment or two.
I want you to know that I’m an open book, for the most part. I believe in putting it all out there because honesty is just so much easier. If you have questions, I’m here to answer them. If you want to know how I came to be HIV-positive — which at times is the initial question after I disclose — I understand. Curiosity is a natural response. And if you really need to know right away, I’ll let you know, but does it really matter? I just worked up the courage to tell you something extremely personal about myself, and I would prefer not to open the wound any further by rehashing the trauma. But at some point, if this goes anywhere beyond just sex, it’s something that I am open to discussing.
Before I open up the floor to questions, here’s some information that I’d like to share right off the bat. It’s all good information, and I’m hoping you already know it, but just in case here’s a refresher. There have been all sorts of studies on whether or not a person who is undetectable can transmit the virus. Some studies have concluded that it’s not possible to transmit, while others say there is a minute possibility of transmission, but I can’t tell you which to believe. What I can say is that even those studies that find a possible risk of transmission say that the risk is so small that experts argue it’s equivalent to saying it’s not possible to transmit. Regardless, the information is out there. And it only applies only if we decide to have sex without a condom.
That all being said, I don’t know if you are aware about PrEP, a once-a-day pill that protects HIV-negative people from becoming infected with the virus. I mean, I’m being open and honest about my status, and I’m comfortable enough with being undetectable to know that I am not putting you at risk, but not everyone is like me. And whether or not you decide to have sex with me, I’d like you to know that you have options to protect yourself. So if you don’t know about PrEP, you should check it out, because it’s the most amazing advancement helping to stop the spread of the virus.
So there it is. I realize this is a lot of unloading, and you can take all the time you need to process the information. Again, I just wanted to be open about it all, and to make sure you are good with it and that you know you can use me as a resource if you want more information. I know it’s a heavy topic, but it doesn’t have to be, and it really shouldn’t be. I hope that one day soon those of us who are HIV-positive will be able to verbalize these thoughts with greater ease, and without so many emotions arising. Let me know what you are thinking. I’m here when you are ready to talk about it.
David Duran is a freelance journalist and writer based in Brooklyn, N.Y. You can follow him on Twitter at@theemuki.
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