Tag: Drug Addiction

One Couple’s Long, Bumpy Road From Opioid Addiction to Sober Living

Posted on by robbie

It’s just before 7 p.m. in Huntington, W.V., and the street lights have turned on for the night. The east side of the city is illuminated by a deep orange that cascades over the roads and trickles onto the large lawns of two-story homes that line these streets.
Justin Ponton sits with his girlfriend, Jami Bamberger, on the stoop of Newness of Life, the recovery home Ponton runs. Both finish cigarettes (they smoke Newports) as they talk about the homemade cooking — much of it deep fried — they missed by not attending church that Sunday.
Ponton sports skinny jeans, a tight-fitted “Kanye West for President 2020” shirt and black sneakers that are impeccably clean. His arms are tattooed into sleeves of crosses, roman numerals and cartoonish lettering. His bombastic, urban style is very much out of place. Ponton knows — and doesn’t care.
“From where I stand, the skinny jeans make me stand out,” he says.
In front of the couple, a group of five men wearing baseball caps and baggy pants slip out of the shadows and walk side by side in the street. Ponton raises his hand and gives a wave.  
They acknowledge him with nods, but continue walking.
“Probably have a meeting or something they need to get to,” Bamberger says as the men walk into Recovery Point, a drug addiction and alcoholism recovery center, at the end of the street.
Bamberger should know. At the time, she was the coordinator for another Recovery Point location about 35 miles away in Charleston, W.V. It follows the same schedule, though that facility is all women.
“Everybody — news outlets, politicians — keep coming to Huntington and talking about how bad it is here. It kills me that Huntington has been reduced to a city that has this dark side to it,” says Ponton. “Dead-ass, we have a problem, but there is so much recovery in Huntington. And nobody ever talks about that.”
In August 2016, Huntington was thrown into the international spotlight when 26 people overdosed on heroin within a five-hour timespan. Since then, a barrage of news outlets have trekked to Huntington — a small city in a rural state that’s experienced the demise of its main industry — to tell the story of how it became the poster child for the nation’s opioid epidemic, nicknaming it the “Overdose Capital of America.”
Residents and public officials resent that moniker. When asked to speak with NationSwell, both the mayor’s office and Huntington Police Department declined to be interviewed, with one member of the mayor’s administrative staff saying that, “even good press is bad press at this point.”
But with a number of options for recovery that are giving thousands of addicts a second chance at life, including peer-mentor models like the ones that Ponton and Bamberger operate, locals have come up with a different moniker for their city: The Recovery Capital.

The Argument for Abstinence

Ponton’s recovery home is well known in Huntington for its underdog  approach to recovery. Newness of Life doesn’t turn anyone away; most of its male residents don’t have any money, and many don’t have stable employment. They are exactly how Ponton was when he was in rehab years earlier.  
Today, community leaders embrace the 33-year-old former addict. But when he was just 10 years old, Ponton was slinging drugs and living on the streets of a Washington, D.C., suburb.
“There’s something about Justin,” says Kim Miller, a close friend of Ponton’s and director of corporate development for Prestera Center, a rehab clinic. “People just gravitate toward him, and they trust him.”
In and out of prison and rehabs for over a decade, Ponton found himself in Huntington at a faith-based recovery center where he turned his life around.
“I was actually kicked out for selling drugs within the rehab,” he says. “But I came back, got clean and started working for the program. And that’s when I wanted to go out and go on my own.”
Newness of Life is an abstinence-only halfway house that operates out of two houses located next door to each other on the eastern side of Huntington — not far from Marshall University and the local hospital. Setting it apart from the numerous other two-story dwellings in the neighborhood: The vending machine dispensing Monster Energy, a heavily caffeinated drink, sitting on the front porch.
Residents are required to stick to a regimen. Morning chores and attendance at 12-step Alcoholics Anonymous meetings and a weekly house get-together are mandatory. No one is allowed visitors, and everyone must have a job.
“I came to Newness and didn’t have anything, didn’t know how to take care of myself or my family,” says Matthew Thompson, a former resident at Newness of Life. “Yeah, it was tough, but with Justin’s help, I was able to get back on track.”
And being tough is exactly what Ponton wants.
“We don’t want you getting too comfortable,” Ponton says. “The point is to become a productive member of society, pay for your child’s bills and get a real home.”
Most importantly, it’s mandatory that every individual living at Newness remain sober — even medically-assisted treatment (MAT) like methadone or Suboxone, which prevents users from suffering withdrawal symptoms like nausea or severe cramping, is not allowed.
MAT is considered the gold standard for recovery treatment. The Centers for Disease Control, The National Institute of Health and dozens of other medical leaders support the use of MAT, and multiple studies have found MAT has reduced opioid deaths from relapsed users by more than half.
“The importance of offering a variety of medication assisted treatment modalities is really that we’re keeping people alive,” says Miller.
But many former addicts reject it.
“You’re just swapping methadone or whatever you’re given for the original drug,” says Ponton. “But not to throw shade on [MAT]… We like to say that not one solution is for everyone.”
In warmer months, Ponton may see only a dozen guys at a time taking shelter at Newness. But once the cold sets in, Ponton usually has a full house, with almost 35 men staying at the facility.
Typically, inpatient rehabilitation centers can cost up to $6,000 a month for residents. Ponton charges just $100 a week for people to stay at Newness of Life, but most of the time, people can’t even afford that. As a result, Newness operates primarily in the red, as Ponton’s mantra is “never turn anyone away, even if they can’t pay.” The houses are in desperate need of maintenance, and shoestring budgets aren’t enough to keep the electricity from being turned off on occasion.
“Somehow, he figures it out. Every single month, the guy has no cash, and he is still able to get those guys heat and water and a roof,” says Ryan Navy, a close friend and executive pastor of New Heights Church, which provides religious counseling for many of the guys at Newness of Life.  
“Everyone in the church knows about Newness and Justin, and they’re right alongside them every Sunday,” he says. “They’re willing to help, which kinda shows you what this community has been doing since the news has come out on the problems here — how we’ve tried to address it.”

How Heroin Took Hold

Huntington’s decline is no different than other towns in the Appalachian region of America. Once filled with miners and coal workers, the city found itself struggling in the early 2000s as the clean energy and technology industries decreased the country’s reliance on fossil fuels and highly-educated Millennials flocked to urban centers along both coasts.
It’s easy to blame the economic downturn for why people started using drugs. But that’s leaving a key point out of the narrative: How the drugs found their way into Huntington in the first place.
Workers’ compensation claims over the past two decades have fueled an increased use of opiates nationally, and West Virginia has been flooded with pain killers at a higher rate than other states, according to an investigation done by the Gazette Mail. Since Huntington is a former city of industry, a significant number of its residents incurred injuries on-the-job. Initially prescribed drugs for legitimate pain management — surgery, injury rehabilitation — many later turned to a cheaper alternative, heroin, as states began cracking down on unnecessary  prescriptions.
“You had this situation where you had large numbers of people abusing prescription opioids and then we took measures to reduce the availability of those pills,” says Robin Pollini, associate director of the West Virginia University Injury Control Research Center in Morgantown, which studies opioid use in the region. “At the same time, heroin traffickers were looking to these places and saying, ‘Hey, we’ve saturated the urban markets, let’s start going into these smaller markets.’ And what they had was a population that was looking for a cheaper, more available opioid for the pills they were using.”
Bamberger, Ponton’s girlfriend, was one such person. At 21, she was prescribed Oxycontin after undergoing surgery for a sports injury.
“[Prescription] drugs did save my life, at first. They did. Honestly,” she says. “I had knee surgery, but from there — and that’s how it started — it only took about five months, and I was already using a needle.”
Originally from Tennessee, Bamberger excelled in staying clean at Liberty’s Place, a rehab in Richmond, Ky. That success led her to the Charleston, W.V., Recovery Point location, which houses close to 100 women fighting for their sobriety without MAT.
The opportunity to work at a rehab center was something Bamberger, 24, always wanted to do. Before falling into addiction, she was attending school to be a drug counselor.
A tour of Recovery Point Charleston reveals that the women live a militaristic lifestyle. Beds are perfectly made, and there’s a limit on personal items. Residents are confined to the building, strictly monitored and have a schedule that includes daily chores, classes and “trudging” — a practice that requires the women to walk miles each day.
Bamberger explains the practice as, “If we could walk for our drugs, we’re going to walk for our recovery.”
Success is rewarded with a paid gig as a peer mentor, a position that pays minimum wage. Recovery Point claims that more than 60 percent of its former residents remain clean. That number is controversial, however, as critics argue that the organization cherry picks data from its alumni events.
“This program, when you come in, they start you from the bottom and you work your way up. You’re taught responsibility, you get jobs, you have to wake up, you have to you know, do a chore here, you go to classes, you learn a lot more,” says Hailey Miller, 24, who is one of Bamberger’s close friends and a resident at Recovery Point.

Get to Huntington

Some states — including those outside the Appalachian region — have started to look at ways proactively to combat opiate addiction. For example, Washington, Colorado and Vermont have discussed legislation that would allow safe injection facilities where users could receive sterile injections while under supervision.
Those programs have come under fire for a host of reasons, including the assumption that they lead to endorsement of drug usage. But safe injection sites are known to be effective in curbing opioid use and overdose. In one study, their use lowered the number overdoses in addition to reducing the spread of HIV and Hepatitis C.
The research, though promising, is so controversial in America that even doctors have conducted studies in complete secrecy without federal approval.
For now, recovery homes and rehabs are the primary go-tos for people seeking help in Huntington. That’s primarily because the city has become very well-versed in triage, but not in prevention or identifying those who are currently in need of help.
“When you’re in the midst of what has been labeled an epidemic, you kind of get in emergency response mode,” says Prestera’s Miller. “What we’re doing is putting out fires a lot. We’re helping the people that we know are coming in seeking our services, and we’re throwing everything at them.”
The work doesn’t stop once someone is clean. Relapse is imminent for many; up to 60 percent of those in recovery will abuse drugs again, according to the National Institute of Drug Abuse, part of the National Institute of Health.
Miller says that there’s no “best solution” to solve for addiction or eliminate the chance of relapse, including MAT. In multiple instances nationwide, addicts placed into abstinence-only recovery programs by drug courts wound up dead because they started using again.
This is why Ponton doesn’t claim Newness of Life residents achieve success, only a chance at it. And it’s why he keeps fighting for others.
On the Sunday morning that NationSwell is with Ponton, he receives a call from an old friend who is using drugs again. The guy is high and called Justin in a moment of weakness, wanting to get help and come back into the program. It’s a phone call Ponton gets often — sometimes daily — he says.
“Alright,” Ponton tells the friend. “Get to Huntington.”
The friend arrived, as promised, but used again the very next day.

A Winter Gift

This past November, Ponton’s heating systems at Newness of Life were shot, and the guys were at risk of having to spend the entire winter with no heat — a scary prospect considering Huntington’s winters are brutal.
“I don’t know where we’re gonna get the money to fix this,” Ponton says under his breath as he analyzes a spreadsheet that reveals in angry red ink the thousands of dollars he’s behind on his bills.
Two days later, Ponton and Navy, the pastor, meet in the back of Lafayette’s, a cigar and wine shop located in downtown Huntington. Navy had news that could only be announced over a Romeo y Julieta cigar: An anonymous donation had been made to Newness in the form of a new heating system.
Less than a week later, the guys at Newness of Life were living in a warm place again.  They may still be battling addiction, but at least they wouldn’t be spending the winter in the cold.
Correction: A previous version of this video incorrectly stated that Ponton and Bamberger opened a new recovery facility in January 2018.
Homepage photo by Joseph Darius Jaafari for NationSwell.

10 Outstanding Solutions of 2017

Posted on by robbie

Across the country, changemakers are operating behind the scenes, working to solve some of America’s most daunting problems. They do so humbly, without seeking praise or notoriety. At NationSwell, we’ve always sought to elevate the innovation and tenacity of their efforts in the hopes of inspiring more people to action. Here, a celebration of the top work in 2017.
My Final Act of Service
Before Marine Corps veteran Anthony Egan dies, he has several lessons he wants to teach his son.
Disarmed: The Reclaiming of a City From Epic Gun Violence
In a community that’s experienced a 200 percent increase in the number of shootings in the past three years alone, ordinary residents are becoming peacekeepers.
The Rx for Better Birth Control
Colorado attempts to end the cycle of poverty by preventing unplanned pregnancy.
When Liberals and Conservatives Came Together on the Environment
Today’s politicians should look to the past for inspiration on how to achieve bipartisan legislation for the good of the planet.
From Blight to Beauty in the Motor City
It started with a dad protecting his family from drug dealers. Thirty years later, his revitalization efforts are still going strong.

An illustration inspired by the #metoo movement.

3 Ways to Show Empathy When Talking About Sexual Assault
The words used when speaking about sexual assault can have an impact on what others view as acceptable.
Neo-Nazi Music Is on the Rise. These Companies and People Are Taking It On
A former white supremacist fights back against the alt-right’s use of music to spread a message of hate.
A Prison With No Walls
Can a facility that relies on strict discipline instead of barbed wire and bars result in lower recidivism rates?
6 Stunning Art Projects That Are Making Cities Healthier
Cities across the nation recognize the revitalizing powers of beautiful community art.
The School Where Only Addicts Roam the Hallways
A cohort of sober youth confronts the realities of living drug free.

Meet the Women Who Blasted into a Male-Dominated Industry, a Smarter Way to Fight Prejudice and More

Posted on by robbie

 
Onward and Upward, Vogue
In this stunning photo essay, take a look at the women who power NASA and learn about how far they’ve come since the time period depicted in “Hidden Figures.” With job titles ranging from research biologist to mission integration manager, the significance of their hard-found positions within the aeronautics industry is not lost on them. It won’t be on you, either.
In Response to Rising Biased Rhetoric, Muslims Run for Office, NPR
With hate crimes on the rise, some members of the American Muslim community are confronting the problem in a bold way: by running for office. Campaigning inevitably puts them in the spotlight and often brings about further vitriol, but many see it as the only way to move the conversation forward.
Surgeons Were Told to Stop Prescribing So Many Painkillers. The Results Were Remarkable. The Washington Post
The opioid epidemic in the U.S. has killed tens of thousands during the last decade, and the overprescription of drugs is largely to blame. A small trial in New Hampshire uncovered a simple, data-driven solution that could lead to a huge cutback in prescriptions and ultimately, addictions.

The School Where Only Addicts Roam the Hallways

Posted on by robbie

A year ago, Penelope sat alone in her darkened bedroom, numbed out on drugs.
It was her junior year in high school. She’d quit the volleyball club after showing up high too many times. Her grades were mostly Cs and Ds. College seemed out of reach. And rehab? She tried that, for four months, but when she got out, she surrendered to the pressure to use again.
“I was just really unhappy unless I was high,” she recalls.
Today, Penelope (whose name has been changed to protect her privacy) is a student at a specialized school in New Jersey that teaches teens how to maintain long-term sobriety—viewing addiction not as a moral wrong, but as a health issue. It ditched old ways of thinking about drug abuse as an acute crisis in favor of a model that treats addiction as a chronic disease that necessitates a lifestyle change.
The school, Raymond J. Lesniak Experience, Strength and Hope Recovery High School, only has seven students. It’s one of just 38 so-called “recovery” schools across the country, says Sasha McLean, a Houston educator who sits on the Association of Recovery Schools’s board of directors. After the failure of the War on Drugs and the spread of addiction into whiter suburbs, new ways of treating addiction view recovery as a long-term, cyclical process that includes relapses and requires new peer relationships, experts say.
Compared to 2002, teen usage of marijuana is on the decline nationwide. Yet over roughly the same period, overdoses have risen. Contrary to popular thought, the classic notion of peer pressure isn’t to blame, explains Brian C. Kelly, Purdue University associate professor of sociology. Rather, young people ponder “whether they think substance use will allow them to have more fun with their friends,” he says. In other words, teens pick their friends based on who else will smoke with them.
While empirical evidence on recovery high schools is limited, they could work by “giving kids the opportunity to hit the reset button on their social networks,” Kelly believes. Extracted from their old schools, young addicts won’t hang out with their drug-using friends and can build strong relationships with other sober youth.

At school, students make a daily contribution to a gratitude chain.

Run by the nonprofit Prevention Links, Penelope’s school is New Jersey’s first recovery high school. Founded in 2015, it integrates traditional classwork with specialized drug counseling. Operating out of a basement in Roselle Park, Lesniak High School’s tiny staff has helped 25 families cope with opioid, cannabis and alcohol abuse. “Really what we’re creating is the opportunity to build new strengths to be able to go back into that [prior] environment and deal with those temptations,” says Pamela Capaci, who opened the school after five years of lobbying.
In most respects, Lesniak resembles a regular public school. Students return home at the end of the day, and no one pays tuition. Math and language arts are taught in person; other courses are conducted online, giving Penelope the responsibility to work through the material at her own pace. Small class sizes prevent Penelope from playing hooky or zoning out in class. “That’s useful if you’re someone like me who likes to be rebellious,” she says.
A sizable portion of the day is devoted to talking about recovery. Penelope sets goals for the short and long term each week in eight categories, ranging from academics to sobriety. After lunch, Penelope and her classmates add links to a paper chain of things for which they’re grateful. If she ever feels the temptation to use, she can retreat to a recovery room to recline on beanbags or jump on a mini-trampoline. But hardest of all, Penelope reports, are the regular drug tests.
That’s because, for months after she enrolled, Penelope couldn’t kick her addiction. She knew she should stay clean. It was her senior year, her one chance to get into college. Still, through December, Penelope couldn’t stop smoking pot. “It was part of my life for so long that it made me feel safe to get away from my problems,” she says, adding, “Addiction isn’t something that is a choice. It’s something you have for your whole life.”
Penelope occasionally sneaks a puff of weed, but relapses are rare. She believes she’s far better off at Lesniak than she’d be at her old school, where she once walked in on a girl snorting a line of coke in the bathroom and the pressure to use felt inescapable.
Temptations flared, in particular, on Friday nights when Penelope’s Snapchat features a torturous live stream of drinking and smoking at local house parties. Old classmates texted her, “Want to burn?” or “Should we get wasted tonight?” Like most teenagers, Penelope struggled to say no.
“Some people can choose to get high. I really can’t stop when I do it.”
What finally changed? Penelope credits her relationship with the school’s clinical social worker and two recovery mentors who are recovering addicts. They draw on personal experiences with sobriety to commiserate and to share tips. Because they understand the tough battle against addiction, they know there will be slip-ups. Rather than berating Penelope when she got high over winter break, they stuck with her. “Recovery is not a linear process,” says program coordinator Morgan Thompson.
A visual recovery plan at Raymond J. Lesniak Experience, Strength and Hope Recovery High School.

Given the complexities youth face, the school says it gauges its effectiveness, not in how many days students stay clean, but in how many full-blown relapses it prevents. “The model allows us to catch things very early. We have kids coming to school saying, ‘I smoked pot last night, and I don’t want to do it again,’” explains Capaci. “The story of our success lies in what happens … to get them back and not experience any lost learning time. It sheds the shame and fear around their struggle to learn new behaviors.”
Penelope vouches this approach works. The fact that someone’s checking in on her makes her think twice, she says. “If I were just at home and came up with a plan, the chance of me following through wouldn’t be too realistic,” Penelope adds. “Here, when I come in every day, they check up on me. It’s a backbone. That’s really what this place is: a backbone for me.”
Penelope has clocked two months of sobriety. She’s back at the gym. Her report card is filled with As. She’s applied to six colleges where she hopes to study medicine and has already been admitted to two.
She will always be vulnerable to addiction, but Penelope now has the tools to triumph over it.

Baltimore Explores a Bold Solution to Fight Heroin Addiction

Posted on by robbie

In the emergency room at George Washington University (GW) Hospital, in D.C., Dr. Leana S. Wen administered anti-inflammatory meds to kids choking with asthma, rescued middle-aged dads from heart attacks and sewed up shooting victims. Unlike a primary care doctor, she knew almost nothing about the strangers wheeled into the frenzied space: their medical history, financial situation and neighborhood all mysteries.
The usual anonymity made it all the more surprising when she recognized a 24-year-old mother of two. Homeless and addicted to opioids, the woman would show up nearly every week, begging for treatment. Without fail, Wen delivered the disappointing news that the next available appointment was three weeks away. Inevitably, the young mom relapsed during that window. The last time Wen saw the young woman, she wasn’t breathing. Her family had discovered her unresponsive, killed by an overdose.
“I always think back to my patient now: she had come to us requesting help, not once, not twice, but over and over again, dozens of times,” says Wen. “Because we do not have the treatment capacity, the people looking to us for help fall through the cracks, overdose and die. Why has our system failed her, just as it is failing so many others who wish to get help for their addictions?”
Last January, at age 32, Wen took a new job as the city’s health commissioner. As the leader of the country’s oldest public health department (established in 1793), Wen devotes much of her attention to an urgent problem: addiction to opioids (a class of drugs that includes heroin, morphine and oxycodone) and prescription painkillers. In the seaside port city of 622,000 residents, two-thirds of them black, heroin addiction grips 20,000 people. Many more pop prescription drugs before turning to heroin, a drug that’s cheaper than ever and more socially acceptable since it can be snorted and not just injected.
Baltimore’s drug addiction is lethal: Last year, 393 residents died of overdoses, a staggering number that surpassed the city’s 344 murders in a year of record gun violence. Long past a criminal “war on drugs,” Wen is implementing a public health response to this medical crisis. Her three-part plan involves preventing overdoses, treating addiction and ending stigma against drug users. By treating addiction as a sickness, not a scourge, she’s now saving lives on a broader scale than any emergency room physician.
“It ties into every aspect of the city. I’ve spoken to kids who question why they have to go to school every morning when everyone in their family is addicted to drugs and doesn’t get up. If we have employees that are addicted or have criminal histories because of their addiction, then what does that mean for a healthy workforce?” asks Wen, a fast talker who regularly works 14-hour days. “This is absolutely something we need to address as a critical public health emergency.”
Tenacious even in childhood, Wen spent the first eight years of her life in post-Mao China, until the 1989 Tiananmen Square massacre forced her politically dissident parents to flee the country. They moved to Los Angeles’s gang-infested neighborhoods like Compton and East Los Angeles, scraping money together from jobs as a dishwasher and hotel maid. With money tight, Wen remembers her aunts choosing between prescription medications, food or bus passes. Never one to wait, Wen enrolled in classes at California State University, Los Angeles, when she was just 13 years old. By age 18, she finished her degree, graduating with the highest honors, and went on to earn her M.D. from Washington University School of Medicine in St. Louis.
Working as a public health professor at GW, Wen spearheaded campaigns to cut healthcare costs, remove lead from homes and design walkable neighborhoods with access to reasonably priced, nutritious food, which caught the attention of Baltimore Mayor Stephanie Rawlings-Blake and landed her a new job.
A key to Wen’s plan for fighting opioid addiction is the distribution of an antidote to reverse a life-threatening opioid overdose. Inhaled through a nasal spray or injected into the upper arm or thigh like an EpiPen, Naloxone instantly revives a person from an overdose with few, if any, serious side effects. During a heroin high, chemicals block pain and induce euphoria — dulling the body to such an extent that the lungs forget to breathe while sleeping or the heart fails to pump adequately. Essentially shaking the brain out of its high, Naloxone creates a 30 to 90 minute window in which medical treatment can be sought. “It truly is a miracle drug,” Baltimore County Fire Chief John Hohman tells the Baltimore Sun. “It takes someone from near-death to consciousness in a matter of seconds.”
There’s only one catch: “You can’t give yourself this medication,” Wen explains. A person in the midst of an overdose often doesn’t have the wherewithal to inject the antidote. “That’s why we need every single person in our city to have access to it,” she adds, explaining that friends, family and community members have the ability to save a life.
In a controversial move, Wen issued a blanket prescription to the entire city last October — meaning anyone can buy the drug from a pharmacist. (For recipients of Medicaid, the price was reduced to $1 at a time when the drug’s price spiked drastically.) Wen sent training videos to jails and hospitals. Health department staffers visited areas notorious for open-air drug markets. Last year, the agency distributed 10,000 units of Naloxone and trained 12,500 residents how to administer it. That’s a big number for a program’s first year, but it’s still only half the number of active heroin users in Baltimore.
Outside of the roughly 30 recorded uses of Naloxone by police officers, there’s little hard evidence whether the drug has saved lives inside the city’s crack houses, parks and underpasses. Using data from Poison Control and other sources, Baltimore estimates Naloxone saved hundreds since 2015. “This remains a vastly underreported statistic,” says Sean Naron, a city spokesperson.
Critics claim that Naloxone encourages risky behavior and perpetuates the cycle of addiction because it removes the risk of death. “Naloxone does not truly save lives; it merely extends them until the next overdose,” Maine’s Gov. Paul LePage, wrote in April when he vetoed a bill that would have expanded access to Naloxone without a prescription. Suggestions like that make Wen balk. She calls them “specious,” “inhumane” and “ill-informed.” “That argument is based on stigma and not on science,” she responds. “You would never say to someone who is dying from a peanut allergy that you’re withholding their EpiPen to make them not eat peanuts.” Similarly for drug addiction, Wen believes there’s no use in talking about recovery tomorrow, if we don’t have the ability to stop a fatal overdose today.
Most in the medical community agree on the dire need for Naloxone. Experts caution, however, that it can’t be the sole response to this health crisis. Like most other cities, Baltimore is still trying to figure out how to effectively direct users whose lives were saved by Naloxone into long-term treatment programs, says Dr. Marc Fishman, medical director at Maryland Treatment Centers, a regional clinic. After reversing an overdose, an addict may “get dusted off and given a piece of paper with some phone numbers. They’re told to call this number today, tomorrow, next week. Maybe somebody will answer. Maybe they’ll take your insurance. Maybe they’ll see you next week or next month,” explains Fishman, who is also an addiction psychiatrist and faculty member at the Johns Hopkins School of Medicine.
Instead, Fishman suggests the medical system needs a “full continuum” from Naloxone administration to addiction treatment. It’s not unprecedented: just look to patients with heart issues, he says. They, too, receive lifesaving drugs to stabilize their ticker, but rather than being discharged immediately, a cardiac clinic assigns a care plan and prescribes maintenance medicines to patients.
Wen fully embraces the idea: she wants to see medication-assisted treatment that fools the brain into thinking it’s getting opioids without getting high or blocks an opioid high after shooting up, alongside housing and supportive social services. In the meantime, she’s set up a 24-hour hotline for users to get treatment option referrals. (Since October, it’s received 1,000 calls every month.) By next year, Wen wants to open a stabilization center where a person can drop in for several days to get sober.
It’s far from the perfect solution, Wen acknowledges. But at the moment, she’s constantly iterating new approaches. Last year, at a meeting of the Mayor’s Task Force on Heroin, Wen asked her colleagues to think of what they could do immediately that wouldn’t need further funding or manpower. That type of thinking fits with the approach she learned from life-or-death decisions in the emergency room: it’s better to act quickly now with what’s available than to wait for an instrument that might never come.
“Everybody is working hard and trying stuff. Some things are succeeding, and some are failing,” Fishman says. “I get a sense of dynamic enthusiasm. People are rolling up their shirtsleeves. I’m sorry that white kids from the suburbs had to start dying before anybody started paying attention, but it’s better late than never.”
Despite Wen’s tireless efforts, overdoses continue to rise in Baltimore. Last year, 260 heroin users overdosed, tripling the 76 intoxication deaths in 2011. Why are people still dying? Wen returns to the idea that a heroin user, on the brink of an overdose, can’t save himself; the rest of the city needs to be on the lookout, which isn’t always the case.
Baltimore’s response to this crisis has the ability to end an epidemic and to unite an ailing community. Wen, who says she’s an optimist by nature, might just find a way to cure a hurting American city after all.
Homepage photo by Spencer Platt/Getty Images
MORE: How Do You Breathe Life into a Neighborhood That’s Been Forgotten?

How Do You Breathe Life into a Neighborhood That’s Been Forgotten?

Posted on by robbie

General Jeff Page walked under the crooked backboard and onto the dusty concrete floor. The basketball court, one of two in downtown Los Angeles’s Gladys Park, seemed like it had once been painted green, now dulled to gray, marred by dirt and grime. General Jeff couldn’t find any basketballs, only deflated rubber kickballs that plopped onto the ground when he tried to dribble. Nearby, cardboard boxes and tents surrounded 40 single-room occupancy hotels and a couple of nonprofit missions. None of the squalor came as any surprise to General Jeff, who, in August 2006, was a brand-new arrival to Skid Row, an area that consists of 50 blocks and is home to a sizable chunk of the county’s 44,000 homeless residents, many of whom are black males struggling with substance abuse, mental illness and trauma. Compacted into one district that borders a resurgent downtown, Skid Row contains the largest concentration of unsheltered people in America.

Skid Row, in downtown Los Angeles, has the city’s largest concentration of homeless people who regularly live on the sidewalks in tents and cardboard boxes.

As General Jeff, an experienced basketball player, nailed jump shots (and retrieved bounceless rebounds under the basket), homeless guys sprawled under the shady queen palms and California sycamores, dodging the heat. When he took a break, a squat, elderly man waved him over. General Jeff thought he knew the guy — an old-timer, Manuel Benito Compito, known as “O.G. Man” on the streets. From beneath O.G.’s graying mustache came a gravelly voice: “Hey, man, I want you to help me start this basketball league.” General Jeff swiveled, looking for eager players. But the vagrant men on the sidelines were mostly gabbing or shuffling through their stuff. “I’ve only been on Skid Row a few months,” he explained. “I’m not sure I want to be involved,” he said and left.
After more pestering, General Jeff (whose name, he says, refers to his willingness to tackle any problem, like high-ranking military commanders do) gave into O.G.’s request. Over the course of a decade, he’d take on many more projects in the community: fixing streetlights, cleaning up trash, painting murals, setting up chess clubs and art collectives and fighting for a seat on the Downtown Los Angeles Neighborhood Council. People started calling him the unofficial mayor of Skid Row.
Jeff on the basketball court at Gladys Park.

From that shoddy basketball court, he and O.G. launched the Positive Movement, a paradigm shift asking Skid Row residents to reclaim their section of the city as a functioning neighborhood, rather than a containment zone. By offering more activities, the Positive Movement provides alternatives to drugs and other undesirable activities. In the process, as residents help themselves, the movement undoes the negative images of substance abuse that have tainted the area. As part of the initiative, next spring, Skid Row residents will ask their fellow downtown citizens to recognize the neighborhood as its own space. With this change in status, citizens would be able to make planning and land use decisions (such as preserving low-income housing from developers, advising city leaders on public transportation and policing and distributing a small coffer of funds for community projects). If downtown residents approve the change, the vote would mark the first time the city has recognized Skid Row as a unique neighborhood, rather than its unofficial status as a dumping ground for lost souls that don’t belong elsewhere in the City of Angels.
“As human beings, we adapt to our environment. And if the environment is completely negative, we’re going to adapt to that…When we talk about Skid Row, when we hear about it on paper, we think of it as a place of rehabilitation, just like a hospital where a human body can heal. But when you think of Skid Row and a hospital, you get two different visuals,” Gen. Jeff says. “As soon as you go into a hospital, the human subconscious, the mind will allow itself to heal. There’s a different smell, a sense of energy, sanitized rooms and walls. You go to Skid Row, and you say, ‘Oh no.’ This is dirty, this isn’t healthy, this isn’t good. It’s hard to heal and truly, naturally rehabilitate on Skid Row.”
Which is why General Jeff set out to change that feeling from the inside out.
This memorial tree was planted in memory of Barbara Brown, a homeless woman who died at the site.

General Jeff came to Skid Row from another notorious L.A. neighborhood: South Central, a place known for its race riots and gang violence. A rap producer who once worked with Ice Cube and Snoop Dogg, “writing, producing, mixing, rapping, deejaying, pop, lock and dancing,” General Jeff says. “You name it, I’ve done it.” After traveling the world, he returned to South Central to organize community members to end gun violence, but ran into difficulties getting them to the table and gave up hope. When the bills started to mount, he gave up his place, stuffed a wad of cash in his sock and started sleeping on the street, finding shelter in warehouses and cooking food with heat lamps. When he moved to Skid Row, he carried two suitcases: one full of clothes, the other containing a drum set — his last tie to his former life. “I don’t know what I am doing, I don’t know why I am here. There’s no blueprint or degree or beacon of light,” he recalls. “The drum machine, that was reality.” He spent a few nights in the park, then at a mission (where men sleep in gigantic dorms with no privacy), before ending up in a single occupancy room (a type of housing for low-income individuals, where, to save on rent, they live alone in a tiny residence, often with a shared kitchen or bathroom) in one of the district’s many hotels, and meeting O.G. in Gladys Park.
General Jeff believes that the negativity of Skid Row can make it hard for residents to rehabilitate themselves, which is why he created the Positive Movement.

After the Vietnam War, servicemen flooded downtown, taking up residence in Skid Row’s dilapidated hotels and using cheap liquor and drugs to obliterate the memories of battle. From that point on, through the crack epidemic in the 1990s, chronic homelessness on Skid Row has been associated with substance abuse and recovery. A 1970 book, “Stations of the Lost: The Treatment of Skid Row Alcoholics,” found that most of the neighborhood’s homeless only spent one-third of the year without a roof over their heads; the rest of the time, they shuffled through jails, mental hospitals, rehab and the missions, before landing back on the streets. Forty-five years later, not much has changed, says O.G. “You go to Union Rescue Mission and spend some nights there. You relapse, then you go to the L.A. Mission. You relapse, then the Midnight Mission. You keep going next door,” he explains. That cycle reveals itself in L.A.’s extremely high percentage of chronically homeless individuals. About 15 percent of all the city’s unsheltered have been on the streets for more than a year or several times over three years. While there’s no data available on why this population remains homeless, it can be assumed that drugs and alcohol continue to play a role.
“I couldn’t believe what I was seeing,” one homeless woman from Las Vegas tells the L.A. Times in 2005, when three people died of an overdose on the same day. “People getting high on the streets like it was legal.”
In Skid Row especially, temptation is always around the corner. Most of the shelters let men out of the large dorms at 5 a.m., and some prevent them from reentering until the evening intake. With few constructive activities in the area, grabbing a beer might suddenly sound like an attractive way to pass the time during non-work hours. Add to that the armies of drug dealers and liquor store owners who profit at users’ expense. (One infamous profiteer, Recondal “Ricky” Wesco, is said to set up his beer cart outside rehab centers and hawk tall boys for just $2, undeterred by more than 50 arrests.) General Jeff feels that the infrastructure of Skid Row itself is designed for people to fail — making the Positive Movement’s “outlets” like basketball, chess, visual and dramatic arts so crucial to the neighborhood; they provide a better way for residents to occupy their time.
General Jeff helped get the mural in the background installed on Skid Row’s San Julian Street.

But as soon as these groups got off the ground, the basketball players asked for whistles, scoreboards and uniforms, and the photography club wondered if they could afford an extra camera. General Jeff realized he would need sustained funding to keep them around. Across Los Angeles, 96 elected neighborhood councils, which can range from seven to 30 members per board, are each allocated $42,000 by EmpowerLA, a city-funded umbrella organization, for discretionary use. General Jeff heard that the education committee of the council that oversees Skid Row — the Downtown Los Angeles Neighborhood Council (DLANC, pronounced “dee-link”) — would be willing to help fund the Positive Movement’s operations, so he simply added an educational component to the basketball league. (The team would discuss various concepts, like teamwork, family, and punctuality before tip-off.) Pretty soon, the team sported jerseys emblazoned with “Skid Row Streetball League,” and the camera club had 10 new digital cameras and an exhibition timed with the Downtown Art Walk.
When General Jeff returned to DLANC a few weeks later to thank the council for the funds, a board member asked why the name “Skid Row” was printed on the jerseys. The elected official was ashamed of the name, painting it as a blight on downtown, General Jeff recalls of the tense meeting. Stating that players were proud to wear their community’s name on their chests, General Jeff argued that if Skid Row didn’t own up to its reputation, it would be easy for the rest of the city to forget about the homeless. After all, he’d seen it happen before. In 2003, “South Central” was renamed “South Los Angeles.” The rebranding effort scrubbed away the images of gang violence associated with the name — a boon to developers hoping for growth but a blow to activists wanting to launch a public relations campaign highlighting old issues that persisted onto the new map. After the meeting ended, General Jeff found out the angry board member was, in fact, his representative for “Central City East,” the preferred name for Skid Row among developers and bureaucrats. General Jeff had never considered a career in politics before, but wanting the person off DLANC, General Jeff ran against him and won in a landslide in 2008, capturing more than half the votes in a four-way race.
From his new position, General Jeff highlighted his neighbors’ concerns. Unlike elsewhere, city maintenance rarely happened in Skid Row. Streetlights burnt out (or were shattered by drug dealers seeking a cover of darkness) and weren’t replaced. Garbage and feces littered the gutters because trash cans and public restrooms in the area were limited out of concern they would become sites for drug use or trafficking. Along with O.G., General Jeff started a cleaning force to pick up trash and made a map of broken streetlights. His most significant battle on DLANC erupted in 2014, when a nonprofit developer wanted to bring in a restaurant with a liquor license on the ground floor of a permanent supportive housing unit that hosts recovery programs and addict support groups. DLANC board members, worried about the impact of pouring drinks around residents with histories of substance abuse and the steady encroachment of gentrification into the area’s borders, fought back. The Skid Row community largely won the fight, but General Jeff lost any goodwill with downtown business owners in the process.
All of General Jeff’s work of the past 10 years started to unravel last spring. He lost his post on DLANC to a newcomer, and he seemed disillusioned with the system. After homeless counts of Skid Row residents hovering roughly around 39,000 for several years, the numbers suddenly spiked to 44,359 people. Charities and public services strained to meet the need, but with no new housing lined up, a long-term solution wasn’t readily available.
Meanwhile, police relations, historically turbulent, frayed even further as law enforcement continued to crack down on residents. Since the launch of the Safer Cities Initiative in September 2006 (the program piloted in 2005), cops had begun to break up sidewalk encampments and issue tickets for minor infractions. Based on former police chief Bill Bratton’s theory of “broken windows,” (combating minor quality-of-life crimes like vandalism or public drinking as a way to keep order in urban areas and deter more serious crimes) law enforcement wrote 1,000 citations for jaywalking and loitering every month during the program’s first year, according to an independent UCLA study. (General Jeff has been arrested for loitering in 2013, but successfully fought the case at trial and avoided a conviction. A related charge of resisting arrest, however, resulted in a sentence of 20 days of community service.) Tensions came to a head in March 2015 when police approached Charly Leundeu Keunang, a 43-year-old Cameroonian national living on Skid Row, known to his friends as “Africa,” and tried to take him into custody for a suspected robbery. Keunang, mentally ill and high on meth at the time, reached for the gun in an officer’s holster. After a brief scuffle, six shots were fired, hitting Keunang in the chest, torso and left arm. Bystanders captured his death on camera, and it was viewed millions of times on Facebook. Skid Row might have looked safer to outsiders, but it didn’t feel that way to its residents.
A memorial in the spot where Charly Leundeu Keunang was shot and killed.

Skid Row citizens have a different set of priorities for day-to-day life, where staying sober or getting to work is an accomplishment, says John Malpede, an artist who started “the other LAPD,” the Los Angeles Poverty Department, an arts group for those who live or work in Skid Row, 30 years ago. “We’re the biggest recovery community anywhere. Skid Row is a resource for not only all of Los Angeles, but also for all of Southern California. It’s a place where there are services and an understanding and a long-term community that suits the needs of people who are suffering from all kinds of disabilities and traumas, whether it be domestic abuse or wars or addiction,” says Malpede, who came to Skid Row to work at a free legal clinic and began offering art workshops when the lawyers weren’t around. “We’re tarred and feathered on a daily basis. They always say there’s drugs and alcohol on Skid Row. Well, there is everywhere, and it’s also true that there are 80 recovery meetings run by community members every week. It’s a very sophisticated recovery culture.”
General Jeff decided to solidify that ethos by creating Skid Row’s own neighborhood council. Through it, Skid Row residents could fight developers to preserve the $365 median rents in the area and other low-income housing, prevent businesses from acquiring liquor licenses and fund community programs. In formation meetings chaired by General Jeff, residents have been discussing the board’s ideal structure. They’ll submit a formal application to break away from DLANC in October, and then start campaigning for the special election that could happen as early as spring 2017. There’s one main issue standing in the neighborhood’s way: a previous requirement that each council must oversee a minimum of 20,000 residents; the Skid Row zip code, according to city data, was just 8,096. Stephen Box, a spokesperson for EmpowerLA, confirmed that the average neighborhood council serves 40,000 residents. But he also pointed out that councils represent communities that greatly differ in size, from the massive 103,364 people served by Wilshire Center-Koreatown’s group to the tiny 7,323 residents in Elysian Valley Riverside.
“We’re getting up and doing something positive for ourselves. We’re not waiting for a handout or even a hand up,” says General Jeff.

“Historically, going back to stereotypes, they’re all drunks bums and addicts. They’re all panhandlers. They don’t contribute anything productive to society. ‘Why don’t you get up and do a job? Why don’t you do something?’” General Jeff squeaks in a high-pitched voice, imitating his critics talk about Skid Row community members. “Let me tell you, that’s what we’re doing,” he says. “We’re getting up and doing something positive for ourselves. We’re not waiting for a handout or even a hand up. We feel that we have something to contribute. We want to add our voice to the conversation that dictates our future.”
Come election season, General Jeff and his neighbors will see whether the rest of downtown is willing to let them assume decision-making power — or whether the poor of Los Angeles will continue to be voiceless.

How Nasal Spray Changed This Community’s Attitude Toward Police Forever

Posted on by robbie

Opiate addiction is taking a grim toll on our country. Seven years ago in Quincy, Mass., more than 90 people died of drug overdoses during a period of 18 months. That’s when the Quincy Police Department decided to look into training its officers in the use of Naloxone, or Nasal Narcan, a drug that “separates the opiate from the receptors in the brain, and allows the individual to resume breathing,” Lt. Patrick Lynn, the Commander of the Narcotics Unit of Quincy Special Investigations told Scott Simon of NPR.
When Quincy Police officers undergo their first responder training, they learn to identify the signs of a possible overdose. When signs of a drug overdose are present, they administer a dose of the Narcan up each nostril, and the results have been striking. Quincy Police officers have administered Narcan 221 times since the fall 2011, reversing 211 overdoses.
According to The Boston Globe, since 2006, health officials in Massachusetts have been distributing Narcan to people likely to come into contact with drug users–such as family members and homeless shelter workers–and the rates of overdose have dramatically reduced. Lt. Lynn told Simon that when the Quincy Police first implemented Narcan training, the overdose death rate fell 66% in the first 18 months, and continues to hold steady at a 44% reduced rate. Perhaps more importantly, people in the community trust the police more, especially since the creation of a good Samaritan law that promises officers won’t charge overdose victims with a crime if they’re found in possession of small quantities of narcotics. “The perception of the police in the city of Quincy is dramatically changed,” Lt. Lynn said. “It’s dramatically changing throughout the state. People are now looking at us as being able to assist them, as opposed to only enforcers of the law.”
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