Opioids in the North Country: What it Really Looks Like

 Like many of you, each day articles pop up on my social media feed referring to a ‘crisis’, a ‘problem’ or an ‘epidemic’ surrounding the use of opioids. But is what I see portrayed on the news or social media really what is happening here where I live? It’s common for us North Country folk to see statistics from New York City, Buffalo or Rochester referred to as ‘New York’ – but where we live is so different than those cities, it makes it hard to gauge how serious it really is. This month, we have enlisted the help of Carrie Coryer to help us better understand what this problem looks like in our community, and more importantly, what we can do to help. Carrie is the Harm Reduction Program Manager for the Alliance for Positive Health and works with individuals struggling with addiction each day to help guide them through the recovery process and break down the barriers they may have to achieve that success. 

Carrie, growing up here I have always heard that drugs were a problem in the community because we are on the direct line from NYC to Montreal, is that really true?

We are like every other small community in our country. Drugs are here. Even the richest and nicest communities are not spared. Many times, the drug supply makes its way north from the larger metropolitan areas. We work closely with our harm reduction teams in Glens Falls and Albany to learn what is coming our way. This gives us the ability to understand what to expect, what to look for, and learn from their experiences. It also gives us time to talk to and warn individuals who use drugs about new trends.

I don’t believe that being in the direct line from NYC to Montreal is something that we as a community need to worry about. My true belief is that these large “drug runs” from big city to big city are financially driven and tend to just ‘pass through’ our region rather than stop here for extended times.

Hard truth time, is what I see in my feed about the crisis what opioid use looks like in Clinton County?

Stigma is a word we talk a lot about as it can suppress the individuals that we work with. Imagine wanting to do better and trying so hard to do the “right” thing but always hearing terrible things about you, your past mistakes or being told that you are not worthy of care, time, and respect. This negativity can come from the community members or professionals that you want to trust. This is STIGMA. At the Alliance for Positive Health, we try to educate and help people understand about people who use drugs. Too many times I have opened social media and have seen words like druggie, addict, and junkie followed by much worse when speaking about a person who uses drugs.

I have seen first hand this negativity and have been shocked to hear how this underserved population is treated. It is disappointing and sad that there is not enough education, understanding, and tolerance for those that have a disease that most do not understand.

Unfortunately, when it comes to social media, very few individuals stop to think about this population and their “loved ones” when they write hateful and harmful posts about this subject. Yes, everyone’s opinion matters, but I think we have lost touch with that old saying, “if you don’t have something nice to say, don’t say anything at all”. We need to always remember that NO ONE wakes up and says, “I want to lose everything, put my life at risk, and leave my mom without a child.” If it were easy, I (and everyone that works in this world) would happily be jobless tomorrow.

Everyone has been impacted, directly or indirectly, by the loss of someone due to an overdose. The people we work with are not just clients, participants, or patients to us. They become our people, our friends. They become the people that we will mourn.  A smile from a stranger or a kind medical provider that is willing to see the person as a human and not as that “druggie, addict or junkie,” can make a difference in the life of someone who is struggling. Offering inclusion and considering the person an agent of their treatment and care, can positively influence the whole community.

Okay, so no one wakes up one day and says “you know what, I’d like to be addicted to drugs”. How does it happen then? Is it a slow progression? Is it that ‘one try won’t’ hurt mentality?

Addiction is a disease. One person can use a drug of any kind and never touch it again (prescribed medication included). Another person can do the same thing and be “hooked” for a lifetime. One sports injury or car accident, and a medical provider can easily start that person down a path of addiction. I worked in the medical field for many years and have seen great changes in how medical professionals must write and be responsible for what they are prescribing.

Additionally, it is very hard to break generational cycles. If an individual grew up in a world where this was the norm, understanding that they can do something different can be very difficult. BUT IT CAN BE DONE! Those people who break that cycle are some of my favorite people. They are some of the strongest people I have ever met. This isn’t about who people are, rather about the chemical make-up in our brains. There is huge misunderstanding about science and physiology behind how substances and the brain, trauma, and undiagnosed mental and physical health work.

Mental health and addiction go hand in hand as a norm. We struggle to have mental health providers easily accessible as a country. It is an even greater struggle here in the North Country. The locations that do accept the client’s Medicaid insurance many times have difficulties having the ability to work with individuals and their barriers to get them the treatment they need.

Many times, a person battling addiction is only physically hurting themselves, but their family and friends will suffer along side of them for as long as they struggle with this disease. Parents, children, brothers, sisters, friends etc. suffer through this and are always fearful that they will lose their loved one to overdose or incarceration systems. When we as a community continue to abuse and target this population, we continue to hurt those family members when we should be showing our support.

Alright, lets talk about harm reduction practices. What are they and how do they help?

Harm reduction works on the core belief that we all need to make our own decisions. I cannot make that for you, and no one likes being told what to do. Harm reduction gives individuals choices and ideas along with the support to make the decisions for themselves. It offers autonomy and respect. I may want something different for an individual that I am working with but they are their own agent.

The harm reduction team offers a syringe exchange. Some feel this is condoning drug use – but it’s true purpose is to harbor positive relationships so that these individuals have a safe place they can go. They can get possibly the one positive and happy conversation that they have gone without all week. For many, they are looking for a way out of the situation that they are in. They are given sterile supplies so that they are not sharing and potentially spreading HIV and or hepatitis. They may be ready for testing. This is something that is done free in our office.

We are also responsible for the Naloxone (Narcan) training in Clinton, Essex and Franklin counties and continue to do outreach for our program. We have a provider on staff to see clients at our Drug User Health Hub (Suboxone Bridge Clinic). When clients are ready, we help them with MAT (Medicated Assisted Treatment). We also take referrals from outside programs.

Finally, we are beginning our newest program that will assist people who use drugs and are experiencing homelessness. This will give the added support to individuals that they need for all aspects of their life. This will include housing, medical, Mental Health and anything else that the person struggles with.

Harm reduction isn’t about forcing change, rather it offers inclusion in one’s care, autonomy to make executive decisions for themselves, empowerment, and education to best support their substance use. It puts a kind, inclusive professional in front of someone who probably doesn’t have that in any other facet of their lives during their active substance use habits. Harm reduction works with people exactly where they are, rather than as a whole population. This in turn allows us to look for opportunities to build up their self-esteem, which then translates to how they are feeling about themselves.

Is there anything I can do as a professional, or even just a resident, to help support these people who are struggling or assist in harm reduction strategies?

Please reach out and ask us questions or come visit us and learn more about our programs and how they have made a difference in our community. For residents it is so important to remember that we are all in this together. Your kind smile or hello (something we take for granted) may be the best thing that happens to someone that day or week. Education is power and being brave enough to challenge people’s inner biases when the opportunity arises is what makes a difference.

Never think twice about reaching out to someone in harm reduction at the Plattsburgh Alliance for Positive Health (518-563-2437). We are always so happy to share what we know but also listen to what you have to say without fear of judgment.

Top 3 things to remember.

1. Harm Reduction is NOT enabling. Making sure that the person who is using drugs is seen, uses safe and sterile supplies, and has the knowledge of what is circulating in our area can help keep them be as safe as possible.
2. It cost nothing to be kind and, in the world we live in, we all need to be a bit kinder and less judgmental.
3. Remember that the person that you are judging is someone’s child, brother, sister, mother, or father. They are a person above all else.