In the basement of Madry Temple Church in New London, Ledge Light Health District Health Program Coordinator Margaret Lancaster shows the pastor how to administer Narcan, the reversal treatment for opioid overdoses.
In New Haven, at the Dixwell Avenue Congregational United Church of Christ, Reverend Jerry Streets and local clinical staff offer treatment for substance use disorders.
These alliances of frontline healthcare workers with trusted community leaders are tackling the alarming rise in substance use disorders by leveraging the cultural power of churches to reach people who need help .
Overdose death rates have increased among all races in Connecticut over the past three years. But the rise has been particularly marked among the black population. A rate in 2019 of 34 deaths per 100,000 people more than doubled to 70 deaths per 100,000 by 2021.
Figures from the Connecticut Department of Public Health show that since 2019, more than 80% of overdose deaths involve fentanyl. The influx of the drug has significantly affected communities of color, data through January 2022 shows.
Alcohol consumption increased early in the pandemic in all populations. But among blacks, there was a steeper increase in binge drinking than among whites, according to a report by the Research Triangle Institute.
Seeking help for a substance use disorder is rarely straightforward for anyone. Lancaster says the barriers are even higher for people of color, who are already marginalized and distrustful of formal institutions.
Reverend Jack E. Madry said, “Alcohol consumption has increased, self-medication. People do everything they can to try not to let depression overtake them.
“Because the lens is already on you, we try not to magnify the lens,” Lancaster said. “Sometimes that means sticking with the circle of people you trust.”
“We’re setting the table for someone to come to the table, come sit with us,” Lancaster said of the harm reduction training she coordinates.
Change the dynamic
Lancaster has been recovering for 17 years. She says lived experience informs her day-to-day work.
“When you get people with substance use disorders, you just have to accept people where they are and love them where they are,” Lancaster said.
She facilitates four weeks of training for 10 New London County congregations. The program is open to communities of all faiths. Trainers from the National Harm Reduction Coalition will lead the sessions.
Harm reduction means just that: it makes it possible for someone with substance use disorders to get treatment if they want to, but the first principle is that they stay safe and alive, even if she continues to consume. The program includes training on the use of naloxone and the distribution of fentanyl test strips so users can be sure the drugs they are taking are safe.
Trisha Rios is a Recovery Navigator with Alliance for Living, who works with Ledge Light, engaging with people in the community on harm reduction and connecting them to treatment.
“It’s absolutely huge,” she said of the faith-based initiative. “It’s going to be a game changer. I had the opportunity to speak in some churches where I could go to tell my story, but I couldn’t bring my Narcan, you know? »
She said this will put knowledge of harm reduction techniques in the hands of community leaders who can make a difference.
“It’s going to change the dynamic,” Rios said. “Our churches are very successful in helping people. But if they have the knowledge of what comes with substance use or mental health, it will be more than just picking up a pair of socks.
A welcoming space
Streets of New Haven uses the word “hospitality” to describe what they are trying to accomplish with the Dixwell Church setting.
“You want it to be in an environment where people are comfortable and familiar,” he said.
“Addiction has hit communities of people of color in a much more devastating way than some other communities,” said Annette Streets, Jerry’s wife. “We feel the urgency to do whatever we can to help address this.”
The program they host was designed by Dr. Ayana Jordan, now associate professor of psychiatry at NYU Langone Health and former director of Yale’s Social Justice and Health Equity Program.
“One of the underlying factors of health care disparities is not that people don’t care about themselves, or that they don’t want access to health, but they are not not treated in a way that makes them feel safe,” she said.
“A lot of what we’ve done in medicine for centuries has been dominated – at least in psychiatry – by white men, really. And now we see the ramifications of that. Not because they’re inherently bad, but that’s just a particular point of view. You don’t have access to different points of view.
She has already run a pilot program at Dixwell Avenue Church to demonstrate her idea. The study recruited people of color with primarily alcohol use problems to participate in an eight-week program.
Recruits currently in the study, funded by the National Institutes of Health, are divided into a control group undergoing conventional treatment at a New Haven clinic run by the Midwestern Connecticut Council of Alcoholism (MCCA), with the remainder entering a group treatment. at the church.
At Dixwell Church, participants follow a computer-based cognitive behavioral therapy program and take part in spiritual sessions with church volunteers that include meditation, music and prayer.
Jordan said there was a central question she was trying to answer: how to deal with the high drop-out rates of people of color in mainstream treatment settings.
“Is there a culturally informed way to get them into drug treatment, but also keep them in treatment?” Jordan asks.
She found a staunch ally in Rev. Streets. In addition to being a minister and professor at Yale Divinity School, he is also a licensed clinical social worker and has taught at Columbia School of Social Work and Wurzweiler School of Social Work at Yeshiva University.
Reverend Streets said: “So I had an appreciation and an understanding of what she was aiming to do.”
Annette Streets, who helps deliver the pastoral aspect of the program, said some of the attendees remember coming to church as children.
“So one person said, ‘I learned to play drums there,’ you know, or ‘I took dance lessons on that stage,'” Streets said. “It’s a welcoming space for people in the community, and they feel comfortable coming here.”
The small group aspect spoke to Terry Ritter, 50, who said she had been using alcohol and drugs since she was 13.
“I’ve been through so many drug programs. I’m on my 10th, 12th drug program. There, I’m in a group, and I can’t wait to leave to get high. I didn’t think about it when I was in a group here. My mind was clear. We have formed a bond. That’s what it was. We have formed a link here.
She said that only once before had she managed to quit completely. However, she now says she has been sober for six months since completing the program in September.
At MCCA’s New Haven site, participants in the control group receive more conventional treatment, overseen by Steve Palma.
“I still think for the most part, in agencies across the state, even within ours, people don’t understand urban trauma and how much that impacts their continued addiction and continued resilience,” he said. he declared.
“God knows, New Haven has a problem – talking about the only public intoxication problem that occurs in these hot areas outside of the package stores“, said Palma. “Sometimes it’s right in front of some churches.
He said the majority of the population his clinic serves is sent for treatment through the court system. This means that even though people attend MCCA sessions, sometimes they don’t engage.
“It’s very difficult for them not to see us as an extension of the justice system, even though we’re not“, said Palma. “They see the treatment as a punishment, not a cure. So that’s what I love about the Black Church project. They trust the church. They are involved in the church.
He is excited about the possibility of learning that could arise from the Dixwell study.
“It could completely change the way we serve these customers,” he said. “Anything that is evidence-based, we will always use to inform our practices.”
For Jordan, changing the treatment paradigm is a deeply personal goal.
“Being a woman, someone whose family has been through many different iterations of addiction and mental illness, someone who is black in this country – all of these identities explain how I can not only engage with the patient, but my point of view,” she mentioned.
The ultimate goal is to design a program that could be replicated and rolled out among churches across the country.
“It really is a matter of life or death,” she said. “We see people dying disproportionately because they don’t have access to people who understand their cultural values to care for them. This is unacceptable.
If you identify as Black, are 18 or older, and want to reduce your alcohol consumption, the Black Church Project is open to new study participants. Contact Lawanda Frederick on 203 641 1218. If you represent a church or community organization that would like more information, contact Traci Norman, [email protected].
This story was originally published on March 28, 2022 by the Connecticut Health Investigation Team.