Thursday, January 5, 2017

Proposal for Directed Study International Border Crossing: Pilgrimage to Uluru - Engaging with the Opioid Dilemma: Aboriginal Perspectives Abroad and at Home

The following is the formal proposal to Andover Newton Theological School requesting that this journey count toward an international travel requirement for both my Master of Divinity as well as a Master of Arts in Global Interreligious Leadership.

 


Journey dates: January 12-24, 2017

Sydney, Australia
Uluru-Kata Tjuta National Park
The Big Island of Hawai’i
Ithaca, New York

The opioid crisis in my hometown of Fitchburg, as well as the rest of the commonwealth of Massachusetts has reached epidemic proportions. It was not my expectation to undertake this issue in ministry. But my Andover Newton education has taught me to seek what is truly there, not just what I expect to find. Fitchburg is one of only 36 communities in Massachusetts with a methadone clinic. The tired, poor, and hungry have been drawn here. But no one is serving them. Fitchburg has allowed the existence of a clinic, but failed in its duty to serve those whom a clinic would most likely draw.

I briefly drove a cab a couple years ago in Fitchburg to learn more about the people I didn’t know. Cabs in small cities do not drive the rich. They drive the poor. They drive people to methadone clinics every morning. Day after day. Paid for by Masshealth. Perpetuated by a culture that thinks addicts deserve more punishment, when they really need compassion. If we serve them or not they will still be citizens. Perhaps if we truly serve them, they will become citizens who feel inspired to serve in return. If we love them rather than vilify them, they stand a chance of becoming a contribution rather than a drain on society. What best serves my own community is not always fluffy and cheerful, though that is usually what I’m peddling to them.

I feel compelled by my own Christian life practice to learn as much as I can about the issue on behalf of my neighbor as well as the radical approaches to the situation successfully occurring in other countries. I also feel deeply called to understand the indigenous perspective of this world wide crisis in both Australia as well as Hawai’i, our farthest American state. Additionally, I plan to continue my inquiries on an eastward path home, in Ithaca, New York regarding the same.

The 23,740 Mile Journey
On January 17, my husband, Jamie Darcangelo, R.N. (Nurse Manager of the Community Healthlink Addictions Continuum, Worcester, MA) and I are registered to tour a medically supervised injecting center in Sydney, Australia to learn as much as we can about this particular model of compassionate substance use disorder treatment (see information about Uniting MSIC below) and visit the Wayside Chapel which serves that community in Kings Cross. Following Sydney, we will be travelling inward to Uluru-Kata Tjuta National Park to experience Uluru Rock and reach out to the indigenous community in that region for their cultural and spiritual perspective on the opiate problem exacerbated by British Imperialism in the 19th century. Since our travels give us an opportunity for spending several days in Hawai’i (travelling on Hawaiian Air), we have decided to inquire with the social service and indigenous community there as well during our three days on the island on our return leg. We also plan to request a meeting with the mayor of Ithaca, New York, Svante L. Myrick, following our journey to inquire about their proposed opening of the first such facility in the United States.

God is in the Details
Much of the remaining details of the trip, however, are being left to Spirit and our intention to discover as much as we can about ways we may serve our struggling community at home. We will ask questions once on the ground in each of these areas. We have several days to spend and investigate in each location. We will do what we can with the chutzpah we have to discover what Spirit would have us know. We are not shy.


Itinerary

January 12 - NYC to Honolulu (overnight layover)

January 13-17 Sydney, Australia:
  • January 17, 2017 - Uniting Medically-Supervised Injection Centre Visit, Sydney

January 18-21: Uluru-Kata Tjuta National Park

January 21-24: Honolulu, HI
  • The CHOW Project, in Honolulu, HI

January 25-March 15: Post Journey
  • Request meeting with Ithaca Mayor
  • Propose final project/paper to advisor (by February 1)
  • Deliver approved final - March 15



Description of the Uniting Medically Supervised Injecting Facility (from their website)

The Uniting Medically Supervised Injecting Centre (MSIC) Kings Cross is a compassionate and practical health service that seeks to connect with people who inject drugs and welcome them in a non-judgemental, person-centred way. Recognising that drug dependence is chronic, with relapse being an in-built part of this, our focus is on harm reduction. This means we concentrate on reducing the negative consequences of drug use on a person’s health and well-being. The Uniting MSIC does not support or promote drug use; it acknowledges that it is part of the community and seeks to provide assistance that is practical and sound.

Description of the Wayside Chapel (from their website)

Today, under the banner of love over hate, The Wayside Chapel creates a community where there is no ‘us and them’ by breaking down the barriers of judgement and providing a safe place where people from all walks of life are welcome just to ‘be’.

The Wayside Chapel draws people out of social isolation and invites them into the healing place of community. People marginalised by homelessness, mental health issues and substance abuse can turn to Wayside for compassion, tolerance and support.


What are Supervised Injection Sites? (from drugpolicy.org)

Supervised injection rooms are legally sanctioned facilities where people who use intravenous drugs can inject pre-obtained drugs under medical supervision. Supervised injection facilities are designed to reduce the health and societal problems associated with injection drug use.

Benefits
Supervised injection facilities provide sterile injection equipment, information about reducing the harms of drugs, health care, treatment referrals, and access to medical staff. Some offer counseling, hygienic amenities, and other services.

They are also successful in reducing public disorder associated with illicit drug use, including improper syringe disposal and public drug use.

SIFs have been researched and evaluated for years. The evidence is conclusive that they reduce HIV and hepatitis transmission risks, prevent overdose deaths, reduce public injections, reduce discarded syringes, and increase the number of people who enter drug treatment.

Locations
There are now actually approximately 100 SIFs operating in at least 66 cities around the world in nine countries (Switzerland, Germany, the Netherlands, Norway, Luxembourg, Spain, Denmark, Australia and Canada). The first North American supervised injection site, Insite, opened in Vancouver, Canada in 2003.


No US Facilities - yet
No such facilities currently exist in the United States, but the Drug Policy Alliance is advocating for supervised injection pilot programs in San Francisco and New York City. We are working to expand the national dialogue on drug control to include policies and programs that mitigate the harms of drug use without mandating abstinence.

While gaining acceptance for a U.S. facility will be an uphill battle, we are committed to challenging the stigma surrounding injection drug use and introducing political leaders and the public to the health and societal benefits that supervised injection sites bring to local communities.


North American Success in Canada
In Vancouver, fatal overdoses dropped 35 percent in the community surrounding its main injection site in the two years after it opened in 2003 and fell 9 percent citywide. According to Donald MacPherson, director of the Canadian Drug Policy Coalition, the addicts who have availed themselves of the program are 30 percent more likely to get treatment and other health services than those who do not.

Facility Possible in Ithaca, NY
Despite the fact that facilities have been around for three decades in Europe, the city of Ithaca, New York is now attempting to open the first facility in the US. Here is how the city’s mayor described the user’s experience to the New York Times last March:

“Addicts would be allowed to carry small amounts of heroin into the injection center where a nurse would explain treatment options. They would also have access to general health care, an important component,” Mr. Myrick said, “since addicts sometimes forgo medical treatment because of the all-consuming need for heroin.”

“They will have just had their fix, so that won’t be their first priority, and they might say to the doctor there, ‘Actually my tooth has been hurting and I have a puncture wound that has gone bad,’” Mr. Myrick said. “You can begin to treat the other physical things and get them prepared for their moment of clarity.’’


Rate of Unintentional Opioid Deaths (In Massachusetts)
The number of opioid-related deaths in Massachusetts in 2000 was 355. In 2015 they were nearly 1,800 and 2016 estimates are already figuring even higher than that.  


Draft Reading List

  • Gillett, Andrew, State Library of Queesland article “Opium and Race Relations in Queensland,” Publisher: Queensland Government, February 2010
  • Document: “The Aboriginal Protection and Restriction of the Sale of Opium Act of 1897” www.foundingdocs.gov.au/scan-sid-528.html
  • Hari, Johann, Chasing the Scream: The First and Last Days of the War on Drugs, Bloomsbury: London 2015

More will be added during the journey...

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