Terrence Cooper nodded at the people walking on the sidewalk next to the beige Winnebago parked in the Benning Heights neighborhood of Washington, DC.
“Hello, how are you?” Asked.
Occasionally, he hops into the RV’s side door and returns with a small box of clean syringes, a food container or a pre-made safe syringe kit in a brown bag for a passerby.
His Job: Keeping people alive in this northeastern Washington neighborhood where drug abuse is rampant — something that’s been a challenge for the past year.
“People were using drugs more in the pandemic — and we had a lot of overdoses,” Cooper said. “So we were missing out on more Narcan if anything, and we got a lot of new customers.”
While new COVID-19 cases are now on average in Washington and more than 50 percent of the population has been fully vaccinated, the opioid crisis shows no sign of giving up, making such services increasingly lively.
The mobile clinic run by Washington Family and Medical Counseling Services Company, which has clinics in DC and Maryland.
RV offers needle exchange services – where customers can exchange used needles for sterile needles – and connect with those looking for help managing their addiction or information about treatment. Cooper and his colleague Tyrone Pinkney commute daily from one neighborhood to the next.
“There are a lot of people here talking about their need for help, but they don’t know how to get help – and that’s where we come in,” Cooper said.
Data from the Washington Medical Examiner’s office shows deaths from opioid overdose rose 46 percent from 2019 to 2020. Of the 411 deaths last year, 351 were in the black community. The majority of these were men between the ages of 50 and 69.
In neighboring Maryland, health officials have noticed a similar trend: While overdose deaths have stabilized in the white community, they have continued to increase in the black community.
Experts say the increasing prevalence of fentanyl, the lack of accessible and affordable treatment options in communities of color, and culturally appropriate care for black communities could explain the disparities.
“This is an active issue within the black community. And if we don’t do something about it, more people will die needlessly,” said Dr. Alia Jones, deputy minister of behavioral health for the Maryland Department of Health.
“I give you something positive’
One of the clinic’s regular clients has the name Milo (he is only given his first name). He comes for a meal and sterilized utensils.
“I turned 64 on the 18th of this month and I’ve been using it since I was 12,” said Milo, who uses heroin but not intravenously.
“They will try to help you if you want to stop using. They give you the opportunity to not use by giving you something positive.”
Long before COVID-19, an opioid crisis was raging on the streets of the capital, with the rise of fentanyl in 2017, and the number of deaths increasing between 2018 and 2019.
Mark Robinson, Regional Injection Service Program Coordinator for Family and Medical Counselling Services Inc.
“It was an epidemic that put itself on top of the opioid epidemic that was already prevalent in many of our communities. It highlighted a level of desperation that was already brewing below the surface.”
Robinson said his team has been forced to pivot outreach approaches to follow COVID safety protocols — not just for their own safety but also for the safety of customers.
“Now we have to keep ourselves safe because we’re dealing with a high-risk population that has a tremendous amount of vulnerabilities and other comorbidities that would put them directly in harm’s way,” Robinson said.
A large part of Robinson’s job is to be regularly present – and reach those who want help in a timely manner.
“the window [of time] He said, “They are often very small. And they close very quickly out of desperation — because of trauma. Because of pain. Because of the state of mental health of many people.”
Task Force started بدأت
Some of the patterns are being reflected in the capital in neighboring Maryland, where the state has launched a task force looking specifically at why the opioid crisis is affecting the black community disproportionately.
“When we looked closely at the numbers, we saw that there was a plateau, if any, in the white community, but a significant escalation in opioid overdose deaths in the black community,” said Jones, who co-chaired a task force. With the Maryland Department of Health.
Watch | An outreach worker talks about facing two crises at the same time:
The task force attempts to understand why the black community is disproportionately affected when the country is predominantly white.
“There are challenges in terms of awareness about treatment options and access to treatment in the black community,” Jones said.
“There is the stigma that we continue to deal with in the black community about the existence of substance use disorders … because of the historical war on drugs and the consequences that have resulted from it and how black people interact with treatment environments.”
Ethnic differences in treatment
Barbara Andraca Christo has studied racial and ethnic disparities in the United States in the use of opioid use disorder treatments such as methadone and buprenorphine (the active ingredient in Suboxone) and identified several barriers in modern magazine paper – Including accessibility.
said Andraca Christo, assistant professor in the Department of Health Management and Informatics at the University of Central Florida.
Andraka Christo said buprenorphine is often seen as easier to access, as it can be prescribed and taken at home, as opposed to methadone, which requires the individual to physically go to a clinic and have their dose. However, she said there are fewer clinics offering buprenorphine in communities of color. There are historical stigmas with methadone use.
Andraka Christo said: “He’s stigmatized. He’s so visible.”
“You might wait outside in line with the entire community seeing you in lieu of buprenorphine, which is offered on a monthly basis with someone picking it up from the community pharmacy.”
Andraka-Christou is calling for expanded Medicaid to cover opioid use disorder drugs, government grants and incentives for more clinics in communities of color to offer opioid use disorder treatments such as buprenorphine.
In April, US President Joe Biden issued new federal guidelines that would make it easier for doctors to be able to prescribe buprenorphine.
Work in the trenches
Meanwhile, those fighting the crisis on the front lines say they will continue their work of building relationships in communities. And according to Robinson, a lot of their work is empathy and not being afraid to approach the problem.
“The goal is to help save lives,” Robinson said. “You know sometimes people don’t think their lives are worth saving.”
“The process is to engage people to try to build those relationships with the people out there in the trenches on the front lines.”