Hampshire Hope: Stigma’s role in OD deaths

  • Antonio Roman is the manager of Tapestry’s syringe-access site in Northampton. Submitted photo

For the Gazette
Published: 8/27/2021 4:30:20 PM

Over the five years Antonio Roman has worked in harm reduction services at Tapestry Health, he’s thought a lot about the role stigma and misconception play in the country’s opioid overdose death epidemic. This is a cause-and-effect impossible to measure, but Roman, manager of Tapestry’s syringe access site in Northampton, believes it’s a factor that should not be underestimated.

Like most people in the field, he carries the overdose reversal drug Narcan with him wherever he goes. He’s used it to revive people who were overdosing about a dozen times, and only three times was it while he was working.

People who overdose when nobody is around are not as lucky and those are the people he worries about: those who use in private; people who do so behind a locked door; people who don’t even reveal to anyone in their lives that they use opioids. This kind of secrecy, he believes, is a direct result of stigma and it endangers lives.

Roman, 41, lost a cousin and three friends over the years to overdoses. He wants people to understand that opioid addiction is present not only in urban centers and inner cities, but in the rural and more affluent communities in Hampshire and Franklin counties.

Before moving into the human services field, Roman had a career in sales. In 2012, when he got a job in a methadone clinic in Springfield, starting out answering phones and working his way up to be a clinical assistant, he realized he’d found a calling.

“I just gravitated toward the people and it became my passion,” he said. “I wanted to work with not only people but people in that community — the drug user community.”

His work in harm reduction at Tapestry has been in three communities: Four years in the syringe access program in Holyoke, which is also where he’s lived since he was 6, and where he’s raising his 8-year-old daughter. He also worked in its Greenfield site for a year, and in July 2020, took over as manager for the Northampton site launched in 1995.

Located on Center Street in downtown Northampton, the site has a staff of three and uses a mobile van as well as the brick-and-mortar offices. In 2020, the site reported this data: 891 people used the services for a total of 1,733 visits. There were 69,678 needles exchanged and 620 Narcan kits given out. For the first seven months of 2021, the numbers are these: 419 different people used the services for a total of 1,121 visits. They exchanged 66,309 needles and gave out 336 Narcan kits.

In recognition of International Overdose Awareness Day, on Tuesday, Aug. 31, marked in communities across the globe around that date, Roman asked if he could talk about his work for this column. (See below for list of Overdose Awareness Day events planned in the region.) What follows are excerpts from our interview.

What happens at a syringe access program?

On top of Narcan education and showing folks how to use Narcan, a big part of our training is how to prevent overdose. We support our participants to look out for each other. We talk about the danger of using alone.

A lot of folks are super-creative: ‘Well, I use alone, but I use a buddy system.’ We try to make them feel welcome and respected. I want folks who are using our syringe access program to feel included. I’ve had folks I’ve talked to who after having come in to our site, felt confident enough to talk to a loved one or friend.

What makes a good harm reduction counselor?

People who experience internalized stigma feel shame and often hide drug use. Good harm reduction counselors treat folks like human beings and build relationships based on a sense of community. They don’t see a number or a “participant,” they see a person, allowing for a deeper friendship-like connection.

What are the similarities among the three syringe access programs you’ve served?

Everybody wants to be helped the same way. Folks just want to be heard. They want compassion and empathy. It doesn’t matter what community I’ve been at, it’s all been the same.

Are there differences?

In Holyoke you see chaotic use, use in public, use in back alleys; some folks experience houselessness. In Greenfield, it’s a lot more private, but there is still chaotic use. Some folks are houseless — or transient — but it’s harder to see.

And then we come here to Northampton, where I would say most of the participants are people who are high functioning, have jobs, have homes and families and are using but not chaotically. It was definitely surprising.

You have said you believe the general public holds misconceptions about people who use drugs. Can you say more?

I don’t believe the general public sees the whole picture. Stigma changes how we think and leads to acts of discrimination. It gets us to believe that people who use drugs cannot function in society and cannot make healthy decisions for themselves or for their family. That is not the case.

How do you see stigma playing a role in the overdose death epidemic?

Most overdoses happen to people who are alone. The folks who can’t come out and say they are using because of the stigma, these are the folks who are forgotten when it comes to overdose. The folks who are forced to use alone. A great many of the folks who are overdosing can’t speak out. The reason they don’t want to tell somebody is because they are afraid of being judged.

Families feel stigma, too. We talk about “the passing,” but you can’t really heal until you can talk about it honestly.

Why do you do this work?

I didn’t know what harm reduction was before I started out in harm reduction, but when I got into it, I realized I’d been doing that my whole life. These are my friends, these are my family, these are my neighbors. I grew up with a strong connection to my community.

What gives you hope?

I’ve definitely seen progress just on the education sharing level. People who come into our site feel confident enough to train other people. Most of our participants walk around with five or six doses of Narcan and they are using it on other folks, not necessarily taking Narcan for themselves but for their community. We call these people “silent heroes.”

Laurie Loisel is director of communication and outreach for the office of Northwestern District Attorney David Sullivan and a member of Hampshire HOPE, the opioid prevention coalition run out of the city of Northampton’s Health Department. Hampshire HOPE members contribute to this monthly column about local efforts addressing the opioid epidemic.

Local Overdose Awareness Day activities

Since 2001, International Overdose Awareness Day has been held in communities around the world to fight stigma, remember people who died by overdose and educate the public about the realities of addiction and the epidemic of overdose deaths in order to prevent overdoses. Pegged for Aug. 31, local communities sometimes mark the day right around that date. The following events are planned in western Massachusetts:

Monday, Aug. 30

Springfield at Northgate Plaza, 3-5 p.m.: Meet at 1985 Main St. Springfield (Northgate Plaza). The one-mile walk starts at 3:30 p.m. Narcan training and other resources available.

Pulaski Park, Northampton, 1-6 p.m.: Co-hosted by Tapestry Health and city of Northampton. COVID-19 vaccinations available; information tables hosted by support groups and organizations; short film “Enabling Life” on display for viewing; Narcan training and other resources.

Chicopee City Hall, 9-11 a.m.: on-site overdose prevention education and Narcan training. Learn about local harm reduction services, free testing, peer support groups and other resources.

Tuesday, Aug. 31

Greenfield Tapestry headquarters, 1-3 p.m.: At 40 School St., in the parking lot, overdose prevention education and Narcan training; local harm reduction services, free testing, peer support groups and other resources.

Light Up Holyoke Purple at Veterans Park, 5:30-7:30 p.m.: At 536 Dwight St., co-hosted by Hope for Holyoke and Holyoke Health Center, featuring memorial activities, purple light bulbs distributed, Narcan trainings and other resources.

Park Square in Westfield, 6:30-8:30 p.m.: Overdose prevention education, Narcan trainings, local harm reduction services, free testing, peer support groups and other resources.

Belchertown Common, 6-8 p.m.: Overdose prevention education and Narcan training, local harm reduction services, free testing, peer support groups and other resources.

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