How’s the Family?


                                  

             “They are fine, thank God.  I can’t say that for my cousin, though, or my neighbor.”

            The line at the check stand fell silent, the clerk pausing in her work. 

            “That used to be such a casual question,” she said. “Something you just said to get a conversation going.  Now, that question goes to what’s in my heart today.”

            Her eyes watered, and she wiped away a tear. 

            “I’ve lost a few relatives, my neighbor, and a couple of co-workers here,” she said. “There’s a lot of people I’m worried about, too. 

            The lady behind me, the one on the asking side of the question, took a deep breath and nodded.

            “We’re in hard times, and I’m so grateful for my health,” she said. “But we don’t talk much about what we are all going through, with all the loss, all the uncertainty.”  

            “We have each other,” the clerk said.  “We need to care for each other, and talk about our pain, and the grief, and all the unknowing, the value of family and friends.”

            We looked at each other, nodding, smiling, sharing some deeply felt emotions that needed to be shared, realizing we were in sacred space and time. 

            The silence filled me up.  I felt comforted, connected with people just like me — scared, fearful, and lonely. I was with my tribe, my people, my community. Simply acknowledging all that jumble of feelings was what I had been needing. 

            The pandemic, the isolation, the sense of disconnectedness, it is all the elephant in our community living room.  We are all going through this together, and sometimes, you just need to put that into words, get it out there, and share our hearts with each other.  It is what community does the best, bringing us together in love and compassion.  

Published in the Tillamook County Pioneer 10/6/2021

10/6/21— by Neal Lemery

Embracing Change


                                   

                                                –by Neal Lemery

Change is in the air. The rains have returned, leaves are turning, and autumn is here. 

Some change is welcome. Yet, I resist many changes. The old ways of thinking are comforting and soothing, predictable. I’m set in my ways, determined and often obstinate. I most always am thinking I have all the answers, I know all the facts, and I’ve always reached the proper conclusions. 

People I agree with have also miraculously reached these same conclusions.          

I can blame my attitude on age. But I was at least as stubborn in my younger years. Part of who I am and how I navigate life can be traced to genetics, and part on the times we live in. 

This is an age of contrariness, obstinance, and too often, argument for argument’s sake. That feistiness is often wrapped in the blanket of divisive politics and thinking that one’s own theology and morality should be everyone’s correct thinking.

There should be no surprise that our sense of current affairs, that focus on egotism, has persisted throughout human history. Heated politics has always dominated our country’ public forums.

            The chaos and uncertainty of the pandemic has shaken our desire for stability and “normal”. Our fears, assumptions, and problem-solving skills have been deeply shaken by the unpredictability, this “facelessness” of cause of this invisible and increasingly fatal infestation. The pandemic seems out of control. Many resist what others, often experts in the field, say are useful and life-saving practices. The issues don’t lend themselves to resolution and harmony. 

            All this argument increases our society’s divisiveness, making humankind’s informed responses less effective. I am reminded of Lincoln’s phrase: “A house divided against itself cannot stand.”

            And, real change requires that I deeply examine my own thinking, my own analytics, and look to correct my thinking and be better informed. I need to be more of a citizen and pay less attention to my ego.

            I am but one person. But I can make a difference in this world.

            This change of seasons brings us new tasks and new opportunities. We are being called to action, to bring new tools and new viewpoints to old problems and old thinking. 

            Angela Davis writes: “I am no longer accepting the things I cannot change. I am changing the things I cannot accept.”

            Each of us is an instrument of change, a presence in the world for real fundamental change. It starts inside of each of us, and can then spread to friends, families, the institutions we are part of. Politics and society don’t change unless and until we as individuals change. It starts with each of us, almost on a cellular level.

            The opportunity for real change is here and now. It starts with me, and with you. Now. 

            What we need — facts, methods, organizing, communication — are literally in our hands. Change takes time, commitment, and persistence. We each and collectively have all of this, in abundance.

            “The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.” — Ralph Waldo Emerson.

9/22/2021. Published in the Tillamook County Pioneer

A Time to Give Back


            September seems like a good time to start fresh, to start a new year.  It’s the beginning of the school year, it’s harvest time, and the weather is changing. 

            September is also the new year according to Jewish tradition, and is the start of the ecumenical year in the Orthodox church.  It is the historical new year in Russia, and was the start of the new year in ancient Egypt.  

            A new year is a time of new beginnings, a fresh start, new resolutions to change our ways and to move ahead, adapting to change. 

            This year, September seems like a good time to reassess how we are living, how we are coping with all the changes and challenges that the pandemic has brought. 

            I’m ready for a fresh start, looking back, but also looking ahead.  We are called to look at the fruits of our labors this busy and often confusing year, a year we have been compelled to make continuing adaptations in our lives.  Looking at September as a new year is my way of not only assessing what we are doing, but where we need to be going, how we can be builders of a better world.

Denzel Washington calls us to look inward. “At the end of the day, it’s not about what you’ve done with those accomplishments.  It’s about who you’ve lifted up, who you’ve made better. It’s about what you’ve given back.” 

            I’ve just completed a postcard poetry festival, sharing short poems I’ve written on post cards, and mailing them to a list of strangers, who are also lovers of poetry.  They are sending me their poems, too, sharing their creativity and inspiring all of us to bring some literary beauty to the world.  I’m carrying that idea further, sharing some inspirational quotes or short poems to people and local businesses that have brightened my life during these challenging times.  

            We can all bring a bit of cheer to our corner of the world, and make a difference, giving back. 

(published in the Tillamook County Pioneer, 9/2/2021)

What I Am Learning From The Pandemic


                                               p

                                                                        by Neal Lemery

            The last year has taught me many lessons, and I hope I can fully absorb and retain the wisdom of these times. The lessons are often challenging and messy, and I struggle to make sense of these times.

  • We human beings are very vulnerable to disease. In this age of “miracle medicine”, technological wonders, and astonishing discoveries and advances in medicine, we can still contract a new disease. We find ourselves susceptible to random life-threatening illness. I am not in control. 
  • There are angels and miracle workers among us, serving as true caregivers. 
  • Humans are survivors.  We have survived other pandemics.  After the Black Death, Europe experienced the Renaissance. 
  • Many of us disregard lifesaving information and medical guidance. 
  • Society is easily prone to mistruths, falsehoods, and deliberate lies. We can be easily manipulated and frightened by deliberate propaganda and gaslighting.  Many of the proponents of falsehoods and distortions do not have the best interests of the community at heart. Instead, they are destroyers and terrorists.  
  • Finding truth is a necessary and sometimes lifesaving skill. Skepticism is useful. 
  • Relationships with others is an essential element of a healthy life and personal sanity. 
  • Human touch and social interaction are vital to my health and my daily life. I can be depressed and lonely.
  • Technology, with its access to information, virtual meetings, seminars, and other gatherings, can be very useful, giving us a sense of connection.  We can conduct our business and be engaged in learning from our homes.  Yet, those virtual connections lack the intimacy, the “spark” of in-person conversation and true interaction. There’s basic human chemistry in that. We are truly social beings, and need to be physically together to share the most essential aspects of our communication.
  • We can be amazing problem solvers and managers of new and challenging situations. We are resourceful and creative. When faced with a common challenge, we can pull together and take collective action. Yet, we often find fear in that success, doubting ourselves for being successful; the “not good enough” thinking. It often takes courage to declare that we can be good at managing the Pandemic. 
  • Life is precious. Relationships are precious. We need to gather together to both celebrate and to grieve. Not doing that is painful and often stifles our souls and fuels our fears and doubts. We can be saboteurs of our best intentions.
  • We can be argumentative, strident, and stubborn in our opinions.  Our personal pride and our egos can derail us from attending to our common desires for a better society. We often fail to realize that our anger and divisiveness are really expressions of our passions and our collective desire to be a society responsive to our needs and our goals for a better world. We struggle with the small stuff and often pass by our common aspirations. 
  • I have again discovered the value of quiet in my life, times to be contemplative, reflective, and simply present in the moment.  American culture focuses on being ever busy, always “doing”. In the newly discovered stillness, I can appreciate the value of rest and uninterrupted thought.

5/21/2021

Courage


                                                            

                                                                        By Neal Lemery 

I’ve been reading and thinking about courage lately, which seems to be in scarce supply lately, and much needed in these times.  I found some useful definitions.  

“Physical courage.  This is the courage most people think of first:  bravery at the risk of bodily harm or death.  It involves developing physical strength, resiliency, and awareness.  

“Social courage.  This type of courage is also very familiar to most of us as it involves the risk of social embarrassment or exclusion, unpopularity or rejection.  It also involves leadership. 

“Intellectual courage.  This speaks to our willingness to engage with challenging ideas, to question our thinking, and to the risk of making mistakes.  It means discerning and telling the truth.  

“Moral courage.  This involves doing the right thing, particularly when risks involve shame, opposition, or the disapproval of others.  Here we enter into ethics and integrity, the resolution to match word and action with values and ideals.  It is not about who we claim to be to our children and to others, but who we reveal ourselves to be through our words and actions.  

“Emotional courage.  This type of courage opens us to feeling the full spectrum of positive emotions, at the risk of encountering the negative ones.  It is strongly correlated with happiness.  

“Spiritual courage.  This fortifies us when we grapple with questions about faith, purpose, and meaning, either in a religious or nonreligious framework.” Lion’s Whiskers http://www.lionswhiskers.com/p/six-types-of-courage.html

            Courage comes in many forms and expresses itself in numerous ways.  One’s act of courage may not seem courageous to others, but it remains a courageous act.  Each type of courage comes into use for different occasions, and different needs.

            I think the source of courage comes from deep inside of us.  It can spring into action often without any deep analytical thought, and instead, literally rises out of us when the occasion calls for us to be courageous. 

            Sometimes, when I worry about something, my mind will anticipate and I will analyze how I might respond.  I’m being thoughtful and analytical, my brain drawing on past experiences and past “learning”. Old habits and prior learning, and prior conversations with others come into play.  Sometimes, it is remembering a story someone told me, or that I read.  

            More common for me, though, is what I like to think is spontaneous courage.  It arises out of the moment, the circumstances, and seems to be impulsive.  But, after the crisis, looking back, I realize my courageous act was mostly the product of prior experiences, and the memory of stories I had heard.  I often realize that I am more courageous inside of myself than I give myself credit for, that I have some deep values and motivations that I am often not very conscious of.  But, that courage is there, inside of me, and is a strong and vital part of my inner self, and arguably, a big part of my soul.  

            I often look back on an experience and, it is only then that I can see the courage in action, that I did a good thing, and that I acted with courage and with strong moral values in play.  At the time of the situation, I wasn’t that insightful, that thoughtful, that aware that the moment required me to be courageous and to act in a morally appropriate manner.  

            I probably don’t give myself adequate credit for being courageous.  I am, I think, deep down, humble an unassuming, and modest about what I can and should do in a situation.

            This week, the Capitol guard who diverted the mob from the Senators was also discovered to be the hero in saving another Senator, his actions caught on video and shown to the Senate during the impeachment trial.  He didn’t mention his actions to others, and didn’t seek attention and accolades. But, the video spoke for itself, a demonstration of courage and swift action to save another person from harm.  

            His actions were courage in action, and serve to show him as a hero.  

            People are courageous in so many ways, and almost always are not recognized for their actions.  I think each of us often doesn’t see what we are doing as being courageous acts.  But, if we are aware of a person’s situation, the circumstances, the background, we can then take the time to realize that what they are doing is truly courageous.  We may not see that, at first.  But, if we take the time and are sensitive to a person’s situation, then the courage becomes visible to others.  

            We can do that with ourselves, seeing our conduct, our interactions, as being courageous acts, brave an often fearless in the moment.  

            I think it is important to recognize that courage, that bravery, is often alive in ourselves, that we often act with courage, facing our dragons, our self-doubts, our fears, and do great things in spite of our feelings of unworthiness, self-doubt and fear. And, I need to give myself some recognitions that I am often brave and fundamentally a good person.  

2/14/2021

Tightrope: A Challenging and Compelling Book for our World


                        by Neal Lemery 1/17/2021

            If you are concerned about kids in your neighborhood, or you worry about your community, or the future welfare of the country, then Tightrope: Americans Reaching for Hope, by Nicholas Kristof and Sheryl WuDunn, is a must-read book for these challenging times.

            A sobering and emotional (and very well written) read, Tightrope tells the stories of Kristof’s classmates and neighbors in rural Oregon, and stories of impoverished Americans across the country, in today’s world, which the authors call “America’s social Great Depression”.  The stories are the stories of the people most at risk in our society. They can be, as Kristof points out, the kids you rode the school bus with, the decent people who are still your mom’s neighbors. 

            “We need economic change, but also cultural change, and ours would be a richer nation if it were more infused with empathy, above all for children,” say Kristof and WuDunn.  Kristof, a New York Times columnist, and his wife look deep and compassionately into the lives of good people, the heart and soul of this country, and tell their stories of struggle. 

            Their previous four books, and many of Kristof’s newspaper columns, have taken deep and hard looks at social issues in what we would call the Third World. Yet, this book compels us to look at the urgent issues we Americans face today; our many problems are Third World problems, or worse.

            We need to “look at our society through the lens of moral grace,” is their heartfelt message.  

            The deep and bloody holes in our social fabric are revealed, along with tales of courage and determination, as well as hope.

This is a book of heartbreaking stories, but we hear about innovative solutions.  “Solutions are difficult and imperfect, but the right programs make a big difference.  “There is a path out of the inferno,” the authors write.  

This book was often painful, and at the same time offers hope and resources.  If you want to be a force for change, the book is both a wake-up call and a great resource.

Acting with Kindness, at the end of 2020


                                    

                                                            By Neal Lemery

(published in the Tillamook County (Oregon) Pioneer 12/27/2020_

            “A tree is known by its fruits; a man by his deeds. A good deed is never lost; he who sows courtesy reaps friendship, and he who plants kindness gathers love.” – St. Basil (329-379 AD)

As the old calendar comes off the wall and the fresh, unmarked calendar of 2021 takes its place, I marvel at all the events written on the old calendar.  Most of them are crossed off.  This year was the year of the Great Postponement,  the year of cancellations and re-dos, of reforming events and projects, to fit the times of contagion, “personal distancing” and self care. And, for most of us, a time of “society care”.  

            2020 was the year we didn’t plan and we didn’t want.  The comfortable, predicable and expected simply didn’t happen, and we had to adjust.  The old and familiar changed, and we have had to change with the times, whether we wanted to or not.  The inner child, the inner toddler in me wasn’t a happy camper, and my tantrums often played out where others could see what a naughty kid I could be.  I’m not alone in all that acting out. 

            Like most of us, I’ve discovered the satisfaction of having the time to focus inward, to take on and complete home projects, to savor experiences with myself and the people I live with, and to reshape our experiences in the greater community.  I’ve grown in many ways, and learned to appreciate the simple pleasures of a safe meeting with friends, a collective effort made possible by technology, and some peace and quiet in nature.

            While there have always been angry, selfish outbursts of social rage that are often based upon fear, ignorance, and anxiety, this year that ugliness has been fueled by a collective access to social media, and the often unpenalized human trait to act out and rage in public. This year agitators have thrown the proverbial gasoline on the coals of unrest, frustration and the impotence of not being in charge of our lives.  Society is changing, and the change is being forced upon us by the pandemic and the resulting economic and social events.  We’ve been asked to adapt and to be tolerant, but that doesn’t mean we like it, or can adapt willingly or with the best interests of the community in our heart.

            In all this, there is a renaissance in personal and community kindnesses. Cordiality, compassion and community caretaking have taken on a new importance.  Now, I cherish the chat with the barista as I drive through for a cuppa, or have a properly distanced lunch with a friend.  Zoom meetings have become a staple of community gatherings.  I’ve acquired new skills and have been able to be part of rich conversations from people from around the country.  In many ways, we’ve been able to accomplish a lot in virtual gatherings. We are more efficient and more organized, while protecting our health and coping with the absence of “presence” and side conversations.  

            We are more gentle in our conversations, more apt to express our appreciation, and extend courtesies and patience.  Sending thoughtful messages and showing respect for others have enjoyed a new vibrancy.  Meeting for coffee seems like a spiritual celebration. 

            Personal encounters have become special, deserving of my full attention and a mutual exchange of good wishes and small acts of courtesy.  Life has slowed down, and I no longer feel compelled to rush through the day’s errands and transactions. I have found that I have time to be kind.  

            Despite the nastiness of political rhetoric, headlines and the seemingly unending social media posts, we have become kinder.  We have realized that kindness matters.  The pandemic and the “Great Pause” have given us some mental space to appreciate and celebrate the small things that make life sweeter.  

            Often, practicing kindness doesn’t get our attention, but it is the undercurrent, the “fuel” of our society. We are all hurting, we are all adjusting, and we all cherish those small, sweet moments where one person does nice things for someone else.  This isn’t glamorous, nor does it gather much attention.  But, it is the fresh spring breeze that comes at the end of a cold winter, and we are all part of it, the “Great Kindness”.  A simple act, kindness, yet so powerful it changes the world. 

            “What you do makes a difference, and you have to decide what kind of difference you want to make.” — Jane Goodall

Citizenship and Conversation in a Disjointed Time


 

By Neal Lemery

(Podcast)

In this pandemic year, our craving for “normal” pushes back against the new rules of social interaction. What lies ahead of us grows even murkier.  Uncertainty is the new mantra of who we are as a society, and where we are going with our own out of sorts lives.  Simple acts of normalcy such as going to school, shopping for groceries, dinner with friends, and a weekend getaway take on all the traits of unpredictability.

 

Nothing seems routine anymore. The old patterns of life now can be simply “paused”, the calendar becoming a mess of cross outs, erasures, and question marks.

 

Sound medical advice, scientific wisdom and evidence-based practices run the risk of being politicized in loud, partisan fashion. Wearing a mask at the grocery store now can be a political statement. Nuances and logical development of analysis are discarded if favor of “right vs wrong” and “us vs them” viewpoints. We don’t seem to be able to even agree to disagree or admit we need more information.

 

Serious discussions about racism and discrimination, the role of police, and how we look at history are now mixed into the swirl of our pandemic responses and thinking.  Political rhetoric grows more heated and polarized.   “Them” and “us”, “right” and “wrong”, “liberal” and “conservative” are becoming the short slogans that can fit on a baseball cap.  Efforts to simplify and quickly label perspectives and opinions are pushing out the deep discussions on public policy and the rich stew of community discourse and public debate that are at the heart of a healthy democracy.

 

Instead, we are experiencing a “shoot from the hip” attitude, with no room for civilized conversation and thought.  Being persuasive and convincing in one’s opinions and views is replaced by an angrily shouted slogan and no room for disagreement, however polite or thoughtful.

 

We are all hopefully looking for a sense of civility, order and normalcy in our lives. I find myself weighed down by all the “pausing” of social life, and the angry, strident rhetoric of public opinion.  Sarcasm and rage, and downright nastiness and vitriol now seem to occupy center stage in public forums.  That approach to our collective life is toxic and exhausting.

 

I should remember that, perhaps, I might be wrong in my views, or that the situation is more complex and requires more information than I have been willing to admit.  Like any effective theologian, scientist, or teacher, I just might not have all the facts, and might not be considering other ways to look at an issue.  I might not have all the answers.  And, I might even be wrong.

 

Many turn to social media to air their own views or the rant of their favorite commentator of the day. In their role as a publisher and editor in the public forum, a significant number of Americans ignore their responsibility to be factual, to educate, and to add to thoughtful debate that will improve our society. Be a builder, not a destroyer.  If you are going to be a journalist of sorts on the public stage, then act like a professional.  It is a public trust.

 

 

 

We have “paused” the democratic ideal of thoughtfully listening to others.  We aren’t doing a good job weighing the viewpoints of others, and striving to achieve a collective, informed response and thoughtful viewpoints. Instead, the quick opinion, shot from the hip, seasoned with sarcasm and hostility, dominates. Public conversations have turned into shouting matches.  Snarky slogans and nasty put downs of others fill our screens and public interactions.  We often forget that “conversation” means a respectful interplay and heartfelt communication.

 

Our freedoms of speech and expression are precious and should be cherished.  And with freedom comes responsibility.

 

 

7/17/2020

Making Our Communities Age Friendly


Neal Lemery

Published in the Tillamook County Pioneer

12/17/2019

 

 

Making Our Communities Age Friendly

 

In ten years, our population of seniors 75 years and older will double. Yet, only 1% of our housing has the amenities that will allow seniors to stay in their own homes.

 

How do we make our housing and our communities more friendly to our aging population?

 

That was a question at the recent Building Our Communities for All Ages conference sponsored by the American Association of Retired Persons (AARP) in Portland.  Over 200 people, mostly community volunteers and professionals, gathered to hear success stories and challenges from experts dedicated to improving the quality of life for our communities and seniors.

 

We need age-friendly housing and neighborhoods, topics which are especially challenging in rural Oregon, where funds for public improvements, housing, retirement living, and transportation are hard to come by.

 

We want to encourage people to grow old in their homes.  It is less costly, more efficient, and prolongs both length of life and quality of life.  Yet, 50% of seniors spend more than 30% of their income on housing. 80% of rural senior Oregonians own their own home, yet 40% of houses need major modifications for aging population, and only 1% of housing is fully equipped to allow aging seniors to safely remain in their homes.

 

80% of Oregon seniors own their own homes, but are increasingly “house rich, cash poor”, as rising property values increase property taxes and other costs also grow, while incomes remain limited.

 

“You cannot do anything alone.  It’s about collaboration.  Sometimes it requires compromise,” Portland Mayor Ted Wheeler told the conference.  “Young people thrive when they have an older adult who cares about them and engages with them – making connections.”

 

“70% of the reasons for a long, healthy life are products of social engagement and activities.  The other 30% are related to genetics and quality of health care,” urban activist Gil Penalosa said.

 

“It’s not retirement, it’s re-hirement,” he said. “People are living longer, and need to be engaged in their community in order to live healthier, longer lives.”

 

His worldwide planning group takes a radical view of making public space people friendly. He brings in art, pedestrian-friendly spaces, and a revitalized sense of community to places all over the world. His message is simple: start small with inexpensive changes that allow people to mingle, and develop relationships with each other.  His premise is “8-80”, creating public spaces for both the eight year old and the 80 year old.  (https://880cities.org. )

 

A healthy community requires eight dynamic factors: housing, transportation, parks and public spaces, health and community service, respect and inclusion, social participation, and communication and information.

 

Aside from the structural needs of housing, healthy social interactions and opportunities for physical activity are critical.

 

“Loneliness is just as lethal as smoking five cigarettes a day,”  Sharon Meieran, Multnomah County Commissioner, said.

 

A decline in our physical activity also increases our risk for diabetes.  25 years ago, 9% of Oregonians were obese. Today, that rate is 29%.  By building sidewalks and improving parks and other pedestrian friendly facilities in our community, we improve our health and our ability to remain in our homes.

 

Rural Oregonians have additional challenges.  A majority of us are sixty miles or more away from health care, and live more than ten miles from a full-service grocery store.  Public transportation is limited, and many people require door to door bus service.

 

More information on the conference and Oregon’s responses is available at https://states.aarp.org/oregon/gov-brown-to-kick-off-age-friendly-summit

 

 

Opioid Summer Energizes Community Response


 

 

 

by Neal Lemery

(Published by Tillamook County Pioneer on 10/20/2019

“Tillamook County is Number One!”

Who doesn’t like to hear that statement about one’s community?  There’s that sense of pride, and a feeling of accomplishment. Time for some applause and even a cheer, except when you are at a conference of about 200 medical professionals and drug treatment experts, and the topic is the national opioid addiction crisis.

Tillamook County is the worst, with the highest death rate in a state that has the fourth highest overdose rate. While we Oregonians are proud of our innovation and progressive thinking, leading the nation on many challenging issues, Oregon is dead last, at the very bottom, #50, in the availability of drug treatment.

This 2019 Opioid and Substance Abuse Summit in Seaside on October 14 is the fourth annual gathering of regional health care providers, and others involved in and concerned about our substance abuse crisis. Organized by the Columbia-Pacific coordinated care organization, the Summit marshalls resources and educates the community on how to respond to the deepening opioid addiction crisis that is ransacking our communities. Columbia Pacific coordinates health care under the Oregon Health Plan and the Affordable Care Act for Tillamook, Clatsop and Columbia counties, and is part of Care Oregon, a non-profit organization focused on health care services.

“It has been a tremendous honor to host these community opioid and substance use disorder summits over the past four years. We have seen such amazing work happening within the region, in terms of expansion of access to medication to treat substance use disorder at TCCHC and Rinehart clinics, drug take back boxes at some pharmacies, improved opioid prescribing, and the start of needle exchange and harm reduction programs in Clatsop and Columbia Counties. We have more work to do to address overdose deaths and improve lives of those suffering with substance use disorder, but events like this can be a space to re-ignite the fire and passion in coming together to continue to make things better.”

—Safina Koreishi MD MPH, Medical Director, Columbia Pacific CCO

 

The Oregon coast is on the front lines, with drug usage, resulting death rates, and low levels of treatment services at the top of public health statistics.

In Oregon, one to two people a day die from drug overdoses.  Five people die from the effects of alcohol every day.  That’s over 2100 Oregonians a year.   Oregon has the fourth highest drug addiction rate in the nation. And, in neighboring Clatsop County, 40% of teens vape tobacco or pot, compared to the statewide usage rate of 16%. The Oregon coast leads the state in sales of alcohol per capita.

The costs of drug addiction is staggering. The collective emotional pain is inconceivable. The economic cost to Oregon in terms of loss of earning capacity and economic value is $5.8 Billion a year.  That’s Billion with a B.

There was other dismal, alarming news.  Yet, the room was alive with energy, enthusiasm to respond, and a strong desire to meet the needs of our families, friends, and neighbors.

“We can do this, and we are taking this epidemic on,” was a frequent statement.

Doctors, counselors, emergency responders, and other community professionals took the stage to discuss new medications, response protocols, and a variety of treatment regimens — programs that are up and running in rural communities, including our county, number one in drug deaths.  Lively discussions were had on the interrelated high rates of intimate partner violence, suicide, illiteracy, and people underserved by the health care system. The crisis is complex and multi-dimensional, and touches all of our lives.

In the background was the disappointing recent news that Oregon Governor Kate Brown has ordered state government to delay implementation of the legislatively mandated strategic plan for a recovery-oriented system of care.  The plan was developed by a large and diverse team of treatment professionals using best practices and current medical science.

We had frank, direct, and often deeply disturbing discussions, often with personal and family stories of addiction, despair, hopelessness, and, ultimately, with awareness of the anxiety and loneliness which fuels the drug use. There can be redemption, there is hope, and there is a growing diverse and empowered recovery community.

Drug and mental health courts and outpatient and residential treatment facilities in rural communities are opening. Peer coaching, 12 step programs, and health insurance plans willing to fund many forms of treatment are springing up. First responders and concerned citizens are arming themselves with the opioid antidote Naloxone, which can take the form of a nasal spray safely administered by a lay person and available without prescription.  The drug neutralizes the drug causing an overdose and saves people from certain death. Other drugs now becoming available tackle the wide range of addictive symptoms and conditions.

“There is hope,” one physician said, “and there also needs to be compassion, understanding, and awareness that addiction is a medical problem, not a character flaw. This is a crisis of culture and education.”

Effective response to this epidemic involves trauma-informed care, focusing on a person’s response to trauma experienced throughout life. Adverse childhood experiences (ACEs) cause the brain and the body to retain trauma throughout our bodies; the trauma response paralyzes our coping mechanisms, and shuts down healthy and healing responses. The more trauma we experience, the less the mind and body are able to deal with and enjoy life.

We self-medicate, trying to ease the anxiety, the pain, and the emptiness we have experienced.  Advertising and social expectations point us in the direction of drugs. Tobacco, alcohol, and opioids are the most poisonous, the most deadly substances we use, yet they are our legal drugs and the most highly marketed and available drugs.

The real “gateway drugs” are freely available at the neighborhood store and where we gather to “relax and have a good time”.

Drugs and alcohol affect the brain’s neural receptors for levels for dopamine, a pleasure inducing chemical the brain releases. Trauma inhibits the body’s ability to feel joy and contentment, and we turn to chemicals in order to reconnect with our natural desire for a sense of well-being and tranquility. Yet, the temporary pain-killing effects of our drugging fades with continuing drug use, moving our desired feelings of joy and contentment even further away from being in our lives and limits our healthy response to dopamine and other endorphins. Drugs are a self-fulfilling prophesy of pain and emptiness despite our desire to heal and feel “normal” again.

Traumatized kids are 46 times more likely to develop substance abuse disorders than kids who have not been traumatized.  Schools now are implementing educational practices and activities that are trauma-informed, approaches that help heal and restore a sense of personal well-being and emotional health.

One physician who shared her story of addiction, chaos, and near death spoke of her first use of heroin as generating a sense of peace and relief she had always sought, but had never achieved. Heroin made her life bearable and the traumas in her life faded away at last. Life became beautiful, until her life spiraled down into deeper chaos.

The tool chest of recovery and health is gaining new tools, yet we are a culture of drug use, instant gratification, and often unattainable expectations of perfection and acceptance. Medically assisted treatment  (MAT) is becoming part of the new standard of care for treatment providers, along with education, peer coaching, and the community gaining understanding that addiction and trauma are interwoven, that addiction is best understood as a medical issue, a condition that can be effectively treated.

Access to treatment remains a critical issue, and is very often a barrier to getting help.  Yet, widespread availability of naloxone, educated emergency responders and health care professionals, and a broader application of medically assisted treatment are making a difference. Trauma-informed responses by the criminal justice system and social services are being implemented.

At the end of the day, after dozens of stories of agony, despair, hope and redemption, there was a spirit of hope in the room.  We are taking on this epidemic, we are finding the tools, and we are able to respond and attack this problem, this epidemic.

We can be number one, not in the number of deaths, but in the availability of remedies, of treatment, and salvation.

 

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