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.

 

—–

Open Mic


 

 

A place of personal courage, testing

Out new ideas, new expressions, a new

Part of ourselves, making our private, secret inner work

Public, part of the community.

 

Giving what is inside ourselves some air, the stage

Intimidating, yet distinctly our own

Space, space to make a statement –

Welcomed by acceptance, community in open arms – a

Declaration of who we are, giving voice

To what has been stewing, churning, fermenting

Inside

Finding its wings, finding its audience

Being heard.

 

This old space, sacred, the past hundred years,

Here others stood here, sharing their souls, over the years,

Voices and music reverberating on old Grange Hall wood, generations past

Giving to the community, making community, building

Relationships, embolding ourselves, our art, our

Creations.

 

I grow, often against my will, on this stage, exposing my private

Self, shyness and private musings somehow

Put on hold.

 

–Neal Lemery, 9/9/2019

Living In A Strong Community


Living in a Strong Community

 

–by Neal Lemery

 

“One of the marvelous things about community is that it enables us to welcome and help people in a way we couldn’t as individuals. When we pool our strength and share the work and responsibility, we can welcome many people, even those in deep distress, and perhaps help them find self-confidence and inner healing.”
― Jean Vanier, Community And Growth

 

I’ve been taking a look at my community, and wondering how we measure up, in these challenging times, when some are wondering if our society is in decline.

 

Here’s a checklist of seven attributes of a healthy community:

  1. Good governance
  2. Walkable, connected, mixed-use character
  3. Parks and gardens
  4. Partnerships
  5. Programming
  6. Neighborhood-responsive schools
  7. Tree culture

–Scott Doyon

 

Being in community is vital to my own mental health and emotional well-being.  Given the continual national stream of tragic events fueled by racism, prejudice, bigotry, and selfishness, I often feel the weight of despair and hopelessness. I am increasingly more sensitive to reaching my limit of how much of that “news cycle” and horror I can be exposed to.

Much of that angst is relieved when I immerse myself in building up my community, and being present with others who are caring, selfless people engaged in taking care of themselves and each other in these turbulent, emotionally exhausting times.

In my town, we are doing it right. I think we get high marks on Scott Doyon’s list of a healthy, engaged community.

In the past three years, the state highway department has funded a major revamping of the traffic pattern (our previously confusing junction of two major highways), narrow downtown streets, and a dilapidated, underused waterfront.

This week, we are celebrating the completion of that project, as well as other efforts by the city and the business community to rejuvenate and invigorate the downtown, making it a welcoming and prosperous town.

Now, we have new sidewalks, a smoother flowing traffic pattern, a town pedestrian plaza, bike paths, a food truck cart center, bike racks, a fresh look in two waterfront parks, and a walkway encouraging people to walk to other parks and attractions.  New bridges span the slough at the north edge of the downtown. New landscaping adds a fresh, inviting look.  The local restaurant scene is vigorous and inviting. Open mics, featuring local musicians and writers, are now the norm.

Downtown merchants have also gotten on board, with renovations, fresh paint, and interesting shops.  We have a number of new downtown events, including a monthly Art Walk, a thriving community art gallery, and a museum which not only showcases local artists, but a continuing schedule of regionally renown speakers and presenters.

 

Community organizations are thriving, and numerous activities are filling up the community calendar with a wide variety of events for every interest. New ideas are being discussed, and plans are underway for even more activities and ways to build a healthier community. We have a “can do” attitude now.

 

Our “Year of Wellness”, a public health collaborative to focus on ways to improve individual and community health, has brought together the entire spectrum of health service agencies, government, and individuals to collaborate on improving public health and a sense of community spirit. We are challenging ourselves to live healthier, more informed lives, and doing it from the ground up.  Grass roots activism at its finest! We’ve decided a year wasn’t long enough for the tasks we identified, and now the work is seen as long term, with increasingly challenging and meaningful goals. Community wellness is now part of our collective experience.

 

The library is spearheading the building of a new downtown park, and library programs are enjoying wide popularity, engaging the community on a variety of experiences and informative activities for all ages.  Public use of the library is setting records.

 

Teachers are developing state of the art educational experiences for students, and we are becoming increasingly well informed about the impact of childhood trauma, domestic violence, hunger, and addiction recovery.

 

The best part of all this is that we have a sense of belonging here.  Each of us is important, and each of us is a valued contributor to the common good, the whole community.  An individual has something unique to offer, and is a valued, unique player in the common effort.  I feel I belong here, and so do all my neighbors.

 

In this town, one person makes the difference, and others listen to their voice, and value their experience, their perspective, and their talents.  And, we have the will power and the courage to take on the difficult, ugly issues that our community, and the nation, has.  Much of the work is hard, and the tasks are daunting at times.  We don’t always achieve 100% success, but we are trying and we see a lot of progress in what we are trying to accomplish. And, that feels really good.

 

In this town, there is hope, and there is a sense of collective purpose. We are committed to be winners, and the changers that create a better world.  Now, we are a town of optimism and determination.

 

Community partnerships are everywhere, knitting together our community fabric in a fresh spirit of resolve and collaboration.  There’s an attitude of “get it done” and pitching in to just do it.

 

As my friends say around town, “Onward!”

 

Renewal


 

 

Before me stood only a few–

Second step up, paint can and brush,

High above the entry way, up where no one would look,

Except we few painters, every generation or two.

 

I am a chosen one, honored to stand in this place, the air still, dusty with time —

adding a new color to the layers of time.

Those who came here before me  —

Their paint splattered fingers on mine, gripping the brush,

whisper bits of history to me in the hot afternoon air.

 

Some sixty years ago, the painter before me dreamed with turquoise,

Covering up the brown of the Depression, and the

Burnt orange of origin, back in 1912.

My turn now, renewal, out of new dreams, an old building.

 

He, too, thought of this place, its stories, as he dipped his brush.

How it came to be, out of the dreams of farmers and loggers.

A place to dance on a Saturday night,

Seeing friends, and sharing a meal,

Simply being together, maybe falling in love,

Building lives.

 

Since then, only spiders and a few flies, and dust,

The still air and silence of the old hall, broken by the rumbling of log trucks,

Milk trucks, and cars on the road nearby —

Daily lives, generations lived, driving by the Grange.

 

The first one, a carpenter, and his helpers —

Farmers, loggers, maybe a store clerk  —

Built this place with calloused hands.

Then the painters, each standing where I am, brush in hand.

Their voices now, in the stillness:

My turn now, to be its steward.

 

Standing on the second step, history in the layers,

I am number five,

Each one writing the same poem,

Hoping I’d show up

With fresh paint.

 

—Neal Lemery, August 6, 2018

 

The Day of the Moon


 

 

Everyone was calling it an eclipse, and this otherwise ordinary Monday turned into a holiday, where all we were expected to do was be present and enjoy looking at the drama in the morning sky above us.

 

Monday — this Middle English word literally means Day of the Moon. So it was indeed Moon’s Day, a perfect day for an eclipse.

 

Through the morning clouds, thinning in the strong summer light, the sun and the moon moved closer, and kissed. They danced to some heavenly song unknown to we Earthlings, and held each other closer. Unseen forces were at play, and the primitive, uncivilized within me grew afraid. The sun was being eaten alive.

 

I’m sure my ancestors thought that heavenly sorcery was afoot, when they stared up at the sky on rare, unpredicted long ago days and watched the gods making love, or eating one another, while the Earth grew oddly cold and dark in the middle of the day, eclipsing.

 

There’s that funny word: Eclipse. In ancient Greek, the word means abandonment. I’m sure the birds in my yard felt abandoned, as they took to the trees at what seemed the untimely end of the day. I felt abandoned, too, maybe even getting a sense of the Apocalypse.

 

Astronomers and the more technical among us would call it an occultation and a syzygy.

 

Syzygy – a word even more fun to say than occultation. It means the alignment of three heavenly bodies.

 

Eclipse. Syzygy.   Neither one fit well into a poem, not even a haiku, or an iambic pentameter rhyme.

 

And, eclipse, what rhymes with that? Like its ancient meaning, I soon abandoned the thought of writing a poem with the word on this Day of the Moon, the day the moon ate the sun for brunch.

 

I looked on, as the clouds thinned, the August sky its traditional blue, the ground warming in a summer’s day. Soon, the dance dimmed the morning light, until it was nearly dark, and an evening chill came up on us. Birds quieted and found their nightfall perch, and the summer breeze died to an almost deathly silence. My watch spoke its usual sun time speak, but then, not following the rules of this Moon Day occultation, this Syzygenarian time.

 

Everything was out of order. The usual reliability of the sun’s methodical walk across the summer sky, a thing I scarcely pay attention to, was seriously out of whack.

 

Indeed, I was truly eclipsed — abandoned.

 

Others in my tribe wanted to gather, to come to this heavenly party with lawn chairs and cold beers, and noisy laughter. I, instead, craved the solitude, the eerie silence, as I peered into the sky, watching this periodic, yet rarely experienced, silent meeting.

 

This time and place, was only reserved for Earthlings, on our little planet, third rock from the sun. We were being eclipsed, finding ourselves in heavenly occultation.

 

It was Syzygy day, an alignment, yet also we were abandoned. World order, even the order of the solar system, was crumbling before my very eyes.

 

High above, the lovers embraced, the moon hiding nearly all of the sun’s light from us, as a false night grew darker. Only the summer’s blue midday sky above, and the sliver of sun told us this was not night, but a rare heavenly embrace. Or was it murder?

 

Light reflected in a bucket of water turned into diamonds, and I snapped a photo. Later on, I looked at the photo, noticing the diamonds on the water were really a cluster of tiny black and white crescents, images of the heavenly dance above.

 

More sorcery, more midmorning magic, this Moon’s Day. Like the neighbor’s dogs, I wanted to bark and howl, hoping that would bring back the sun.

 

On it went, until the moon moved away, inch by celestial inch, until once again, the two orbs moved further apart, teaching us the celestial geometry of spheres, the amazement of heavenly bodies in motion, perspective, and proportion, our dependence on the sun’s seemingly eternal warmth and light.

 

Birds flew, and the ground warmed, summer’s light again appearing, as if this was just a usual day.

 

Humility, insignificance, timelessness, the lessons for this day, the sense of wonderment of things and doings not human. The universe teaching me again, how it can dance.

 

–Neal Lemery 8/26/17

Taking Non Violent Action


“Non Violent Action”. I came across that phrase today, quietly found in an article in the midst of all the news of violence and political dystopia.

 

How do I respond? I speak up, I voice my opinions, I keep informed. People have invited me to march, write letters, sign petitions. But is that really engaging me, really making a difference?

 

I believe I can do more.

 

I try to give back to my community. I may not be able to change the world, but I can change myself, and help others. And when we learn to work together, we change ourselves, our neighborhood, and, eventually, the world.

 

I’m helping to start a non-profit foundation to improve local parks. Working with others, maybe we will build a trail, help someone to experience nature, find some inner peace, connect with the world.

 

I’m helping to set up an art gallery to support local artists and bring art to the heart of my town. We are teaching art to kids, and planning a mural to brighten the downtown. I need to make art, too. Creating is part of me, and essential to a balanced, healthy life.

 

I’m helping other master gardeners in a variety of community projects, teaching each other and others about gardening and scientific inquiry and curiosity.

 

I play in a community band. We help each other be better musicians, and we’re playing at a cancer charity event this summer. Every week, we play and laugh and build a better community.

 

There’s a groundswell of community engagement going on. People volunteering, initiating projects and events, and helping others better their lives. They cheer me on and I cheer them on. Together, we are moving ahead and taking non violent action to change the world, one person at a time.

 

 

 

Neal Lemery 6/5/2017

Building Community


Building Community

Takes time.

Time for coffee with a friend, time to say hi on the street,

Time in the grocery store to ask how someone is doing,

Time to listen, and have that five minute conversation, and

Not worry about the to do list, the errands yet to be run.

 

Building community

Is giving someone else the credit, get the award,

Have the idea you had become theirs,

Letting someone work through the process and stumble

When you could do it twice as fast, knowing that they are learning

And will be proud of their accomplishment when the work is done, and to

Know we will all be better off because of that.

 

Building community

Is teaching skills and quietly providing tools

Helping someone grow in confidence and pride

While you stand back, and just coach, mentor, applaud,

Brag about them to others about how they are growing.

 

Building community

Is letting the gossip stop with you, not passing it on,

Not finding something to criticize, or mock, or disparage

And instead, to praise, to applaud, to find the good in something,

And let the flowers bloom in someone else’s yard,

To quietly weed when no one else is looking, and let someone else

Take all the credit.

After all, don’t we just want the flowers to bloom?

 

Building community

Is to keep smiling, to praise, to recognize the good in someone,

To remind yourself that you haven’t walked that mile in someone else’s

Shoes, that you don’t really know all of their story,

And that we are all on a journey

Together.

 

–Neal Lemery 5/16/2017