By JULIE MINDA
West Virginia has the nation's highest age-adjusted rate of drug overdose deaths involving opioids — its rate is three times higher than that of a statistically standard U.S. generally. And the city of Huntington has been described by politicians, media outlets and others as the epicenter of the nation's opioid epidemic.
Huntington, West Virginia, police officer Dakota Dishman searches the belongings of a woman who was suspected of acting under the influence of heroin in April 2017 in Huntington. Huntington has been described as the epicenter of the opioid crisis. On Aug. 15, 2016, over a six-hour period, 28 people there overdosed on heroin laced with fentanyl, a synthetic opioid. Brendan Smialowski/AFP via Getty Images
"It's everywhere here — the situation knows no bounds," says Rev. Greg Creasy, director of the department of spiritual care and mission at Huntington's St. Mary's Medical Center. He says the crisis has devastated the community.
A steep escalation of opioid use documented around 2014 and an alarming rash of 26 opioid-related overdoses and two deaths one day in August 2016 spurred the community to action. The mayor's office has put in place new treatment and recovery, drug prevention, law enforcement and drug control policies. And, the 393-bed St. Mary's joined with other hospitals, health systems and health agencies to, in October 2018, open a "one-stop" treatment facility called the Provider Response Organization for Addiction Care & Treatment, or PROACT.
The hospital's spiritual care department too has upped its response to the opioid crisis, creating education programs for staff and community, devoting a chaplain full-time to aiding people with substance abuse disorder, launching a support group for loved ones and working to combat what Rev. Creasy says has been a lingering and pronounced stigma around opioid abuse.
As St. Mary's and the community have been navigating their response to the drug crisis, the spiritual care department has continually advocated to ensure spiritual care is at the heart of the hospital's response. People abusing opioids "are individuals with a spiritual nature in them, and we must connect with that," Rev. Creasy says.
The spirit moves
Prior to PROACT's opening, St. Mary's spiritual care department's outreach around opioid abuse included assigning spiritual care staff members to Cabell-Huntington Health Department's needle exchange site, where people using heroin and other injectable street drugs can trade used syringes for sterile replacements, without fear of arrest. That harm reduction program is open five days a week, and the spiritual care team members are present for two, four-hour shifts each week. Rev. Creasy says providing a reliable, nonjudgmental presence at the needle exchange site has smoothed the way for some of the exchange's clients to seek spiritual care and drug treatment through St. Mary's.
Members of the spiritual care and mission team at St. Mary's Medical Center in Huntington, West Virginia, hold a department meeting. The team has made it a priority to address spiritual needs related to opioid dependence. Rev. Greg Creasy, the team's director, is at the head of the table.
Mike Brady/St. Mary's Medical Center
He adds the spiritual care department — which includes five full-time chaplains, six per-diem associate chaplains and five full-time chaplain residents — wanted to do more. So, around the time of PROACT's launch, spiritual care staff studied up on the opioid issue and networked with local organizations involved in the community response, clergy and other St. Mary's responders to better understand the landscape.
They developed and have been implementing a plan for a strong spiritual component to the response to the opioid epidemic. The hospital:
- Provides a full-time chaplain for PROACT.
- Trained 40 hospital staff, local clergy and other responders to use motivational interviewing and other methods to aid people addicted to opioids.
- Hosts support groups for loved ones of people with substance abuse disorders.
- Has self-care programming for hospital staff and frontline responders worn down by the number of patients with substance abuse disorder and the unrelenting nature of addiction. Caring for these patients over the long term can be stressful.
- Has a debriefing protocol to aid hospital staff following the death of a patient from an opioid-related cause.
Getting to know you
Rev. Rodney Adkins, the St. Mary's chaplain assigned to PROACT, says the program averages about 86 new clients a month for drug treatment and recovery. As part of an initial intake process, a therapist screens clients for spiritual care needs and refers those interested in spiritual care to Rev. Adkins. The chaplain says he also spends a great deal of time mingling in PROACT's common areas, introducing himself to clients, building familiarity and relationships with them and establishing trust.
Rev. Adkins says newcomers are often afraid he'll proselytize, but they quickly learn that is not his style. Most of his client base results from informal one-on-one interactions with PROACT clients.
PROACT clients interested in receiving spiritual care at the center have a formal meeting with Rev. Adkins where he asks questions and uses active listening to learn about their spirituality, spiritual path, sense of purpose and meaning, their faith tradition, and beliefs and practices. In ensuing one-on-one appointments, Rev. Adkins delves more deeply into the clients' spiritual lives, moving at their pace, helping men and women think through spiritual goals and supporting them in pursuing those goals as part of their recovery.
In December, Rev. Adkins introduced himself to 79 clients in PROACT common areas, conducted assessments with 12 clients and had substantive follow-up conversations on spiritual topics with 41 people.
Rev. Adkins says a common theme with people who are substance dependent is that they have experienced "pain, trauma, abandonment, spiritual issues and mental health issues." That's why a spiritual approach can be so vital to getting at the root of drug addiction.
Paraphernalia for smoking and injecting drugs found during a police search in April 2017 in Huntington is arrayed on the car hood. Brendan Smialowski/AFP via Getty Images
He adds, "As I work with clients regarding where they are and where they want to go spiritually, I often realize they are disconnected from themselves, from others, from the world, and from a higher power." He says this is because substance addiction very commonly involves people becoming increasingly isolated and losing the connections that once were important to them.
A big part of Rev. Adkins' role is to help clients reestablish important relationships or build substantive new ones. He may refer a client interested in reviving a lapsed faith or religion to a church or member of the clergy he knows will be supportive.
Rev. Adkins counsels and walks with clients who feel hopeless and daunted at the prospect of rebuilding their lives. He says, "I try to be a loving presence. I encourage them and help them see they're valuable and important."
He says he is deeply gratified when clients tell him they are feeling more peace, and more hope, and more grounded in their recovery.
Child of God
Rev. Creasy says research shows that spiritual care has a positive impact on the success of drug abuse treatment. He sees the results of the spiritual care department's outreach in the increasing number of St. Mary's patients and PROACT clients doing the work in recovery programs to regain their lives and become productive members of society.
The individuals touched by St. Mary's efforts have expressed how much it has meant to them to be treated as valued human beings. Rev. Creasy says, "No matter what is going on with them, we treat them with respect and dignity because they are a child of God. We treat everyone with the same loving care as Christ would, and that is what fuels our work."
See previous coverage in CHW: St. Mary's marshals community response on front line of the opioid epidemic
Research indicates spirituality may help promote recovery from addiction
Austine Duru, vice president of mission for Mercy Health of Youngstown, Ohio, wrote a research review on the topic of spiritual care's impact on opioid addiction, in the May -June 2018 issue of Vision. That is a publication of the National Association of Catholic Chaplains. Duru wrote that the few research articles available show that spirituality practices can have a favorable impact on addiction recovery. Duru was SSM Health mission director when he wrote the piece.
He cited a 2016 research survey in the Journal of Clinical Psychiatry that queried 50 people in a residential substance abuse treatment program about their views on spirituality and their recovery. Ninety percent of respondents said they believe in the value of spirituality, and 81%percent were able to articulate how their spirituality helped them in their recovery. Ninety-four percent of respondents said they wanted a spiritual focus in their treatment program.
Duru also cited a 2012 study in the Journal of Religion and Health that examined the relationship between religious coping, opioid use and participation in a 12-step addiction recovery program. The survey of 45 people with substance-dependent disorder receiving opioid-detoxification services found that those people who used positive religious coping were more likely to attend 12-step program meetings and attended the meetings more frequently than those who did not have positive religious coping practices.
Duru also reported on a 2010 study in the journal Substance Use & Misuse based on qualitative and quantitative surveying of 25 people in methadone outpatient treatment. The researchers' analysis suggests, wrote Duru, that spirituality and religious practices can help with recovery from active addiction. Most respondents supported having a voluntary spiritual program offered to them for substance abuse treatment.
Duru wrote that these and other studies suggest that spirituality interventions in substance abuse treatment can help to reduce illicit drug use and promote attendance in program meetings — a strong predictor of long-term success in addiction recovery.
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