New Opioid Addiction Issue Brings New Awareness To Old Problem For Hispanics


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Photo credit:
Photo credit:

Bill Sarno
Addiction treatment specialists who have struggled, in some cases, for decades with drug abuse among Connecticut’s urban Latino and African American populations are hoping to “ride the wave” and gain additional support and attention as  mainstream media and politicians respond to the so-called opioid epidemic .
“We have been fighting the good fight, but we desperately need resources,” said Asher DeLerme, executive director of the Chemical Abuses Services Agency Inc., a program that for more than 20 years has provided chemically-supported addiction and behavioral health services to a largely Latino clientele in New Haven and in Bridgeport.
 Substance abuse program directors welcome a shift in the depiction of the addiction scourge beyond racial, criminal, and urban stereotypes to what U.S. Rep. Rosa DeLauro called a “true public health crisis” impacting all communities.
However, those who have been in the trenches fighting drug abuse for years question why it has taken so long for political leaders to recognize the depth of the problem.
“All of a sudden it is an epidemic. It always has been an epidemic in urban areas, in communities of color,” said DeLerme.
The answer, said the  U.S. House Speaker Paul Ryan, is that the increase in drug abuse deaths became an epidemic when it began to cut across all demographics. Much of the increase in overdoses and deaths is in white, middle class communities.
In Connecticut, non-Hispanic whites, who comprise 70 percent of the overall population, have experienced a disproportionate share of the 444 deaths attributed to opioid misuse in 2015. This total is up from 195 in 2012. Still, in terms of percentage increase, Hispanics also have been hard hit with this death toll more than quadrupling in the same period, from 9 to 38.
For those living and working in social and health programs in lower-income minority communities, the opioid problem is not only an old antagonist but also one that has had a personal impact.
State Rep. Chris Rosario of Bridgeport has seen his older brother and uncle “struggle with heroin addiction for the better part of a generation” and even spend time behind bars. “That is why I fight so hard for my constituents. We are all going through the same things,” Rosario said.”We need to tell our story. Our community is suffering,” the freshman legislator said. 
This upsurge of overdoses and deaths from prescription drugs such as oxycodone and morphine as well as heroin, particularly in the white, middle-class population across the nation has generated a slew of opioid-related bills in Congress. However, it remains uncertain whether this concern will translate into significant funding to prevent more deaths, expand treatment programs and help families of addicts.
What is more certain, however, is that the state is unlikely to provide additional resources. Due to the strain of balancing the budget, the legislature and governor have taken away a big chunk of the funding proposed for substance abuse treatment grants. “This is a horrible time for this to happen,” DeLerme said, noting that CASA Inc.’s programs, are dependent on the state and the need for them has not abated.
Now, not only is CASA Inc., especially at its New Haven center, getting more opioid cases but the demographics have changed in the last five years. “There are more patients from the suburbs, from shoreline towns; they are Caucasian and younger,” he said.
CASA Inc., which provides medically supervised methadone, a synthetic opioid, to more than half of its 600 patients, is considered unique in the provider community, DeLerme said, “because its services are designed for the Latino community.” This is especially true, he said, in Bridgeport where the staff is largely bilingual and the program always has been geared to Spanish-speaking residents.
Heroin has been the “street drug” and “the big issue in the Latino and African American communities,” DeLerme said. He added that many of those addicted to legal painkillers like oxycodone and morphine graduate to street heroin because it becomes “much cheaper, illicit, but available.”
Rosario said his uncle has been on “the right path, clean and sober” for nearly four years, but it would only take one bag of heroin to destroy his life again.
One way Rosario is trying to improve lives in Bridgeport is by raising the public’s awareness of the growing opioid problem. He and state Sen. Ed Gomes of Bridgeport are sponsoring a panel discussion 7 to 9 p.m. Tuesday, May 17, at the Southwest Community Health Center on Albion Street in Bridgeport. The setup, Rosario said, is borrowed from Shelton where Rosario works with the police.
In addition to DeLerme, the panel will include other treatment professionals, political leaders such as Mayor Mark Lauretti of Shelton, police narcotics specialists and some recovering addicts.
As a legislator, Rosario has seen the budget process up close and said the decisions that had to be made were difficult and an effort was made to protect those who are most vulnerable, even if this has meant opposing the governor.
Still, the Department of Mental Health and Abuse Service, which had anticipated receiving $22.667,934 for grants allocated to substance abuse services, was cut back to $20,967,047 under the budget agreement between the state and the legislature. 
Dr. Noel Casiano, who directs the Youth Challenge residential recovery program in Hartford, said his nonprofit organization would like to do more, including expanding its facilities, but is stymied because of the financial situation at DMHAS.
“We need more residential treatment” programs and educational efforts, particularly among young people, said Casiano who has been doing more preventative work recently at schools, such as Hartford High School and the Alternative School in Willimantic.
Casiano said that those people coming into Youth Challenges’ residential treatment program are not just from Hartford, but include clients from the suburbs.
Casiano noted that the governor has supported providing state troopers with NARCAN kits, which contain the overdose reversing drug naloxone. While this program has saved lives, more has to be done. When NARCAN is administered, he said, it is “too late” to prevent drug addition.
Getting clear data of how the opioid epidemic is impacting Hispanics is complicated because of inconsistent reporting of Hispanic ethnicity on death certificates, warns the Centers for Disease Control.
CDC statistics for 2014 show the national opioid death rate for Hispanics ticking up slightly to 4 per 100,000 population from 3.8 the previous year. This rate of drug-abuse deaths is one-third of that for white, non-Hispanics and less than the 5.6 rate for black non-Hispanics, two populations that saw significant increases in opioid fatalities in 2014.
In Connecticut, figures provided by the state medical examiner show that the overall total of drug abuse deaths doubled to 723 from 2012 to 2015. There were 81 deaths in Hartford, 47 in New Haven and 37 in Bridgeport, as compared to 7 in Stratford, 5 in Greenwich and 1 in Trumbull.
In Connecticut, the legislature has sent a bill to the governor which calls for increased access to overdose reversal drugs, limiting the prescription of opioids to a seven-day supply and the creation of an Alcohol and Drug Policy Council. Information as to when and if, Malloy will sign this bill was not available.
Meanwhile, there are already institutional changes under way to address the drug addiction problem. The medical community, which has received a big slice of the blame for the opioid epidemic because of the over-prescription of painkillers, has become more understanding and has made it easier for addicts to get referrals into treatment programs, DeLerme said. The criminal justice system also is beginning to recognize the health issues, he added.
In the Latino community, drug addiction still carries some stigma but generations of seeing this problem destroy families and friends has fostered a numbing effect, DeLerme said. What is needed is more of an attitude that this situation is unacceptable and “let’s do something,” he said.
Moreover, DeLerme observed, there needs to be a “real cultural shift,” with all communities taking greater responsibility for the opioid addiction epidemic and recognizing this is an issue that affects everyone.