Imagine you’re volunteering at the Preble Street soup kitchen in Portland because it’s the holidays and you’re a good person and this is what good people do this time of year.
Across the table from you sits a homeless woman. She’s addicted to opioids, and it being the holidays and all, she has what those in social services call a “moment of clarity.”
“I’m ready,” she says, more of a plea than an observation. “I need help.”
Now what?
In a perfect world, as Preble Street Executive Director Mark Swann noted last week, a social worker would “jump on that,” recognize the opportunity for what it is and immediately steer that person toward recovery and, fingers crossed, a better life.
But Maine, for all the talking we do about opioid addiction, is far from a perfect world.
“Instead – we don’t use these words – but we’re kind of saying ‘Don’t get your hopes up,’ ” Swann said. “Which is the worst thing in the world to tell somebody” seeking help, he noted.
On Thursday in Augusta, the leaders of the Maine Legislature will sit down to hear appeals on bills that were proposed by lawmakers earlier this fall but were turned down for the upcoming legislative session, when only “emergencies” are supposed to find their way into the hopper.
One, sponsored by Rep. Drew Gattine, D-Westbrook, is titled “An Act to Save Lives and Create the Homeless Opioid User Service Engagement Pilot Project.” When it last came before the Legislative Council in October, the measure failed on a partisan 5-5 tie – meaning all of the Democrats on the panel deemed it worthy of consideration as emergency legislation, while none of the Republicans did.
That needs to change. Lives depend on it.
In the first 38 years of its 42-year existence, drug overdoses were unheard of at Preble Street, Portland’s safety net for those in need of food and shelter and a variety of other supports that help the downtrodden stay on their feet.
“Not one. It just never happened,” said Swann, who’s been there since the beginning.
That changed with the first on-site overdose four years ago. It was an “earth-shattering event,” Swann recalled, but it was only the beginning.
“Within a year, we had a couple more,” he said. “Two years ago, it was every three months. Last year, it was every two weeks. And this year, we’re reversing an overdose once every eight days.”
Like everyone at Preble Street, Swann carries a dose of Narcan – the life-saving antidote to opioid overdose – everywhere he goes. In the past two years, the staff and first responders have successfully revived 70 overdose victims at Preble Street. They’ve lost just one.
Gattine’s bill would establish two pilot programs – one rural, the other urban – aimed specifically at connecting Maine’s homeless population with the help so critical to getting off opioids. And, perhaps more daunting, staying off them amid the challenges of their daily lives.
He envisions a collaboration of existing organizations – Preble Street, Maine Behavioral Healthcare, Maine Medical Center, to name but a few – creating a network called Homeless Opioid User Service Engagement, or H.O.U.S.E. It would provide homeless addicts quick access to detox, medication- assisted treatment, stable housing and ongoing case management.
“It’s hard for me to speak about why people would ever vote no on something like this,” said Gattine. “We keep talking about this as if it’s a crisis. But we don’t really act as if it’s a crisis.”
Hear, hear! For all the hand-wringing that went on in Augusta during the last legislative session over the alarming fact that Maine now logs more than one death per day from drug overdose, precious little has happened to end the madness.
Sure, yet another task force is scheduled to report out its findings on Tuesday. And while the Legislature last spring did fund a statewide network of Opioid Health Homes for those who struggle with addiction but lack insurance, many fear that model will fail to specifically address the acute needs of the homeless.
“This is a public health emergency and you can task force and meeting it to death, on and on and on,” said Swann. “And next year, will we have overdoses twice a week instead of once every eight days? Are we going to have more people actually die in our building?”
Bill Burns, Preble Street’s health services director, knows the drill inside out.
When an overdose occurs – often in the bathrooms, where the bottom 8 inches of the doors have been cut off so staff can see if someone has collapsed inside – a “Code Blue” is sounded.
“Somebody’s going to be with the person who overdosed, someone’s on the phone with Medcu, someone’s out front waiting for Medcu to arrive to bring them in,” Burns said. “Probably a couple of people are doing crowd control, some people are bringing people downstairs to use the bathroom because that whole area has been closed off … .”
Maybe, if you’re one of the 6,000 or so good souls who have volunteered at Preble Street this year, you’ve had the displeasure of watching all that unfold.
Or maybe, when you’ve worked a shift at the soup kitchen or, as dozens did last week on the day before Thanksgiving, stood in a human chain ferrying donated food into the cavernous pantry, you had no idea that you’re volunteering, literally, at death’s door.
Either way, it’s no longer enough just to donate to Preble Street or spend a few hours there each holiday season wishing Maine’s homeless all the best.
If you truly care, it’s time to call your legislators and demand they stop talking about this opioid scourge and start doing something about it.
Remind them that a just society is judged by how it treats its most vulnerable.
And if that doesn’t work, tell them that for every dollar we spend on intervention and medication-assisted treatment, we save $3.54 in the cleanup costs incurred when a cry for help goes unheeded and another lifeless body hits the floor.
Call them. If ever there was an emergency worthy of lawmakers’ attention, this is it.
“At least give us our day at the Legislature,” Swann said. “We are looking for turkeys, but much more importantly, here’s something people can do besides dropping a turkey off or some cranberry sauce.”
It’s called social justice. It goes great with charity.
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