Mind & Body

Recovery community flexes its newfound political voice

Four Democratic candidates offer a revealing, candid dialogue; two Republicans are no-shows

Courtesy of RICares

From left: Providence Mayor Angel Taveras, Clay Pell, James Gillen from the Anchor Recovery Community Center, Todd Giroux, and Treasurer Gina Raimondo applaud the audience at the RICares forum on Aug. 22. Neither Ken Block or Cranston Mayor Allan Fung chose to attend.

Courtesy of RICares.

The RICares gubernatorial forum on Aug. 22 drew a capacity crowd of more than 150 people.

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By Richard Asinof
Posted 8/25/14
The undertow of addiction and the push for recovery offers up a compelling metaphor for the current state of affairs in Rhode Island in 2014. It touches everyone and everything. The gubernatorial candidate’s dialogue at the RICares forum on Aug. 22 was deeply personal – in a way that candidates rarely allow themselves be vulnerable – sharing their own life stories, with amazing candor, just two weeks before the primary election. Because the news media chose not to cover the forum, the comprehensive coverage provided by ConvergenceRI allows Rhode Islanders to share in the conversation.
If incarcerating someone for a drug offense is 10 times more expensive than recovery treatment, is that a good use of scarce resources? Will any member of the news media actually ask a question to candidates about addiction and recovery in Rhode Island, starting with the debate on Tuesday night? Here’s a suggestion: What will you do as governor to push for recovery coaches at Rhode Island’s hospitals, given that there is only one such program in place now, at Kent Hospital? Which candidates will pledge to hire a person in recovery as part of his cabinet or staff? What kind of resources will the candidates pledge for mental and behavioral health – and treatment and recovery programs? Will they give a specific number?
The forum at Anchor Community Recovery Center marked Tom Coderre’s last night in Rhode Island before he left to take his new job in Washington, D.C. Coderre, who served as chief of staff for R.I. Senate President M. Teresa Paiva Weed, has been very much the success story of the recovery community in Rhode Island.
As he posted on Facebook after the event, the forum “was an amazing way to spend my last night in Rhode Island before I head to Washington to start my new job.”
He wrote: “Wow, all four Democratic candidates for Governor showed up at tonight’s forum hosted by Rhode Island Communities for Addiction Recovery Efforts. The overdose epidemic in our state was front and center in the questions and answers. Unfortunate that we didn't hear from Ken Block or Allan Fung.”
Coderre continued: “It was, however, nice to see the recovery community being recognized as a constituency of consequence during this year’s election in Rhode Island. Now, don't forget to go out and vote on primary day, Sept. 9.”

PAWTUCKET – Perhaps the most revealing and intriguing political forum in this year’s race for governor occurred on Friday evening, Aug. 22, at the Anchor Community Recovery Center, before a crowd of about 150 people.

More than a debate between candidates, it was much like a revival meeting between rival pastors, offering up competing views about how best to lead the Rhode Island flock. In response to answers – and even follow-up questions – the audience clapped and applauded, engaging in a supportive call-and-response with the candidates.

It was also a deeply personal dialogue – in a way that candidates rarely allow themselves be vulnerable – sharing their own life stories, with amazing candor, just two weeks before the primary election.

The undertow of addiction and the push for recovery offers up a compelling metaphor for the current state of affairs in Rhode Island in 2014.

That push-and-pull seems to touch everyone and everything; it connects the dots to all the hot-button political challenges, often translated into the political haiku of taxes and jobs, education, health care and economic recovery.

Dive deeper and you discover the debilitating reefs built by years of political inaction and indifference – and the terrible cost in the loss of human life and potential. The emerging recovery community is perhaps the true comeback story in Rhode Island.

The four democratic candidates – Providence Mayor Angel Taveras, R.I. Treasurer Gina Raimondo, Clay Pell and Todd Giroux – displayed different styles of preaching. All were responsive and collegial, even if their gospel was different.

Taveras, in a firm, soft-spoken voice, touted his ability to get things done – and his record of accomplishment.

Pell spoke in an evangelical tone, vowing to listen as he delivered his future policy priority promises.

Giroux, in a humble, often rambling tone, talked more as a neighbor to a neighbor than as a candidate.

Raimondo, with a reassuring tone, delivered her messages with practiced skill of someone used to the podium, seeking to bond emotionally with the audience.

The clear winners were the recovery community in the audience – and the candidates themselves – because of the candor of the conversation.

The losers were the Republican candidates, who didn’t show.

The forum forced the candidates to move beyond 30-second sound bites – a rare moment, with two weeks to go before the primary on Sept. 9, as the candidates and the news media revved up their hype machines in what has become one of Rhode Island’s most expensive gubernatorial campaigns.

But you won’t be able read or hear about it, or see it broadcast – except here in ConvergenceRI – because the news media failed to cover the event.

The no-shows
Neither of the two invited Republican candidates, Cranston Mayor Allan Fung or Ken Block, showed up.

Did they, their campaign managers and pollsters believe that there are no Republicans or Independents in recovery from addiction?

Or, that the recovery community in Rhode Island was not their constituency?

That the epidemic in overdose deaths from substance abuses was not a major public health crisis? Or, that it was not an important policy priority for the next governor to address?

Fung never responded to numerous invitations and follow-ups, according to organizers. Block, who had initially committed to showing up, never appeared. Block also never called to say he wasn’t coming.

News of the candidate’s failure to show – allegedly because Block wasn’t “feeling well” – was relayed by a member of the news media. Block apparently felt well enough to talk with the TV news personality and share his plans, but not with the forum organizers.

Hits and misses
The other big no-show was the Rhode Island news media. Bill Rappleye of NBC10 was supposed to moderate the forum, but he called a half-hour before the start to bail.

Ed Fitzpatrick of The Providence Journal, whom organizers said they had asked to be part of a panel asking follow-up questions, was also a no-show. Fitzpatrick told ConvergenceRI on Monday afternoon that it was the result of a communications glitch -he had not understood that he had been asked to be part of a panel.

If he had, Fitzpatrick told ConvergenceRI, he would have rearranged his schedule to be there; he said he would plan to make himself available in the future for any future panels, given his extensive reporting about the issues of recovery and substance abuse, citing 62 stories he had written on the topic.

Fitzpatrick, who said he was on vacation last week, said he hadn't read the follow-up e-mail from RICares, sent to him on Aug. 19, three days before the forum, which detailed his role in the forum.

However, Fitzpatrick is scheduled to ask questions at a televised debate with the gubernatorial candidates on WPRI on Tuesday, Aug. 26. He told ConvergenceRI he would consider asking questions about health care, substance abuse and recovery at that time.

No TV – no WPRI Channel 12, no WJAR NBC10, no WLNE Channel 6, no Rhode Island PBS. No radio – no WPRO, no Rhode Island Public Radio, no Latino Radio. No Associated Press.

Only one print reporter was there – Randall Edgar from The Providence Journal – but he was there to cover a candidate for a profile, not to cover the forum. No Providence Phoenix. No Pawtucket Times. No Valley Breeze. No Providence Business News. No GoLocal. [It is a learning curve for RICares; next time the news media may be more responsive.]

Perhaps it’s not news – unless there’s a dead body
Given the number of people who have died since Jan. 1, 2014, as a result of accidental drug overdoses – 127 and counting – and the number of doses of Narcan administered by emergency providers – more than 930 to revive overdoses, one would think that what the candidates running for governor had to say about this public health crisis in Rhode Island would be important enough to cover, say, as the food industry sector or the hospitality sector forums were.

For sure, on the day for the forum, there was no lack of news making headlines [mostly from news releases] about substance abuse and addiction. There were stories published and tweeted about CVS’s decision to make Narcan available at its pharmacies in Rhode Island without a prescription – a positive move, even if it's a year after Walgreens had taken that same step.

There were also stories published and tweeted about how the U.S. Food and Drug Administration had published new regulations regarding prescription opioids, moving many of them from Schedule 3 into Schedule 2 and tightening the amount of pills that could be prescribed.

And, there stories published and tweeted about the R.I. Department of Health’s decision to be the first state in the nation to make data from its Prescription Monitoring Program available to the public on its website. The data showed that the amount and volume of prescribed opioids in Rhode Island is not decreasing.

As reported in ConvergenceRI, the data also showed that an increasing number of Rhode Islanders are “doctor shopping” – going to multiple providers and multiple pharamacies to obtain prescription opioids that they do not need. And, that only 25 percent of physicians are currently participating in the Prescription Monitoring Program. [See link to ConvergenceRI story below.]

Given the lack of coverage, what follows is an in-depth – and somewhat lengthy – reporting on what the candidates had to say at the Aug. 22 forum. The value is in sharing the conversation. Who knows? Maybe it will result in Ted Nesi, Ed Fitzpatrick or Tim White actually asking a cogent question about the high cost of health care, the lack of resources for behavioral and mental health, and the crisis in substance abuse, addiction and recovery at Tuesday night’s debate.

Blow-by-blow account
James Gillen, manager of the Anchor Recovery Community Center, opened the evening, addressing the audience, many of whom wore a sticker that said; “I’m in recovery and I vote.”

“We vote,” he said. “We’ve become a constituency of consequence, as more and more people have had the right to vote restored. It’s like being a kid at Christmas all over again, and people are excited.

“They know the issues; they are not afraid to speak up and say how they feel. We vote,” he said, again.

“I’m a person in long-term recovery, which for me means I haven’t used alcohol and drugs, I’ve been managing my condition of addiction, since 1998.

“And, as a result, my life has gotten a whole lot better. Recovery is a reality, and ladies and gentlemen, recovery will save the state money, a lot of money.”

Garry Bliss, communications director at The Providence Center, served as moderator, following Jim Gillen. He said: “There are hard acts to follow and there are impossible acts to follow.”

In their opening statements, the candidates were asked to share the ways in which their own lives have been touched or influenced by the disease of addiction, setting the tone for the conversation.

Mayor Angel Taveras
Taveras, who has often talked about his mother and her courage as a single mother raising a family, talked about his father. “My dad was someone who drank a lot of alcohol,” he said. “He was a happy drinker; he was functional; I was fortunate.”

Today, Taveras continued, his father is a born-again Christian who has left alcohol behind. But the memories are still strong, he continued. “I can still smell the alcohol and remember the conversations.”

That experience, Taveras said, “is probably one of the biggest reasons why I don’t drink alcohol. It’s because it’s not something I want to do.”

“I have a number of people who are very close to me who are in recovery,” he continued. “They really have been able to change their lives because of recovery. I also understand that recovery is a life-long process. It’s day by day.”

Taveras continued: “I have also knowingly hired people who are in recovery. So, I have not just talked about it, I have done something about it.”

The first step, Taveras said, “is having the knowledge and understanding. When you have that personal connection, it helps you see the issue in a very different way. That should give you a sense of where I come from and the what kind of Governor I will be.”

Clay Pell
Clay Pell began by thanking everyone in the audience for their courage. “I have known a number of people who struggled with substance abuse and sometimes the related disease of mental illness.” What he learned, Pell continued, “is how scary it is to struggle, to fight alone.”

“I think having everyone here together is a really important statement about how we need to combine the issues of addiction and substance abuse with mental illness in a more comprehensive way, in a way where people don’t have to be alone,” he said.

Pell continued, stressing the importance of people to speak and be heard. “The very first step is having access to community-based health care,” he said. “In this little state of ours, the smallest state in the country, we might be able to come together as a community and be a voice for those who are often not heard.”

Todd Giroux
Giroux began by saying he, too, was familiar, with having an alcoholic parent. “I grew up knowing what the sound of a beer can opening would mean. It was my mom, and my family was strong enough to see that through.”

He continued: “I can also say I had a cousin, her name was Christine, she was an IV drug user, and she died of AIDS, in the early 1990s, in the early wave of that disease.”

Giroux said that a number of personal friends had also struggled with addiction, some successful, some not. “I’ve been in construction for 25 years,” he said. “We’re often the first to hire people in different phases of their life.”

Being a leader means being tough, but also being a friend, being able to say: “You’re fired today, and rehired tomorrow.”

Giroux continued, saying that Rhode Island was in dark place. “Rhode Island needs a recovery, and I’m that working class guy that understands the problems of Rhode Islanders.”

Treasurer Gina Raimondo
Over the years, Raimondo began, “I have had friends who have struggled with addiction, but one experience that has stuck with me the most is when I was a law student,” talking about her legal representation of a client who was a single mom who struggled with addiction.

“She struggled mightily with addiction,” Raimondo said. “More than being her lawyer, I became kind of a case manager and friend.”

Raimondo explained that her experience – “when I was a kid, before I had my own children” – had influenced her. “Now that I am a mother, I have so much respect for her, because as a single mom, you desperately want to get your life back together, you desperately want to do the right thing for you kids.”

What she learned, Raimondo continued, was that it was a privilege to be able to help her client out.

“I will take to the Governor’s office my belief that we need to prioritize treatment over punishment.”

Responses to questions
The moderator Garry Bliss posed questions that had been given to the candidates in advance. They also responded to follow-up questions from ConvergenceRI, drilling deeper for more complete answers. In addition, three questions were asked from those submitted by the audience.

The first question posed to the four candidates was why Rhode Island had seen such an alarming rise in overdose deaths in 2014 and what they would do as governor to address this crisis.

Raimondo
It’s a good question and I’m not sure I have all the answers. One of the things I would like to do is to engage with this community; you’re the ones who are dealing with it, day in and day out, and you need to be part of the discussion.

What Raimondo thought was going on was that the drugs available were a lot more powerful, and people weren’t aware how strong the drugs were.

The good news, she continued, “is that doctors are cutting down on prescriptions for pain killers. The bad news is that people are going out on the streets to get the drugs, which are a lot more dangerous.”

Raimondo also cited the state’s terrible economy as a cause, given that it has one of the highest unemployment rates in the country, saying it had been particularly bad for the building trades.

To deal with it, she continued, Rhode Island needed to get people back to work – to get “the guys in the building trades back to work for that they can have a more stable life.”

She also suggested that Rhode Island borrow an idea from Vermont, that if you call 911 for an overdose, you would be immune from prosecution – unaware that Rhode Island had already enacted a similar law.

“We need to prioritize treatment,” she concluded.

Giroux
In his response, Giroux rambled a bit, beginning with a story about watching a woman who was dancing in the street in her nightgown, during last year’s art festival in Pawtucket.

“It was as though she was crawling out of her cave, watching civilization for the first time in years,” then moving onto the idea how loneliness was a factor.

“I have seen people turned away from a recovery program because they were not high,” Giroux continued, saying that such behavior was wrong, that if people sought help, they should be given it.

Further, Giroux proposed that everyone who leaves the ACI needed to have a plan how to integrate back into the society.

As for the problem of substance abuse and addiction, he said: “It’s not in our backyard, it’s in our front yard, and we have to face it.”

Pell
The starting point, according to Pell was to face the truth: “Our society and our health care system does not include substance abuse treatment in the continuum of care.”

What we need to do, he continued, is to treat this seriously as any other illness, touting his plan, which he claimed recognized “the incredible acute nature of this need.”

Pell voiced his support for community-based health centers such as The Providence Center. “We need to make sure that when someone is picked up off the streets, maybe they don’t need to go to the ER with the huge costs,” but somewhere where they might get the necessary care, and with much better health outcomes.”

It was unclear if Pell was aware that such a pilot plan has already been enacted by the R.I. General Assembly, but has yet to be fully implemented, for lack of resources.

“We need to bring together the resources that we have in this state to ensure that people have a fair chance, a safe place to go.”

Taveras
Taveras began by talking about what he’d done in Providence and how he would build on that as Governor. He reorganized a city task force on substance abuse, with the focus: “Recovery is prevention and prevention is recovery.”

Providence was the first city police force to be trained to carry Narcan. Taveras also touted the prescription drug take-back program, which had collected more than a ton of prescription drugs.

Taveras also stressed the importance of having a focus on prevention. “We need to make sure that kids don’t start, because if they do, it’s a bigger problem,” he said.

Investing in recovery, Taveras continued, “saves money.”

Drilling down
ConvergenceRI asked the candidates to respond to two questions: With only one recovery coach program in place at an emergency room in Rhode Island, at Kent Hospital, and one yet to be established at Lifespan’s Rhode Island Hospital, how would they use the bully pulpit of Governor to ensure more compliance at other hospitals? And, given new statistics that show there is too much product on the streets, and that many patients in Rhode Island are doctor shopping, how would they address the problems of over-prescribing?

Pell
This is something that extends beyond the borders of Rhode Island; it’s a national problem, Pell said. He pledged to increase drug-monitoring programs. As to recovery coaches, he said: “We should be providing 24/7 access to recovery coaches, by phone or in person.”

Pell continued: “This is about ensuring that we are providing lifetime access to recovery services. We know that this illness doesn’t go away. We need to provide access, just as we would continue to provide care to other diseases, such as cancer, diabetes or heart disease. And, we should expand the number of recovery centers in Rhode Island.”

Giroux
For several years, Giroux said that he had been advocated for unifying the database of services in Rhode Island. “All the community-based services, whether it be for housing, substance abuse, or food services, all these places that offer help to people, should be unified in a computer-based system. Enter the system, and all the services are available to you.”

Giroux continued: “It’s the new minimum. Like the New Deal. I call it the New Minimum.”

“We all expect housing. We all expect health care. We want safe pharmacy drugs.”

To accomplish this, Giroux proposed creating a $25 million health care trust fund for Rhode Island.

Raimondo 
The most important thing that a governor can do, in respect to the bully pulpit, Raimondo said, is to talk about an issue. “Let it be known, this isn’t a bad thing to talk about, it shouldn’t have a stigma. We shouldn’t be ashamed about it. It’s something that has to be dealt with.”

Raimondo claimed that through her efforts on pension reform that she isn’t afraid to use the bully pulpit. “If the governor gets up there and says, we are committed, we’re not going to pretend that we don’t a problem, it will send a loud and clear signal. We can’t bury out heads in the sand and pretend that the problem doesn’t exist.”

The second thing a governor can do is to educate people, Raimondo continued. “There’s a lot of misconceptions about addiction and substance abuse.”

She cited Vermont, where she said it costs about $100 a week for someone to be treated and over a $1,000 a week for someone to go to prison. “Even my 10-year-old can do the math.”

Let’s get people in treatment and not in prison, she continued. “I believe strongly in the bully pulpit and leadership. It will help us make the right policy decisions and budget decisions.”

Taveras 
Part of the reason why there is a prescription drug problem, according to Taveras, was the way that drug companies and pharmacies have been pushing illegal incentives.

Similar to his work in fighting tobacco companies and their efforts to push tobacco products on children, Taveras said the city was considering, as some other cities are now doing, to take up that legal fight.

[The city of Chicago sued five drug makers for $9 million in June, claiming the drug makers promoted broader use of opioids for financial gain. The suit alleged that the companies, “in order to expand the market for opioids and realize blockbuster profits, needed to create a sea-change in medical and public perception that would permit the use of opioids for long periods of time to treat more common aches and pains…”]

“As governor, I am willing to take on that fight,” he said.

In response to how he would use the bully pulpit to deal with a hospital system not providing recovery coaches, Taveras said: “I would bring them in and say, ‘This is something that is very important for us as a state, it is important to you as well, let’s think long-term, not short-term. Let’s make an investment in our priorities, and recovery is part of our priorities. It’s a smart thing to with our money. It saves lives and improves lives.”

And, he added, as governor, he would make sure that Medicaid covers these services as well.

Incarceration vs. treatment
The third question posed to the candidates asked them to address the fact that many of those incarcerated or under community supervision by the Department of Corrections are suffering from untreated on inadequately treated mental illness and addiction. What specific sentencing and corrections reforms will you take as Governor?

Raimondo 
Right after law school, Raimondo said, she clerked for a federal judge, where she saw first hand what she called overly harsh punishments for drug offenders. “I saw this time and time again, sentences that were not fair, because the crime committed involved drug use,” she said.

As governor, she continued: “I would like a robust discussion, which is going to require you to participate, a robust discussion on how we change our sentencing guidelines and the way we sentence people for drug-related offenses.”

She continued: “You don’t know how many mothers I talk to who say: my kid cannot get a job because he had one offense. What are we going to do?

Also, she said: “I want to be the most innovative state in the country around re-entry programs for former incarcerated people.”

As the smallest state in the country, she continued, “we should be the most innovative.”

Raimondo continued: “I would like to embrace something called social impact bonds – where you go out and ask philanthropists to put money into Rhode Island around specific programs to work with former incarcerated people to help them with outcome-based re-entry and getting them jobs.”

Giroux
“What you put in is what you get out, just like a computer,” Giroux began. “I’ve been in courtrooms, I listened to judges tell people: sit down and shut up.”

“I wonder what it’s like for people who have been incarcerated, what kinds of support do they get in that system? What services are available?”

When they enter the system, Giroux continued, “There should be supports in place to make sure that it is the Department of Corrections. Are we living up to the words of that model, corrections?”

He asked: “Are we helping people? Are we reducing recidivism. Is this a commercial business?”

Pell
“We need to make sure we are providing health care, mental health care, substance abuse care to all our populations in the correctional facilities,” Pell began. “I think we need to recognize that we have been a failure in many regards.”

Pell said he recently, as a candidate, had the opportunity to visit the ACI and talk with the staff. “I believe we have to build on the some of the models of success that we have, such as the dry dock that is now in the women’s facility.”

He continued: “We need to have career training and educational opportunities within the correctional facilities, in order to provide people with the opportunity to get the skills so that they can get their lives back together.”

Taveras
As mayor of Providence, Taveras began: “I’ve been very support of re-entry services. I have hired people who are in recovery. You need to give people an opportunity to succeed. But let’s also focus and trying to avoid going to prison in the first place.”

Addiction and recovery, he continued, “Is a life-long process. You’re not cured, so we should recognize that and treat it as such. And recognize that you’re better off in the long-term if you make the investment in treatment and prevention.

[Raimondo left the forum at this point to go to another engagement.]

Beyond playing to an audience
ConvergenceRI asked the candidates, who had been impressive in their answers, how they would take the messages beyond this audience, beyond the recovery community, so it wasn’t just talking to an interested sector, but to the broader electorate. The audience applauded the question.

Giroux
“What we do as candidates is to take all our knowledge and take that with us everywhere we go, watching families play in the park, or attending 100-year-old birthday celebrations. We take these lessons, and we talk to people. That’s what we do. We answer questions about our personal lives, and bringing up memories that refresh. That’s what we take with us, and we don’t forget. That’s how the process happens.

Pell
“Not only substance abuse and addiction, but so many of the substantive issues of this campaign, don’t get talked about, given the way the media covers the race. What we can do, as candidates, is to talk about it, you’re right, not only to interested audiences. I’ve been proud to put out a detailed policy on crime and justice issues, on re-entry issues, and health care.”

Taveras
Pointing to his support for the 2013 Rally4Recovery, Taveras said: “These conversations make the public aware that recovery touches everyone, it’s one degree of separation. A lot of people don’t recognize that. We need realize that everyone has an important role to play in our state.”

The evidence, he continued, “is in what I’ve done and how I’ve done it. We need to support recovery and prevention, prevention and recovery.”

UPDATE: A new program of recovery coaches at the Rhode Island Hospital emergency room, along with training and dispensing of Narcan, will begin on Aug. 29, according to Lifespan spokeswoman Ellen Silngsby.

Comments

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Bill_Gilbert

As candidate for Lt. Governor I attended this forum. To bad I wasn't invited to discuss the issues. With over 20 years in the recovery community, owner and operator of transitional homes and sober houses I am the only candidate with intimate knowledge of the recovery community. Today 8/25/2014 we lost another youngster to an opiate overdose. Until our leaders treat this as the medical and health crisis it is more are certainly perish. West Nile virus gets more attention yet hasn't caused a single death in RI. Bill Gilbert for Lt. Governor. Drug addiction is a medical condition it shouldn't be a crime. I have yet to see someone punished until clean and sober!

Monday, August 25, 2014

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