PROVIDENCE – On Thursday, May 4, more than $3.25 million in new grants were announced, given to 15 nonprofit organizations to address opioid use, treatment, and prevention in Rhode Island, according to a joint news release from the Rhode Island Foundation and the R.I. Executive Office of Health and Human Services.

The largesse of money for the grants comes from the successful legal advocacy by R.I. Attorney General Peter Neronha, who secured more than a quarter-billion dollars [emphasis added] in legal settlements by holding “numerous opioid manufacturers, distributors and consultants …accountable for deceptively peddling highly addictive narcotics to Rhode Islanders,” according to a quote by the Attorney General in the news release.

While the purpose of the money was to use it for “opioid prevention, treatment, and recovery [emphasis added],” there are those in the recovery community who are questioning whether there needs to be a greater emphasis put on “recovery” in the state’s approach.

Indeed, “recovery” was missing from the quotes in the news release attributed to both Gov. Dan McKee, and Acting EOHHS Secretary Ana Novais. The goal of “recovery” was included in the statements by Attorney General Neronha and by Neil Steinberg, outgoing President and CEO of the Rhode Island Foundation. Is there a disconnect?

The question about recovery, however, is more than just a matter of “word choices” or semantics – it gets to the heart of an ongoing conflict about the ineffectiveness of strategies that have been deployed by the state to combat the opioid epidemic – an epidemic that has changed and morphed dramatically in the last decade.

One measure of the problematic ineffectiveness in the state-directed strategies being pursued is the continuing high number of overdose deaths in Rhode Island – 435 in 2021, the highest total ever – and the trending increase in those numbers for 2022. When data is compared from the first two quarters in 2022, overdose deaths increased by 13 percent – to 232 deaths, compared to 205 for the first two quarters in 2021. [Editor’s Note: The data for 2022 is incomplete, pending official confirmation on the cause of death by the state’s medical examiner. The data trends, however, suggest an even higher number of OD deaths in 2022, once all the data is tabulated.]

“The demand for drugs continues to exceed the demand for treatment and prevention services,” wrote Ian Knowles, program manager at RICARES, in a story for ConvergenceRI, about the changing nature of the epidemic. “The sad reality is: It’s far simpler and easier to obtain and use illicit drugs than it is to access treatment for addiction and any underlying mental health issues.” [See link below to ConvergenceRI story, “Opioid OD crisis is not an unsolvable problem.”]

“We keep shining a light on the despair of addiction, and it’s important for us to understand addiction, and to understand it as the brain disease that it is. But we also need to shine a light on what you can do – and not keep focusing on what you can’t do,” said Sandy Valentine, the executive director at RICARES, who stressed that “recovery is prevention” in a recent interview with ConvergenceRI.

Valentine urged that the focus be on removing “those barriers that keep folks from being in recovery, to reduce their reliance on the disease that is controlling their lives, and finding a way for recovery to seep in.” [See link below to ConvergenceRI story, “The healing arts of recovery.”]

The courage to speak up
On Friday morning, May 5, the day after the news release was issued announcing the $3.25 million in new grants, ConvergenceRI sat down to talk with Roxanne Newman, a community recovery advocate who has decided to speak out publicly, in order for her voice to be heard about what she called “the disconnect” between the strategies being pursued with the new influx of money, and the long-term goals of promoting recovery.

Newman, a single mother with two children, is a Ph.D. candidate in psychology at Brown University. She is a former heroin addict who recently celebrated 11 years in recovery. [See second image.] And, she is speaking out, voicing her concerns that that recovery seems to have been left out of the equation – and that many of those with lived experiences are being shunted aside or pushed out in the academic environment.

“People are building their careers off the bodies of my friends who have died,” Newman said, her voice rising in anger. “They are building their careers. Institutions are making money, big money, off of the bodies of people.”

Instead, the goal, Newman believes, should be: “What can we do to help you get to where you don’t feel the need to inject drugs.”

Here is the ConvergenceRI interview with Roxanne Newman, who has made the decision to speak out, based on her expertise both as an academic researcher and as a person with lived experience.

ConvergenceRI: You have decided that now it is a time to talk, to speak out. What motivated you to want to talk about recovery at this point?
NEWMAN: There are a lot of factors. Yesterday I celebrated 11 years in recovery.

ConvergenceRI: Congratulations.
NEWMAN: I was a heroin and cocaine addict. I am an overdose survivor. And, as far as recovery and overdose, I believe wholeheartedly that recovery is possible.

The state has moved into this lane where funding, research, and advocacy are all being pushed onto harm reduction. I am a supporter of harm reduction. I was practicing harm reduction in 2007. I was doing it; we were doing it, all of us, trying to keep each other alive.

And so, I feel like it has moved to the point where people have no hope for anyone anymore. It’s like, here, we are going to give you everything you need in order to use safely, but that’s all you’re getting. And, we’re not going to be pouring resources into ways to help people who do not want to use drugs anymore.

I’ve lost a lot of people. There is a lot of pain. There is a personal factor – and there isa professional factor [in my decision to speak out].

ConvergenceRI: You’re a single mom. You are getting your Ph.D., and you are moving forward in the academic world. Is the academic world welcoming you at this point? Or, do you find that they don’t fully embrace recovery and lived experiences the way you’d like them to?
NEWMAN: There are a couple of things going on. One, I’m in public health. And, many public health researchers don’t really understand addiction.

ConvergenceRI: Why not?
NEWMAN: I don’t think they understand the mechanisms. I think a lot of public health stuff is kind of tertiary, like they are going to use us to stop the symptoms. But the problems that underlie the symptoms are what you have to get to, and that’s more where recovery from addiction comes into play.

I am not saying, as a blanket statement, that people who are in public health don’t understand addiction. But that is not where the research is focused.

I know, because I have worked with people where I have said, when I critiqued the research, and my goal, was to say: the data is not adding up, because you didn’t think about this. The [objective] of recovery is to get rid of addiction. So there is a big disconnect.

I think that, and this has happened to other people, and not just to me. Yes, I’m in an environment where I am happy, I am in recovery, they value my lived experience, blah blah blah blah blah, all that good stuff. But they don’t actually really care.

They have an agenda. And that agenda is to advance careers. Get grants. And make institutions money, a lot of money.

So, when I say things that are not only backed up by science, but are also [backed up by my] lived experience, and it doesn’t coincide with what the agenda is, I get a lot of head nods out of respect, but… Because what are you going to say? You are not going to publicly denounce me, because then you are going to look really bad.

But, there are these things that go on behind the scenes, where I am supposed to be a puppet. I’m not valued. My lived experience is not valued.

ConvergenceRI: Clearly, your lived experience has great value. I have a sense that you don’t feel heard. Is that accurate? In what ways don’t you feel heard?
NEWMAN: This is why I am here with you, talking to you. Because for a lot of years, as you know, I kind of went under the radar.

I was brought into the [academic] environment, and I was trying to build a career. You have to be careful about whom you speak to and what you say. You can’t ruffle people’s feathers, because then if they are in charge of funding, you won’t get funded for your studies. All these mechanisms are meant to keep people in place and abide by what the agenda is.

I can’t live like that, Richard. I have to be true to myself. I have to live authentically. You know, people are building their careers off of the bodies of my friends who have died. These are family members, children who are now without parents. They are building their careers. Institutions are making money, big money, off of the bodies of people.

The reality is that we have been dishing out methadone and [medication-assisted treatment] now for years – and naloxone. And, 2022 [promises to be] the worst year for overdoses in Rhode Island. Why? Why? It’s not COVIID; COVID was a factor back in 2020.

There is a reason why, and the reason why, I believe, is that help is not being offered. People are like, here: you need this to stay alive. You need naloxone. But the next step of that is to ask: What can we do to help you get to where you don’t feel the need to inject drugs?

I mean, some people in this academic [space] believe that people are shooting fentanyl and smoking crack recreationally.

I have never in my lifetime met a recreational crack addict. I’ve never seen one. People do not inject drugs while sitting down and having a coffee in the morning, injecting themselves with fentanyl and going on with their lives.

If someone is telling you that, backed up by anecdotal evidence, they are outliers, if you want to use the technical term. Maybe, maybe, there is one person in the whole system that is able to do that. They are an outlier. From the scientific viewpoint, we cut them off and don’t even include them in the data.

I’m over that. I’m done with that. And, I am happy now that I have disconnected myself from it. I don’t care if I’m not a big [shot] in the academic environment. It means nothing for me, other than they used me – and my experiences. I am no longer serving [the agenda] so they spit me out. I’m not buying it.

ConvergenceRI: I don’t know how much you know about me…
NEWMAN: You put out stuff on recovery that people need to hear.

ConvergenceRI: It’s been frustrating for me, because I find the people in charge of the bureaucracy all of sudden have access to lots of money, but it’s not really changing the outcomes.
NEWMAN: No, it’s not.

ConvergenceRI: Do you know Ian Knowles?
NEWMAN: I love Ian Knowles.

ConvergenceRI: He wrote a story about how the opioid epidemic has morphed and changed, but we are still stuck using tactics that are mostly a decade old, that didn’t work. And, they are not working now.
NEWMAN: They are not working now.

ConvergenceRI: There appears to be a disconnect. How do we change the mentality around recovery? That is why I am excited that you are willing to sit down and talk with me, because I believe that your voice can help change the perspective and the dynamic around recovery.
NEWMAN: You have so many people on the Governor’s Task Force who have been involved in making decisions for years [around strategy]. They have shown no progress. Some of these experts on the Task Force, how long have they been on the Task Force? And, nothing has happened. Obviously, if you’re not that good of an expert, you need to go.

We need other perspectives. Some organizations that are huge and they are not making a dent in anything; the only thing that has happened is that they have made a lot of money. They need to go. They are monopolizing, and they need to go. They are not doing what they said they were going to do, and they need to go.

We would be better off, honestly, investing in quality over quantity. We would be better off investing in smaller organizations, within communities, in clinicians that can work with people, where they are not overloaded with 160 people on their caseload, and they are making only $21 an hour, which is, at this point in time, crap.

People are not signing up to be clinicians anymore. We know that. We would be better off, chunking that stuff down and not allowing big organizations to monopolize.

ConvergenceRI: What would you like to do, now?
NEWMAN: I am working on a lot of social media stuff. I am going to be doing a podcast, where I can use my education and my lived experience.

I want to debate publicly the experts, to have a public debate, a scientific debate. Sit down with me. Talk with me, publicly.