The BDN Opinion section operates independently and does not set news policies or contribute to reporting or editing articles elsewhere in the newspaper or on bangordailynews.com
Hannah Koval graduated from the University of Southern Maine in May with a Bachelor of Arts in psychology and a minor in sociology. This piece was part of a capstone project for the psychology in the public interest class, which is taught by Kristen Gleason, an associate professor of psychology at USM. These are their views and do not express those of the University of Maine System or the University of Southern Maine. Gleason is a member of the Maine chapter of the Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.
Roughly 12 percent of Americans struggle with alcohol dependence, 2 percent with illicit drug dependence and 8 percent with substance use disorder. Dependence on a substance refers to the continuous use of the substance that results in an increase in need and amount used, often accompanied by negative effects related to use. Maine alone sees around 10,000 overdoses each year. These numbers will only continue to grow unless we reframe our efforts to more compassionately understand substance use and to introduce more progressive methods of rehabilitation, including the use of safe consumption sites. It is easy to view the numbers as mere statistics until it hits you directly. In 2006, it hit my family directly.
My uncle John was a man who had sworn off drugs his entire life, but he had the unlucky fate of getting injured at work and being prescribed addictive pain medications afterward. Uncle John slowly turned into someone he wasn’t, something he had sworn against and eventually into another statistic. It is crucial to remember that those affected by substance use are people with families, goals and aspirations.
Substance use and poverty are both complex issues. Operating together, they present unique risks. Both living in a low-income neighborhood and starting substance use early put one at higher risk of negative life outcomes. These include: dropping out of high school, getting involved with the criminal justice system and having a low personal and household income.
Housing cost and availability also have been found to have a direct relationship with poverty and substance use. A recent study has found that higher housing costs and lower housing availability can increase one’s risk for substance use. Additionally, family and school hassles, such as stress and fear, can put an individual at higher risk of substance use and delinquency.
Yet despite these structural risk factors, many still place much of the blame on individuals. Recent research has found that health care providers often hold stigmatizing attitudes, believing that substance use can be largely explained by the individual having a “bad character.” It should not be a matter of luck or privilege to have health care providers see you as human and treat you with respect. Stigmatizing and punishing substance use has not lessened the weight of poverty and substance use as we have not made much progress in slowing down the rapid increase in those who suffer. We must now take a different perspective.
One promising idea for changing our approach is to allow for more safe consumption sites. These are places where drugs can be used safely and under the care of trained staff. In other countries, safe consumption sites have been shown to serve as a middle ground between sobriety and active addiction. They allow an individual to use drugs under supervision, while simultaneously being open to giving the necessary support for a person to choose sobriety, on their own terms. Typical rehabilitation facilities have a large financial barrier, making it less likely for those who live in poverty to be able to afford treatment. We must stop pointing the finger at the individual and turn it to the systems in which they live.
Having grown up in the Lewiston-Auburn area and seeing the impact of substance use not only in my family but in the surrounding community, I believe it is important to recognize that we all have the ability to advocate for and create change. Maine is one of the few states where legislation was introduced to create safe consumption sites, in which they cover the proposed facility provisions that would be given to those who receive care. We have the ability to bring this topic to the next legislative session. Additional information on the bill, LD 1375, can be found on the Legislature’s website. We need to demand legislation to allow for safe consumption sites to be fully legal in the United States.
Finally, community members need to talk about the problem and educate each other about not just the statistics, but the stories behind them. The negative associations about substance use and poverty must be challenged so that we can move forward with research-based intervention strategies.
