Centering Equity & Empathy in the Treatment of Substance Use Disorder

More than 60% of the overdoses in Providence are in public places. Think about that. That person you just walked past who looked asleep might actually be dying. “I’ve revived 3 people,” Project Weber/RENEW Director Dennis Bailer told the crowd at the recent College of Health & Wellness Health Equity lecture. “My colleague Ashley? She’s revived 9. So if you see a person laying there, check on them. See if they’re breathing. If there’s an ashen tinge around their lips or fingertips, they may be overdosing.”

“We want to give people hope because living this life is tough.”

Bailer’s talk wove his own personal story of addiction and recovery with an inspiring narrative around changing the language, public opinion, and public support for harm reduction services.

Project Weber/RENEW’s Mission to Make Systemic Change

Each year, Weber/RENEW’s street team distributes more than 10,000 units of Narcan/naloxone and conducts more than 2,500 hours of street outreach. Their peer-led recovery support services include transportation and referrals to substance use treatment, recovery coaching, and connections to recovery housing. They also offer trans and non-binary community support groups, gender-affirming healthcare referrals, and transition support.

While overdose prevention and harm reduction is a considerable part of Bailer’s everyday work at Weber/RENEW, he’s also focused on building relationships with state legislators to make longterm systemic change. He is the founding co-chair of the Racial Equity Working Group, one of 9 such groups advising Governor McKee’s Overdose Prevention & Treatment Task Force. He has also been appointed to sit on the Governor’s Council on Behavioral Health and Rhode Island’s Opioid Settlement Advisory Committee. And Project Weber/RENEW recently announced plans to open the first state-regulated overdose prevention center in 2024.

“You live in a very progressive state,” Bailer explained to the crowd. “You live in a state that’s really doing a lot in regards to substance use disorder. Saving lives. Decriminalizing simple possession. In some other states, you get arrested for having Narcan; you can get arrested for having safe syringes.”

Like any good advocate, Bailer is very persuasive about using personal history to build a strong foundation for shifting public opinion. He shared his own story of drug and alcohol use that quickly escalated by the time he was graduating high school. Eventually, he ended up “homeless and hopeless” in California, where he got into recovery for the first time. He got married and had children. “I managed to put together 15 years of recovery. I didn’t use for 15 years, which is pretty amazing for people like us. But this is a disorder that can cause relapse if you’re not on your toes. That’s one of the things that I tell people now when they’re in those moments of despair. I say, ‘Remember this pain, because it will return, just like it did for me.’”

Destigmatizing Language and Perspectives

At JWU, Bailer emphasized the importance of destigmatizing the language used to talk about addiction. “Don’t call me an addict or a junkie, and don’t use those stigmatizing phrases,” he explained. “I have substance use disorder.”

Now in his 7th year at Weber/RENEW, Bailer has seen constant radical shifts in the drug landscape, from the rise of Fentanyl to the growing ubiquity of Xylazine — typically used in equine medicine — that causes sores and abscesses in users. The drugs might change, but the despair he sees among users is universal: “When you’re walking through downtown Providence or through the South side, and you see people who you can tell are living that life, they’re not happy. That deep down in here, all that pain … that feeling of hopelessness and helplessness. It’s truly overwhelming.”

“Don’t judge. I can’t judge because I know that one more bad day, one more bad decision, and I could be there again.”

Bailer got help, and since getting sober, he’s made it his daily mission to help others going through the same vicious cycle. “You need to understand that this is a person who had dreams and hopes just like you. Just like me. But that brain disorder is overriding those dreams. Don’t judge. I can’t judge because I know that one more bad day, one more bad decision, and I could be there again. I ask you to try to show a little understanding that this is a behavioral health issue.”

Before and after Bailer’s talk, he was inundated by JWU students looking for internships, research opportunities or potential community work. From Public Health, Health Science and other health- and wellness-related undergraduate programs to expanding opportunities for independent study or internships, the options are wide open for JWU students who want to improve the lives of individuals suffering from substance use disorder. (There is also a master’s-level study in Addiction Counseling or Clinical Mental Health Counseling.) And we can all be inspired by Bailer’s sense of radical empathy: “We want to give people hope because living this life is tough.”

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_{TOP: VARIOUS HARM REDUCTION PAMPHLETS FROM PROJECT WEBER/RENEW. INSET: DIRECTOR DENNIS BAILER DEMONSTRATING HARM REDUCTION TECHNIQUES. BELOW: THE WEBER/RENEW TEAM, INCLUDING DENNIS BAILER (TOP RIGHT).}