The NC Council of Churches and others lobbied in Raleigh for Medicaid expansion as a way to get more people with substance use disorder into treatment.

By Taylor Knopf

Rebekah Paulson found God in jail. As a former heroin user with a criminal record, she faced a lot of barriers when she got out.

She wanted to attend church but discovered that many in the pews around her didn’t understand what she had been through. She eventually found Source Church in Dare County, where she said the pastors and members understood her story.

One of the pastors is a former gang member who did time in prison.

“So he gets the streets,” Paulson said. “I can talk to him.”

The church encouraged her as she sought employment with a felony record. They walked by her as she worked with the child welfare system to get her now 6-year-old daughter back.

One day, the head pastor asked Paulson if she wanted to start a church outreach to people using drugs. He wanted to start a needle exchange.

She loved the idea. Paulson has lost 31 friends and family members to drug overdose, including her father and best friend. She connected with the NC Harm Reduction Coalition and delivered needles and naloxone — overdose reversal drug — to people using drugs in the community.

She even went to her old dealer’s house with harm reduction supplies. And Paulson has done naloxone training with kids of people who use drugs.

The church established its needle exchange in October 2016, and some members left the church.

“We had someone try to start a petition against us,” Paulson said. “They said, ‘You’re putting the weapon in their hand. How are you going to feel when that person overdoses?’”

Harm reduction strategies aim to lessen the damage caused to a person by their use of drugs.

HIV and Hepatitis C are bloodborne infections that can spread through sharing syringes and needles. By offering drug users clean injection supplies, it reduces the risk of disease spread. And naloxone is a tool used to reverse a drug overdose and prevent a person from dying.

Needle exchanges are a first point of contact with a population that feels stigmatized by society. Harm reduction workers often end up referring drug users to medical and social services once trusted relationships form.

“It’s more than just giving people needles, but that’s all people saw,” Paulson added. “We bring people food. We keep an eye on them. I link mothers to resources and help them find ways to get on maintenance medications.”

Addiction and the coverage gap

One problem Paulson said she saw over and over were people who wanted detox and treatment, but they didn’t have health insurance. The wait for both could be weeks, and people would become discouraged or lose interest in treatment.

Paulson and others in the faith community urged state lawmakers last week during an advocacy day called “Healing, Hope and Recovery, a summit on the Opioid epidemic in North Carolina” to close the Medicaid coverage gap so more people with substance use disorder can get treatment.

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Jesse Bennett, overdose prevention coordinator with NC Harm Reduction Coalition, said that many of the organization’s program members want healthcare, but they don’t have insurance.

“Why do you think people refuse to go to the hospital after an overdose?” he said. “The stigma, yes. But they also know they don’t have the coverage to get the treatment they need.”

Steve Mange, senior policy and strategy counsel for the N.C. Attorney General’s Office, spoke about the overlap between substance use disorder and other mental health disorders and the fact that so many end up in the criminal justice system.

Law enforcement diversion programs and therapeutic treatment courts have been put in place to keep people with these illnesses out of prison. There are community groups around the state that ask the Attorney General’s Office how they can help with this, Mange said.

These community groups try to find treatment options for people, but often the only options are facilities that only take private insurance.

If North Carolina closed the coverage gap, more people would get into addiction treatment and it would help relieve the pressure on law enforcement, jails and district attorneys across the state, Mange said.

Church support for Medicaid expansion

The NC Council of Churches has come out in support of Medicaid expansion, particularly as a way to address the opioid crisis. The council is made up of 6,200 congregations from 18 different Christian denominations across the state.

“Jesus was the original universal health care provider, offering healing to all who came his way,” said the council’s executive director Jennifer Copeland. “Restoring them to their communities and families, ending their separation.”

She urged clergy in the room to talk about healing stories in the Bible and bring awareness to the issue of Medicaid expansion.

While the Council of Churches encourages scripture-centered sermons, not sermons about “issues,” Copeland said it’s not hard to find stories of healing in the Bible.

James Gailliard, pastor of Word Tabernacle Church in Rocky Mount, argued for the immediate passing of Medicaid expansion.

“It is inconsistent to suggest support of addressing the opioid crisis and not also support closing the coverage gap,” he said.

He went on to say that it is wrong for faith communities to stay silent on issues that impact their congregations.

“Too many pastors have been silent on political matters, and what they’ll say is, ‘We don’t do politics,’” Gailliard said. “As a preacher of a church, let me tell you something, every church does politics.”

“It is time that churches understand that the gospel is a matter of proclamation and demonstration,” he said.

“If they are willing to go on a mission trip 3,000 miles across the Atlantic, they should be willing to drive down Highway 64 East and address the severe health disparities in our own state.”