Opioid crisis: Seeking help for pastoral response

This story appears in the The Field Hospital feature series. View the full series.

Fr. Frank Almade, pastor of four churches in New Castle, Pennsylvania, presides over more than what might seem like his share of funerals.

He's pastored for the past five years in the old manufacturing town, long in decline, located about an hour's drive from Pittsburgh. For much of his early years in New Castle, funerals marked the end of the line for old-timers, some of whom were close to the century mark.

Almade noticed something different in the past year. He led funerals for five men, in their 30s and 40s. Families were tight-lipped about the cause of their deaths.

"There's something going on here," Almade thought to himself. And, as the funerals continued, he heard the whispers. These men were not dying of natural causes. The national opioid abuse crisis had arrived in Almade's small western Pennsylvania town.

New Castle, near the highway connections uniting Pittsburgh, Cleveland and, points east, Philadelphia, Washington and Baltimore, is a way station to other, larger drug markets. According to the New York Times, deaths from opioid overdose in the United States now exceeds 50,000 per year, more than those attributed to gun homicide and car accidents combined. New Castle is not alone: drug abuse affects rich and poor of all races and backgrounds. It has hit particularly hard in New England, New Jersey, Ohio, West Virginia and Pennsylvania.

"I felt powerless as to what to do about this," said Almade. Months into his realization, Almade has no easy answers, but is seeking them out. What he's found out is that he is not alone.

He brought up the topic at a recent priest conference for the diocese. Afterwards, seven of his fellow clergy recounted similar experiences. Pastors are recognizing the problem but have few resources.

Almade, who formerly worked in the social concerns secretariat for the diocese, sees connections between this new crisis and the older economic crisis afflicting New Castle and other similar towns. There is little opportunity in New Castle for younger people. There is plenty of exposure to heroin and prescription drugs. He believes the epidemic feeds on silence and shame.

"They don't talk to me about it," he said about the survivors. "They don't want to talk about it in polite company."

One man, in his 40s, was long estranged from his family. At the time of his death, he had only just begun to reconnect with his young adult children.

The local drug court promotes the carrot of rehab for drug offenders, with the stick being the threat of jail time that can be avoided upon the successful completion of a program. Still, treatment doesn't always work.

"There's a culture. Once you're in, it's hard to get out," said Almade. He's afraid that the drug culture in New Castle has entrenched itself.

Spurred on by his encounter with families burying loved ones, Almade would like to learn more. He is now in the exploratory stage, attempting to figure out how his parishes, and those in other communities, can help.

Perhaps churches, he said, can become more involved in supporting families of those in recovery. Clergy meetings across denominations might help. One such conference is planned for a Presbyterian seminary in Pittsburgh in May. Almade believes the cycle of denial and silence must end.

"We need to be aware of it for a possible pastoral response," he said.

Almade is anxious to find out more. He can be reached via email at falmade7@verizon.net. If anyone has had pastoral success in countering the opioid epidemic, he is willing to listen. Almade doesn't want to preside over any more funerals for young opioid victims.

[Peter Feuerherd is a correspondent for NCR's Field Hospital series on parish life and is a professor of journalism at St. John's University, New York.]

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