“This is a once in a hundred-year epidemic type issue.”
Originally published by The Providence Eye, a publication partner of Ocean State Stories.
By Kristine Yang
Homer Lee-Walker felt he should have been dead a long time ago from his addiction.
He says he fell in with the wrong crowd as a teen, and soon after, he was using cocaine, pills, alcohol, and anything else he could get his hands on. By 22, Lee-Walker had been arrested on drug-related charges. For the next thirty years, he was in and out of jail “a hell of a lot” – he estimates around twenty-five times.
With a failing kidney and deteriorating health, Lee-Walker slowly grew weary of his drug usage. “I was so tired of doing the drugs and the drinking,” he says. He knew he needed help.
One night, he found himself caught in the pouring rain, lost in an unfamiliar alleyway with nowhere to go. Sobbing and praying, he remembers falling to his knees and begging God, “Just take it away from me, and I will never do it again.” The next day, he says, he was looking for help to get sober, an act he credits to God.
In 2021, 435 people died from accidental overdoses in Rhode Island, placing the state 15th in the nation for drug overdose fatality rates.
The opioid epidemic, which once disproportionately affected white individuals, is now having a greater impact on people of color, says Josiah Rich, expert advisor to RI Governor McKee’s Opioid Prevention Task Force and addiction medicine physician at Miriam Hospital. “The Black and Brown communities are being hammered here in Rhode Island.”
In recent years, Black residents — of whom Lee-Walker is one — have had the highest opioid-related death rate compared to any other racial group. Yet they were participating in recovery programs at the lowest rates, the state’s Department of Behavioral Healthcare, Developmental Disabilities and Hospitals found.
Stigma surrounding addiction is often a major barrier to substance use treatment for people of color. Lee-Walker says he was initially hesitant to seek recovery help because the treatment center was in his neighborhood. “I felt kind of embarrassed if everyone knew my problems,” he says.
Linda Mahoney, State Opioid Treatment Authority for Rhode Island, was searching for a targeted intervention to address the sharply increasing opioid-related death rate among Black residents when she came across a webinar on a Connecticut program called the Imani Community Recovery Program.
Imani offers an unconventional solution to the persisting racial disparities in opioid recovery: funding the churches.
Black Americans attend church more frequently than any other racial group, with 47% reporting they attend at least once a week, a Pew Research survey found. From slavery through the Civil Rights Movement, the Black Church has served as a center for spiritual, social, and political life.
“There is this historical expectation that if all else fails, you come to the church,” says Ericka Mack-Andrew, Rhode Island’s Imani Project Program Liaison. “That culture persists.”
Imani means ‘faith’ in Swahili. The program was first conceptualized in New Haven in 2017 by Yale University physicians Ayana Jordan and Chyrell Bellamy. It is a 22-week faith-based opioid recovery program hosted at local churches and is specifically designed to provide community-centered care to Black and Latine individuals.
“It was exactly what we were looking for,” says Mahoney. After the idea gained enough traction, the program was piloted in Rhode Island at the Bethel AME Church, a historic Black church in Providence, in summer 2023.
Each host church chooses two facilitators to undergo program-specific training to lead their cohort. One of the facilitators is required to have had lived experience with substance use and the other to be a member of the host church. It is not required that faith leaders or medical professionals directly facilitate the program.
The approach is similar to the 12-Step program developed by Alcoholics Anonymous.
The Imani curriculum emphasizes holistic and person-centered care. It is modeled after the 8 Dimensions of Wellness: emotional, physical, occupational, intellectual, financial, social, environmental, and spiritual, as well as the 5 R’s of Citizenship: Rights, Responsibilities, Resources, Roles and Relationships.
While faith is not a requirement of the program, “Spiritual tools are tools, and they are something that we do not deny the power of,” says Mack-Andrew. Sobriety is also not required for participation.
Seven participants completed the pilot program in January 2024. Soon after, state authorities supported the expansion of Imani to three host churches across Providence and Woonsocket, with the second cohort starting in April 2024. Of these churches, the Bethel AME Church and the Allen AME Church were predominantly Black congregations while the Vida Church had an even mix between Black, Latine, and white congregants, says Mack-Andrew.
At 64, Lee-Walker had been sober for twelve years, never once relapsing since that fateful day in the alleyway, he says. Still, he admitted, the temptation will resurface, and he fights to keep it in check each time.
Opioids are highly addictive and rank among the drugs with the highest relapse rates, with approximately 65-70% of users experiencing a return to substance use, according to the U.S. Food and Drug Administration. Lee-Walker enrolled in the program at the Bethel AME Church, hoping that it could help him manage his temptation to use again.
At the beginning of each weekly Imani meeting at the Bethel AME Church, Stephanie Jones-Pringle, one of the program’s facilitators, started with a prayer.
“It felt comfortable because it’s one of the few times you can talk about faith and not feel that you’re going to be beat down for it,” she says. “Here, we talk about God.”
Through Imani, Lee-Walker also reconnected with his faith. At church, he found solace knowing he was in a safe area with safe people. “It eases the soul when you go there,” he says.
Following the prayer, participants took turns introducing themselves and talking about their weeks. Though the program provides facilitators with a curriculum, Jones-Pringle soon learned that each session needed to be tailored towards the interest of her group. She took the issues raised and turned it into the lesson for the day. The focus often revolved around making healthy lifestyle choices.
Lee-Walker says one of the most meaningful outcomes of the program was gaining a community he could rely on. He says participants still frequently call each other to check in, even after the end of the 22-week program. He recalls the relief of receiving a phone call from one of his fellow participants one night when he was alone and getting in his own head.
“They fell in love with each other too, because we promoted love,” says Jones-Pringle.
At the end of every weekly session, the program provided participants with sandwiches and ten-dollar gift cards to incentivize further participation. Seeing the growth of her group over the course of the program brought her joy, says Jones-Pringle. “I wanted these people to walk away every single time feeling that something had been accomplished.”
Many participants were able to turn their lives around through the program, Jones-Pringle says. Success stories included participants finding jobs, securing permanent housing, regaining child custody, and even getting a girlfriend.
“I don’t have a special code for how to do it successfully,” she says. “But I do know that love helps a lot – love and dedication.”
Across all three host churches participating in the second Imani cohort in Rhode Island, thirty-seven people finished. A third cohort of the program is scheduled to start in early 2025, says Mack-Andrew, the state’s Imani liaison.
With each new cohort, Mahoney, the State Opioid Treatment Authority, hopes to expand to more churches and reach more individuals struggling with opioid addiction across Rhode Island.
Faith-based opioid recovery programs offer significant economic benefits, too. In 2020, the United States spent an estimated $1.5 trillion on the opioid epidemic, a Congressional Joint Economic Committee report found. A comparable faith-based recovery program in Baltimore saved the Maryland government over $14,000 per participant each year, according to a study published in the Public Health Nursing Journal.
“This is a once in a hundred-year epidemic type issue,” says Rich, expert advisor to the RI Opioid Prevention Task Force and physician at The Miriam Hospital.
In 2023, overdose deaths decreased by 7% in Rhode Island, the first decrease in four years. Rich says that this represents a step in the right direction but there is still a long way to go. “We really need to double down on treatment,” he says. He says that while methadone and medication-based treatments are still the most effective recovery options, he believes Imani is a good supplement.
Lee-Walker feels that communication is an undervalued tool in opioid recovery care and says he is hopeful of the future of Imani.
“I know for a fact each and every addict out there, they’re crying inside,” he says. “All they need is for somebody to care.”
Kristine Yang is a senior at Brown University, where she is studying Applied Mathematics and Biology. Originally from Falmouth, MA, she is interested in writing about local and regional issues, as well as exploring scientific journalism and the intersection of different scientific fields.
