Colman Domingo
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Drug Use in Our Community Requires Immediate Action

GMHC's Substance Use Clinic

Every seven hours, someone dies of a drug overdose in New York City.

That equates to nearly four drug overdoses each day and nearly 1,400 unintentional overdose deaths in 2016, according to the New York City Department of Health and Mental Hygiene. Overdoses in the city reached a record high in 2016 — the sixth consecutive year of increases. And though there are many factors that contribute to these dramatic numbers, one factor is the lack of quality, accessible substance use care around the city, given the scope of the problem. If people using drugs want help or want to talk to someone about their situation, the barriers can be daunting. This is especially true for LGBTQ people, who are statistically more likely to abuse substances but, because of stigma about their sexuality, may not seek counseling.

That’s why, today, Gay Men’s Health Crisis has opened the doors to our new Substance Use Clinic at our midtown headquarters on West 33rd Street. The new facility will be open to adult New Yorkers of all sexual orientations, identities, and income levels regardless of HIV status, and serve as an enhanced tool in the campaign to end the HIV epidemic in New York State by 2020 — a goal set by Gov. Andrew Cuomo.

In our 35 years, we have seen how substance use has affected the health of thousands of our clients. As GMHC grew from its inception in 1981, we continued to see a steadily increasing need for food and mental health and/or substance use counseling. But along with the organization’s growth came an increased awareness of drug and alcohol addiction, which we quickly understood was a driver of many new HIV infections. We saw firsthand — and local and national studies corroborated our observations — that if people living with HIV or AIDS, or who are at risk of contracting the virus, feel stigmatized, they are more likely to feel depressed and increase their substance use. HIV and other STIs thrive when inhibitions are lowered and sexual decisions are blurred. 

When we realized this, we created support groups specifically for individuals who had a current or past history of abusing drugs or alcohol. By 1991, the problem had reached crisis levels: In that year, nearly 25 percent of GMHC’s clients had a history of injection drug use.

After 1996, when lifesaving HIV medications began to allow more HIV-positive people to extend their lives, we began encountering a new foe: a growing crystal methamphetamine epidemic within the gay community. We saw, and studies began to show, a clear link between crystal meth use and an increased risk of HIV transmission. Even as we continued to offer more critical support services for people using substances, we knew we could and should do more.

Building on this knowledge and experience, our state-of-the-art New York State Office of Alcohol and Substance Abuse Services-licensed outpatient clinic now provides New Yorkers with a holistic approach to substance use and mental health. The clinic will also offer vital services to increase access to care, helping individuals with HIV or AIDS to control their viral level while also offering services to help HIV-negative, high-risk individuals keep from contracting HIV.

And since we know that mental health and substance use are inextricably linked, the new clinic will take advantage of our Carl Jacobs Mental Health Clinic, allowing us to incorporate innovative treatment and counseling into our service models. This will also give us the ability to work directly with people — both HIV-positive and HIV-negative — who are dually diagnosed with mental health and substance use issues. These kinds of side-by-side clinics are a rarity in New York City, and they will enable us to reach more people effectively.

Caring remains at the foundation of all of our services, which more than 12,000 New Yorkers access every year. GMHC’s two clinics will help us decrease stigma and new HIV infections, propelling us to our collective goal in ending the epidemic.

KELSEY LOUIE is the CEO of Gay Men's Health Crisis.

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