Transforming Opioid Addictions Care in New Mexico: Combining Medication Treatment with Patient Autonomy, Civic Engagement and Integrative Healing

Opioid addiction is a complex issue. New Mexico has historically experienced some of the highest rates of deaths from opioid overdose, and opioid addictions have affected generations of New Mexicans -- starting many years before the more recent national crisis. Treatment approaches to opioid and other addictions are fraught with paternalism, stigma, surveillance, criminalization, shaming, racism, discrimination, and issues with access to care. Current treatment paradigms fail to take into account the social and economic factors of people, community, and context. New paradigms embracing a broader, more-just contextualization of addictions, along with evidence-based treatment approaches are needed to transform medicine's historic role in the "war on drugs". The Strong Roots/Raices Fuertes program was developed by two community clinics, Casa de Salud and Centro Sávila, in Albuquerque, New Mexico. The program evolved from a desire to to acknowledge and right historical harms that the medical-industrial complex has caused; to provide rapid access to dignified, life-saving, evidence-based holistic treatment for opioid addictions in a community setting; and to build a model of care that transforms the biomedical model into one of solidarity with community and collective care. Five key concepts underpin the program design: 1) Harm Reduction, Autonomy, and Agency; 2) Healing-Centered Engagement; 3) Language and Cultural Humility; 4) Transforming Health Systems Design; 5) Workforce Diversity and Pipeline Training. The program's core components include conventional approaches such as low-barrier access buprenorphine (suboxone®) to medication treatment, primary care, case management, syringe exchange, and counseling/therapy in addition to more community-rooted and integrative healing modalities such as healing circles, acupuncture, massage, reiki, ear acudetox, and civic engagement. In sharing the values, lessons learned, and tools from our work in the Strong Roots/Raices Fuertes program, we hope to inspire and encourage others wishing to develop new systems of care for people dealing with addiction issues.