The Rev. Rosie Veal Eby, priest associate at the Church of the Nativity in Huntsville, Alabama, imposes ashes to homeless people every Ash Wednesday. Photo: Courtesy of Rosie Veal Eby

[Episcopal News Service] Every Ash Wednesday, the Rev. Rosie Veal Eby, priest associate of the Episcopal Church of the Nativity in Huntsville, Alabama, goes to the homeless camp in the city, known locally as “The Slab,” and the First Stop daytime homeless shelter downtown to distribute ashes to the community and pray with them. This year, Eby, who volunteers at First Stop, will also distribute the drug Narcan along with information on how to use it to revive people suffering from opioid overdoses.

“On Ash Wednesday, we say, ‘Remember that you are dust, and to dust you shall return.’ It reminds us that this life is not forever, but it also reminds us that we got this chance to be in relationship with God,” Eby told Episcopal News Service. “We’ve got to have a good relationship with ourselves, and substances can keep you from having that relationship.”

In 2021, 106,600 people died from drug overdoses in the United States, a 14% increase from 2020, according to the Centers for Disease Control and Prevention. More than one million people have died from drug overdoses since 1999. Worldwide, approximately 600,000 people died from drug use, about 25% of which were attributed to opioid overdoses, according to the World Health Organization. Opioids — such as Percocet, fentanyl and morphine — are a class of prescription drugs used to treat moderate to severe pain, and they come with serious risks and side effects, including addiction and dependence.

Narcan — the nasal spray version of the drug naloxone —has been proven to save many lives because it can quickly reverse an opioid overdose when immediately administered. Still, like drug addiction in general, the use of Narcan is stigmatized, partly due to the persistent myth that having the antidote readily available enables drug use, even though studies have proven otherwise.

“Narcan is a safe drug, and by the way the drug is distributed, there’s really not enough to get an overdose,” the Rev. Robert Serio, deacon at Church of the Nativity, told ENS. Serio is also a retired pulmonologist and sleep physician.

Eby said she and Serio will impose ashes while accompanied by a case worker who specializes in opioid addiction, a community development representative, a peer specialist from the Recovery Organization of Support Specialists and two community resource police officers. They also will distribute the Narcan and information pamphlets on how to use it, as well as prayer cards to remind the unhoused “that we’re thinking about them and they have another resource to turn to.”

Serio said that even though he’ll wear his clerical collar to represent the Church of the Nativity while at the homeless camp and shelter, he’ll primarily be there as a doctor.

“We’re not going out there to evangelize. We’re primarily approaching this from a medical point of view,” Serio said. “But if being there leads the people to being aware of our presence, great.”

In Alabama, an estimated 3,434 people are unhoused on any given night, according to data compiled by the U.S. Department of Housing and Urban Development. In Huntsville, the state’s most populous city with almost 222,000 people, the homeless population is estimated to be about 600, though the number is likely higher.

Nationwide, at least 580,000 people are experiencing homelessness. Substance abuse is often a factor in homelessness, according to the National Coalition for the Homeless, a network of individuals and organizations dedicated to ending homelessness.

Eby said she recently had to personally administer Narcan and rescue breaths to a homeless woman who had overdosed. The woman survived.

“It’s something that I never want people to have to do, but I want them to be prepared for it,” said Eby, who also distributed Narcan to attendees at the Diocese of Alabama’s convention Feb. 8-10 in Montgomery in case parishes need to use it.

“How is somebody going to get to the point of going to rehab if they die before they get there? Being passionately present and giving people struggling with addiction things that will save their life is what we’re called to do. We’re not supposed to judge.”

Eby said she hopes other congregations will learn about how Narcan can save lives and consider distributing it among their communities.

“I’m a big fan of harm reduction,” she said. “I don’t think you’re encouraging people to use substances as much as you are encouraging them to live.”

Anyone struggling with drug addiction can call the Substance Abuse and Mental Health Services Administration’s free and confidential helpline at any time at 1-800-662-4357, or they can text 435748 for support and resource information. Having health insurance isn’t required.

-Shireen Korkzan is a reporter and assistant editor for Episcopal News Service based in northern Indiana. She can be reached at skorkzan@episcopalchurch.org.