On 5NP: Passion, Selflessness and Overwhelming Need
an interview with Chuck Pyle, national 5NP advocate, plus an important announcement!
We’ve got some big news about 5NP in Oregon: our legislation is now an actual bill with an actual bill number — HB 2143 — and a hearing date, THURSDAY JANUARY 30th AT 3 PM.
Here’s some more information plus guidance on testifying from Will Miller of the NAYA Action Fund, with a video example to help us prepare.
Please join us in Salem if you can, or sign up to testify virtually, or submit written testimony! And if you’re like wait, what’s 5NP and why are we talking about it? Read this.
Meanwhile, to celebrate this milestone1, here’s an interview with someone who played a big role in getting us to this point: Chuck Pyle, who organizes and advocates for 5NP laws nationally. Chuck has been a major support for us in Oregon as we work toward legalizing acudetox.2
Me: You’re a retired federal judge, right?
Chuck: I worked as a federal judge for 17 years from 2001-2018. My chambers were in Tucson primarily, where a lot of our cases focused on drug trafficking and human smuggling because we are only 60 miles from the international border with Mexico.
In 2017 I retired, but the only federal judge in Flagstaff became very ill with breast cancer, so I came out of retirement and went to Flagstaff for six months, while she received treatment and recovered. There are 12 federally recognized Indian Tribes in Northern Arizona, so my criminal caseload was 75% Native American defendants, very different from Tucson. That experience taught me a greater appreciation of the importance of Indigenous culture and the similarities between Indigenous therapies and 5NP.
Me: So how did you get involved with 5NP?
Chuck: In 2014, while I was still an active judge, I started a nonprofit called Second Chance Tucson to help people released from prison get help with jobs and benefits to make the transition easier. In April 2016, my wife Nobi (who is a licensed acupuncturist) went to Albuquerque to be trained as an Acudetox Specialist and then signed both of us up for the two-day NADA conference that followed the 4-day training.
Her trainers included Dr. Michael Smith and Carlos Alvarez. Nobi signed me up for the conference because the keynote speaker was Hassan Latif, the Executive Director of the Second Chance Center in Aurora, Colorado. She told me I could learn something from him, which was correct. Hassan is a very thoughtful, inspiring and accomplished figure. Even though Nobi, being an acupuncturist, was very familiar with the five points, she greatly appreciated the training and both of us were inspired by the passion, commitment and selflessness of the speakers at the conference. This is back when the NADA Annual conference was organized by Sara Bursac.
Driving back from Albuquerque, Nobi and I started thinking of applications for 5NP. At that time, the use of 5NP in Arizona was limited to state and federally licensed chemical dependency treatment facilities, requiring us to try to expand the law. That required us to work a lot with Sara who had a lot of legislative advocacy experience. We set up an Arizona 5NP advocacy group, where I met Ellen Vincent in 2018 or 2019, as she was helping us get our bill passed and was trying to get the POCA AllEars training course approved in Arizona. Ellen got POCA approved in July 2019 and we got the law changed to include trauma in the scope of practice, remove any site limitation and allow anyone to be trained in April 2021, effective September 2021.
Since then, Nobi and I have been focused on training people to provide 5NP as well as setting up drop-in community 5NP clinics inspired by the NADA Cafe model in Denmark. After our success in Arizona, I continued to work on advocacy to enact or change 5NP laws in other states to help make 5NP more accessible.
I became a 5NP advocate because from the beginning I was so impressed with the safety, simplicity and humility of the 5-Needle Protocol, and the passion and selflessness of the people advocating for it. That and the overwhelming need in our communities for this treatment.
Me: Tell me more about your drop-in community clinics.
Chuck: For about three years, Nobi and I went weekly to the Dismas Charities Bureau of Prisons contracted halfway house every Tuesday evening after Nobi got off work. Out of 120 residents, we would usually treat 12-20 people in two groups separated by gender. Over time we had issues with population fluctuating and conflicts with mealtime, so we decided to focus on establishing a clinic in a community setting.
We had presented AAT training at a YWCA facility, so we asked if we could hold a Sunday clinic at the same site and we were given the go ahead. We started in August 2023 and in the ensuing year and a half we have missed 3 Sundays. We think it is important that people can rely on us being there, same place, same time, every week. The clinic is open from 2-4pm on Sundays, and people start showing up about 1:50pm. The clinic is located in the South Tucson barrio, the poorest part of Tucson. In early days we would get 4-8 people, but we now normally have between 12-20 people. We bring 4 folding zero gravity chairs and otherwise use the conference room chairs. Most of the people receiving treatment are there almost every Sunday and are very appreciative. We offer seeds and beads after treatment, or to people who do not want needles, and have a jar with sandwich bags of Sleep Mix tea for people to take when they leave if they want. It is usually just Nobi and me providing treatments, except when we need coverage.
In November 2024, we started a regular drop-in clinic at the Goodwill Youth Reengagement Center. I am there with another AAT every Monday from 1-2pm to provide treatment for participants and staff. We usually get between 3-6 people, evenly split between youth participants and staff. Because this program is limited to participants and staff at this program, and because we need to get parental consent for minor participants, we get informed consent once and advise parents/guardians that they can revoke written consent in writing at any time. I anticipate in the next few months participation will double.
In connection with working with Goodwill, Nobi and I have provided 5NP treatments at several Goodwill events. In April and July, I was at the Goodwill Fresh Start event that focused on clearing warrants and criminal history for justice-system involved people. In April I treated 17 people and in July I delivered 5NP to 31 people. In mid-September 2024, we were invited to have a table at the Goodwill Employee Wellness Event held at a hotel conference center. This event went for 4 hours. We had a table to provide information and were able to set up the 4 zero gravity chairs behind an adjacent partial wall to provide treatments. About 250 employees signed in to the event, which featured about 15 tables with information on nutrition, exercise, massage among other wellness topics. During the 4 hours, we ran out of flyers with 5NP information and provided 52 5NP treatments, plus 10 treatments using only beads. Those numbers stunned us and reflected the high level of trauma and chronic stress impacting people delivering social services, as well as greatly increased acceptance of acupuncture as a legitimate therapy compared to 5 years ago.
We do not have any trouble getting AATs to cover for us when we are unavailable, but volunteers do not show up week after week for an extended period of time. That is understandable. My goal is to raise money through donations, grants or direct payment from host agencies so that we can pay AATs $50 to provide 5NP at a clinic session. This will probably end up being more complicated than it should be, but it is necessary both for the continuity of clinics and getting trained AATs out in community settings delivering 5NP on a semi-regular basis.
We have learned that people are incredibly grateful for the clinics. Most of the people we treated at Dismas, YWCA and Goodwill were repeat attendees. We need to focus on improved marketing to get more people to try 5NP and get a little bit of funding to set up another 5NP clinic at a different place and time. To date all of our clinic activities have been self-funded.
In our experience, impact on host operations is negligible. No YWCA personnel are present for our Sunday clinic. They have given us keys and codes so that we can operate independently. At Dismas and Goodwill, we sign in when we enter and then proceed to our assigned room. We obtain and maintain the written informed consent forms. We set up the room and we leave the room as we found it. No staff involvement is necessary.
The zero gravity chairs are very popular and appreciated. The four chairs are a pain to haul back and forth, but the people like them so much that we continue to cram the chairs in the back of our car each week. We wipe down the chairs with alcohol at the end of each clinic session so that they are clean but do not have an alcohol smell when people are being treated.
In the future we intend to prepare short surveys to get feedback from the people attending the clinics. We will also expand our marketing of the regular clinics as well as the 5NP clinics delivered in connection with special events. We will also increase our communications with host agencies. The fact that 5NP clinics impact host agencies so minimally is a blessing for both the agency and us, but it encourages our services to be devalued and taken for granted. Finally, we will focus pitching 5NP program ideas to middle managers instead of upper administration, at least initially, because those managers are closer to the stress and burnout service providers are experiencing.
Me: Thank you — that’s fantastic food for thought for us as we continue to work on our community partnerships! One more thing (for now): In keeping with recent themes in this newsletter, what are your thoughts on 5NP and shame?
Chuck: In the old days 5 or 6 years ago when I spoke to judges or probation officers, I had a slide I took from a book by Brene Brown. It said: "Guilt = I did bad; Shame = I am bad." Dr. Smith would have a great time explaining how the "needles don't care" if you think you are good or bad. The distinction between guilt and shame is very important, although underappreciated. I can't speak for the health care and behavioral health system, but the criminal justice system by its nature continually loads shame and trauma on the people going through the system. Our goal is to guide people to a better, law-abiding path, but shame and trauma work against us having success.
In the Fall of 2018 I was speaking with some fairly progressive probation administrators making some suggestions. When I suggested that officers should be trained in trauma-informed care, the question was "what is that?" I suspect that the behavioral health system is behind where they should be on the impact of trauma, stigma and shame, but I know the criminal justice system is only in the very initial stages of understanding the critical importance of these considerations, and far from the point of understanding how the system undermines attempts to respond to those concerns.
To be continued
Apologies for the short notice — we would have loved to have more time to plan, but one of the things I’m learning about legislative work is that there are lots of aspects that we don’t have control over. A number of factors moved our hearing to the beginning of the legislative session, so we’re going to go with that flow.