Updated 12:07 p.m.
Owen County, Ky., has one of the highest risk rates for drug overdoses in the region.
Northern Kentucky University recently received a $1.8-million grant to combat the opioid epidemic there.
The county is a rural community that sits an hour away from Lexington, Louisville and Cincinnati. With the grant money, NKU is working to establish and expand access to substance abuse disorder and mental health services.
Shanna Osborne is a county native and NKU care coordinator who gave me a tour of the area and says she couldn't imagine living anywhere else. Outside the windows of Osborne's white Jeep, I saw a quaint town with an abundance of land and churches.
"The lack of resources and ability to dig yourself out is harder in a rural community because of the lack of resources, transportation; because of the poverty; because of the isolation," she says.
Before the university started accepting clients, it held community meetings to hear what residents wanted and to understand how NKU could help.
"The real challenge is how do you reach people who don't want to be reached?" NKU Vice President of Health Innovation Valerie Gray Hardcastle says. "Because they're not the ones who are going to show up to a community meeting."
The county is considered a bedroom community because people who live there work in other counties which may have more resources readily available. For those who don't commute, accessing resources can be more difficult. Hardcastle wants to create a community of health to encourage all residents to get regular check-ups as a preventative measure.
"In the country the ratio of mental health providers to the population is 360 to one," says Hardcastle. "In Kentucky it's not as good - it's about 490 to one. In Owen County its almost 3,000 to one." Her goal is to boost preventative health participation for all community members.
According to multiple state reports, the number of accidental poisoning deaths in Owen County doubled from 2017 to 2018. The increase is notable since accidental poisoning deaths decreased throughout the state of Kentucky during that same time.
The local hospital closed in 2016 after months of consistent low patient volume. There are some clinics in town like Triad Health Systems and NorthKey Community Care. But some people don't have access to those services because of transportation or because they're unaware they exist.
Hardcastle says 45% of people in the county don't have internet access in their home and the terrain can make cell phone service spotty. "So, the idea, 'Oh just put it on social media; oh we'll do telemedicine,' those practices are not effective in a place like Owen County," she says.
So NKU is getting crafty as it reaches out to potential clients. Getting pharmacists to hand out bags with advertisements of NKU's program is one way it's reaching out.
Hardcastle says nationally, things are turning around but in Northern Kentucky it's a different story. "Five years ago, we would see the majority of overdose deaths happening between the ages of about 35 to 55, " she says.
Now most overdose deaths are people between 18 and 35 years old. "Which tells us then that people started abusing drugs about 10 years earlier," Hardcastle says.
Darrin Carter says he was introduced to pain pills in 1991 after injuring his leg playing high school football. "I didn't know anything about pills," he says. "I thought it wasn't going to help. Well I took 'em. Next thing you know, I was off to the races and I couldn't function without 'em." Carter says he would convince himself the pills weren't working because he couldn’t get enough.
"When I took my medicine, I turned into a comedian," he says. "I guess you could say I had the blinders on. I felt more into people. Attention - it felt like it fixed me." During that time, he says it felt like nobody noticed a change in his behavior.
It wasn't until Carter's son visited him in jail that reality began to settle in. "I remember 2-6-13 - that's my clean date," Carter says. He realized being a single parent that his children only could rely on him. "I wanted to change."
If Carter didn't stay clean he was facing five years in jail. He says the consequences of what could happen helped him stay on the recovery path.
He says back then if you weren't a popular family, people didn't care that you were struggling with addiction. Now almost everyone is pitching in to reel the community back to its glory days.
According to an Asbury Park Press investigation, in the 1980s the medical community knew drug addiction was a disease. But politicians decided to focus only about one-fourth of the $1.7 billion federal dollars allotted for treatment and prevention programs; the rest went to law enforcement and incarceration.
The impact of that was the mass incarceration of African Americans.
Now, the national conversation about drug epidemics like opioids have become more compassionate in tone as the impact largely shifts to white communities. Federal dollars have shown this shift, with three quarters of the $7.4 billion Congress set aside to respond to the opioid epidemic being put toward treatment and recovery/prevention programs.
A report by WBUR found that doctors are less likely to prescribe narcotics if a patient is black, and cited a 2010 study that found white Americans are two times more likely to receive an opioid prescription than black Americans.
Hardcastle says both the crack and opioid epidemics have similarities in what drove them. "When people are feeling despair, feeling hopeless, feeling frustrated, they turn to a substance that makes them feel better. Who wouldn't?" She says what we learned is that treating people as criminals isn't a solution and it locks a generation away.
The criminalization of drug charges persists in Owen County which is 96.6%, white according to the census.
Osborne, the NKU care coordinator, started working to connect clients to resources months earlier than expected due to high demand. She's scheduling clients with Owen County resources, but waiting for appointments that are two months away causes some of her clients to relapse.
"They're not trying to do things illegal," Osborne says. "When they try to do things legally its hard, it's hard to wait on, hold on. It's easy to self-medicate. It's easy to try and make yourself feel better by using illegal drugs. Which then starts the cycle of, now we're back in jail; now we're losing our kids and we've relapsed."
Over the next three years, Osborne will work to create a recovery community so people with substance abuse disorders can have and be sponsors. Carter seemed eager for Osborne to get the program up and running. "It makes me feel good to know that I can help somebody because there wasn't nobody there to help me," he says.
Carter says he feels good that the program is helping get back to the town's motto of being "where community matters."