Give Ohioans time to listen to one another and they are capable of developing a plan to turn around the addiction crisis. So why isn’t it happening?
Journalists from the Your Voice Ohio media collaborative of nearly 40 print, radio, television and web news outlets met with several hundred people across the state from late 2017 well into 2018. The journalists were with the people, at the table, listening and sharing different perspectives on the crisis killing 4,000 in the state annually.
Below you’ll find a summary of what we heard at the meetings. To dive deeper, download the full report the Your Voice Ohio collaborative made to state officials in April 2018.
In 11 meetings so far, there has been consistency:
In every community there was a feeling of desperation among those struggling with recovery, and a feeling of guilt or helplessness in their families. That suffering is profound and ripe for action, constructive or destructive.
There is a belief that the crisis is a symptom of far deeper issues in Ohio, with roots in the economy, education and culture of the people and and their leaders. There is deep-seated anger and hurt regarding the stigma with addiction, especially as it pertains to opioids. They blame media and American culture for a stigma that suggests people struggling with addiction are flawed. This stigma prevents open discussion about practical solutions, they argued.
Ohio’s philosophy of local control is resulting in needless deaths and infections. Communities suffering from economic hardship cannot afford the necessary services – some of them highly effective at low cost.
Again with local control: The state has no uniform policies for harm reduction, intervention and law enforcement.
Examples: Needle exchanges, drug testing, rapid response teams, hotline services. There is no encouragement or guidance for all 88 counties.
People were perplexed that we operate sophisticated international espionage operations yet drug dealers at computers are able to order fentanyl from China, which is delivered through the mail. Or that doctors continue to write prescriptions for 30 days of opioids and that there are reports of pharmaceutical companies spending lavishly on politicians.
Conspiracy theories abound, and they are often backed by strong experiential evidence.
Reporter Katie Wedell, at the Dayton Daily News, heard people say they need to know where to go for help at any moment, and they need to be passed from one responsible provider to another. She heard people say that their local officials, while trying to do good, are not providing seamless services that people need.
In most sessions, the question was raised: Where is the medical community? There is belief that doctors and hospitals continue to over-prescribe and lack sensitivity.
We heard concerns of collusion to make money at the cost of lives.
Media were criticized for writing often about deaths and not enough about hope and solutions.
After 90 minutes of discussing what the addiction crisis looks like and its causes, hundreds of Ohioans were asked to work together on solutions.
“Where to begin?” was the initial reaction. Universally, from Warren to Cincinnati, we heard them say: restore human dignity to the victims and show them hope. Until people struggling with addiction are treated as something other than criminals, or people making bad choices, there can be no discussion of hopeful solutions.
“No one,” we heard several times, “gets out of bed saying I want to be an addict.”
Many people came to the meeting with ideas about causes and solutions. As they talked, though, minds changed and moments of clarity emerged.
Here are solutions they identified: Respect, dignity and hope were prevailing themes.
The act of listening, sharing and accepting people must occur to have meaningful solution conversations.
The causes of this crisis vary widely, thus action must be wide and reflect the multiple entry points.
Conversation must move from illegal activity to mental health. This shift has not happened in many Ohio counties, preventing proven solutions.
Moreover, this health issue is not limited to fentanyl. Alcohol was named repeatedly as a pervasive killer and pathway to opioid abuse.
Doctors and others in the medical community must engage reflectively in community discussion. Some patients are terrified of opioids and in awe of the ease with which they are prescribed.
For example, we heard anecdotal evidence of opioids prescribed to patients without consultation, refusing them and sometimes still billed for the drug. When one doctor joined the Cincinnati session, the conversation changed dramatically as people heard his perspective.
The word “trauma” was used repeatedly to describe impact on families.
Education is imperative, not just for the children, but for the people who nurture them.
We heard adults say young people need “coping skills” for difficult situations at home and in social situations.
In a West Virginia community that trained students to lead a conversation about drugs, teachers were stunned by the stories students told about life at home.
In Belpre in Southeast Ohio, schools are using a K-12 curriculum that encourages children to discuss real-life situations.
Data should be used across the state. Cincinnati pinpoints overdose hotspots by collecting and publicly mapping all EMS OD calls every 24 hours. The city has evidence that this online feature is saving taxpayer dollars, lives, and reducing stress on first responders.
Government and non-profit social welfare organizations say they watch the real-time maps and adjust services to neighborhoods at appropriate times of the day.
Jobs: This is a crisis for Ohio. A work force of non-violent felons or people who cannot pass drug tests is unattractive to new industry.
One man in Youngstown said he cannot complete his recovery and support his child unless someone hires him. He has a felony related to an addiction he overcame a year earlier.
Reporter Rachel Dissell at the Plain Dealer, using Ohio’s OD death list, identified industries prone to pain and drug overdoses. What has been done to help those workers and businesses navigate this challenge?
People want to help. The most experienced and passionate people are those from families who lost a member to opioids. Who is harnessing this power? Who can guide these families in helping others?
We heard a Middletown woman describe her own mission by joining Facebook support groups and connecting people in far-away cities.
In Wilmington, a man who lost both children said he attends many public meetings to be a voice for the addicted.
The state program to distribute the overdose antidote Naloxone was well received.
Tougher rules limiting opioid prescriptions did not receive uniform support. There is evidence that the new rules resulted in people who needed medically-directed treatment to seek illegal drugs.
Rapid response teams have been effective in Hamilton and Lucas counties for a couple of years. There has been a recent and rapid rush in other counties to implement these teams, yet rural areas with high death rates remain without. Response teams encourage victims into treatment.
Again, local control and lack of resources result in unnecessary deaths and resentment toward authority.
Jail coordination: We heard anecdotal evidence of many dying after release from jail. While the attorney general has discussed efforts at a few jails, what do we know about uniformity?
Drug courts: Some counties have become highly effective at using seamless services through drug courts. We detected tension among judges on this matter and saw differences in death rates between two similar counties where one had medically assisted treatment through drug court and the other did not.
In a state that routinely ranks among the top four for death rates, should there be an 88-county policy?
Needle exchanges: So what IS the law in Ohio? We know the answer, yet in some counties where health departments want to launch needle exchanges, commissioners and prosecutors block implementation with the argument that exchanges are either unsupported in law or they support illegal activity.
Meanwhile, numbers illustrate clearly that the costs to families and the state are rising due to more cases of hepatitis, HIV and heart disease caused by used needles. This is low-cost and high-reward intervention, yet Ohio’s aversion to local control allows people to die.
Safe-injection rooms. These are highly controversial as they allow the use of controlled substances. Nonetheless, this idea was raised in many conversations. These are used effectively in foreign countries, reducing deaths, spread of disease and reducing the need for EMS calls. If safe injection reduces government cost and saves lives, what are the reasons this is not discussed?
Visit the web site of each county as if you are in a life-and-death panic and get an understanding of how difficult it is to find help. In many cases, resources are not immediately clear, including in crisis counties. Can the state provide templates for websites?
We heard multiple anecdotes of ineffective local services, mostly because the victim or family struggling with recovery was left to their own to find the help. Should there be a process for evaluating those services?
In each community conversation, people were instructed to change tables twice so that they could hear a variety of life experiences as they worked toward solutions.
There was one community official responsible for helping people who did not budge. Same table, whole time. She was overheard twice saying something along the lines: “Can’t, that’s the law.”
At the end of every session, a show of hands was asked for the question, “How many learned something new?”
Of the more than 500 who attended in the past several months, she was one of the very very few who did not raise her hand.
Doug Oplinger is the former managing editor of the Akron Beacon Journal and now leads the Your Voice Ohio media collaborative. He can be emailed at firstname.lastname@example.org
WYSO is a partner in the Southwest Ohio Your Voice Ohio project. It's a collaborative effort to produce more relevant, powerful journalism based on the needs and ambitions of Ohioans and Ohio communities. We’re beginning with the opioid epidemic and will let the public guide us from there.