As billions roll in to fight the US opioid epidemic, one county shows how recovery can work

Communities ravaged by America’s opioid epidemic are starting to get their share of a $50 billion pie from legal settlements. Most of that money comes with a requirement that it be used to address the overdose crisis and prevent more deaths. But how?

It could mean that places look more like the area around Findlay. Here, conservative Hancock County has built a comprehensive system focused on both treatment and recovery. “People recover in a community,” said Precia Stuby, the official who heads the county’s addiction and mental health efforts. “We have to build recovery-oriented communities that support individuals.”

It was 2007 when Stuby began hearing from officials about prescription opioids being misused. That was about the same time Jesse Johnson, then 14, was prescribed the painkiller Percocet.

The Findlay native was pregnant when she needed stents put into her kidneys as treatment for infections and kidney stones. After seven months on the opioid medication, she gave birth to a healthy daughter. Then she underwent an operation to remove the stents. The prescriptions stopped and she became sick from withdrawal. “I remember not even being able to hold my daughter,” said Johnson, now 31. “It just hurt.”

Alcohol, marijuana and, a few years later, cocaine and opioids from the black market helped Johnson ease the pain. By then, county officials were seeing the area’s fatal opioid overdose toll tick up. The recovery system then included only some outpatient services and Alcoholics Anonymous.

From 1999 through 2020, 131 deaths in the county were attributed to opioids. Across the country, it was more than 500,000. The county’s opioid-linked death rate over that period paralleled the nation’s as the crisis moved from pain pills to heroin to even more potent fentanyl.

But the county took a path that many places did not. Officials created a plan with the help of the federally funded Addiction Technology Transfer Center that stressed recovery and built upon a local recognition that “this is our family, our friends, our brothers, our sisters,” Stuby said.

The settlement funds from drugmakers, wholesalers and pharmacies will not be enough for every harm reduction, treatment, recovery and prevention program that might be needed to fight the nation’s opioid epidemic. But it could be enough to jumpstart major changes to the efforts.

The county’s approach, which echoes experts’ recommendations for use of the settlement money, is that people with the right support can recover from addiction. Since its implementation began a decade ago, Hancock County has brought in more than $19 million in grants, largely from the federal government. Other funding comes from a county tax levy and the state. Health insurance helps pay for treatment.

Among the steps Hancock County has taken:

1. Like hundreds of communities, it’s launched a drug court where people can avoid jail if they work on recovery.
2. The University of Findlay began offering classes on addiction. They can lead to an entry-level certificate for work in the field.
3. It’s added three recovery homes and a community center where people can attend 12-step meetings, play video games or learn to crochet — and a similar place for teens.
4. The county launched a needle exchange, providing supplies to reduce needle sharing and the risk of HIV and hepatitis C. These are policy staples in larger cities, but less common in smaller ones.
5. At the Family Resource Center, the quick response team identifies and reaches out to overdose survivors and people with substance use disorder who are being released from jail or prison.
6. The county deployed outreach workers to help people who survive overdoses, those who are incarcerated and others navigate the recovery system.

There’s evidence that the efforts are helping. After 28 overdose deaths from all drugs last year, Hancock County has three confirmed overdose deaths and five suspected ones so far in 2023.

“It’s not just about how to get people off of opioids, but how do we keep them in remission and increase their stable recovery?” said John F. Kelly, of Harvard Medical School. His research has shown that recovery support services — such as housing, community centers and peer coaching — can help.

It’s worked for Johnson. After she was released from a hospital following an overdose when she was 27, a peer support worker tracked her down in Findlay’s homeless shelter. Now 31, she’s still in recovery, has two of her children living with her and regularly sees two others who live with her stepfather.

Earlier this year, she started a peer support job with the Family Resource Center, the same organization that employed the worker who was so instrumental in her own early recovery. “It’s something that I’ve always wanted to do,” she said, “because I wanted to be that person that reached out to me and then found me at one of the worst times in my life and pulled me together somehow.”

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