Forums yield variety of responses to addiction

and American culture and said the stigma prevents open discussion about practical solutions.

In the sessions, participants were asked after 90 minutes of discussion to name ways the community and state should respond.

Here are solutions we heard:

• Respect, dignity and hope were prevailing themes. Without those, meaningful solutions are unlikely.

• The causes of this crisis vary widely. Action must reflect the multiple entry points. Alcohol was named repeatedly as a pervasive killer and pathway.

• Conversation must move from illegal activity to mental health. This shift has not happened in many counties.

• 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. When one doctor joined the Cincinnati session, he added a new 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 socially.

• Data should be used across the state. Ohio makes little effort to do so. 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 and lives while reducing stress on first responders.

• Jobs: This is a crisis for Ohio. A workforce of nonviolent felons or people who cannot pass drug tests is unattractive to new industry. The Plain Dealer, using Ohio’s OD death list, identified industries prone to drug overdoses. What has been done to help those workers and businesses?

• People want to help. The most experienced and passionate people are from families who lost someone to opioids. Who will harness this power?

• 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 people in need of medically directed pain treatment turned to illegal drugs.

• Rapid-response teams that visit recent overdose victims have been effective in Hamilton and Lucas counties for a couple of years. There has been a recent rush to implement teams in other counties, yet rural areas with high death rates remain without.

• Jail coordination: We heard anecdotal evidence of many dying after release from jail. While the attorney general has discussed reentry programs at a few jails, there is no uniformity.

• Drug courts: Some counties have become highly effective at using seamless services through drug courts to gain treatment in lieu of a criminal record. We 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 Ohio law? We know the answer, yet in some counties where health departments want needle exchanges, 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 dirty needles. This is low-cost, high-reward intervention, yet Ohio’s penchant for local control allows people to die.

• Safe-injection rooms allow the use of controlled substances under supervision. 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. What are the reasons this is not discussed openly?

• Visit the website of any county as if in a life-anddeath panic and begin to understand how difficult it is to find help. In many cases, resources are not conspicuous, including in crisis counties. There is no state leadership on web templates.

• 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. Who tests the system for its effectiveness?