Reassessing Law Enforcement’s Approach to the Opioid Epidemic

This week, we took a look at various studies which assess the scientific basis of law enforcement interventions intended to prevent or at least minimize the negative effects of the opioid epidemic. Many people agree that we “can’t arrest our way out of the opioid crisis.” The end result of the “war on drugs” and the criminalization of addiction has led to a cycle of over-incarceration that has failed to address the root causes of drug abuse in our communities. Local governments are beginning to reassess those practices and shift their approach to drug enforcement. Below, we examine the effectiveness of suggested solutions and goals for law enforcement.
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Alternative Pain Treatments: Part 2

Last week, we looked at alternative pain treatments including over-the-counter drugs and cannabis. This week, we’re exploring non-drug treatments and the role virtual reality has in pain management. If you have heard of other alternatives for treatment and want to add to this list, let us know, and we’ll add to our ongoing list of solutions.

Non-drug treatments

Though exercise, physical therapy, and yoga may sound extremely unappealing when dealing with chronic pain, these techniques have been found to help patients regain strength and actively manage their symptoms. Acupuncture and seeing a chiropractor could also be effective. Organizations such as the American College of Physicians, the U.S. Department of Veterans Affairs, and the Centers for Disease Control and Prevention recommend trying non-drug treatments first to deal with chronic pain.
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Alternative Pain Treatments: Part 1

We read statistics on opioid use disorder every day when covering the crisis. According to a study published earlier this year in the New England Journal of Medicine, one in 48 patients receiving an opioid prescription becomes a long-term opioid user, and four in five new heroin users starts out by misusing prescription opioids, according to the American Society of Addiction Medicine.

While opioids have reigned supreme in recent years for pain treatment, as our research shows, they are just one way way of dealing with pain. This week, we’ll take a look at over-the-counter pain medication and other drugs like marijuana. Next week, look for our blog exploring non-drug options for pain treatment like physical therapy, Cognitive Behavioral Therapy, virtual reality, and more.
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What does effective treatment look like? Breaking down the Risk-Need-Responsivity Model

Drug courts are redefining how we approach the opioid epidemic, by putting it in context of a health issue, rather than a crime one. Because of this, we are able to see more people get clean and move on with their lives. We have already explored the effectiveness of drug courts, but what should treatment look like once they get there?

Over the past couple of decades there has been a decent amount of research focused on correctional rehabilitation. Together, the risk principle (i.e., “who” to target); the need principle (i.e., “what” to target); and the treatment principle (i.e., “how” to target) constitute the Risk-Need-Responsivity model, a commonly used model in the field of criminology that outlines effective correctional intervention.
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How do prescription regulations affect substance abuse?

The United States may make up 4.4% of the global population, but according to the United Nations International Narcotics Board, we consume 30% of the world’s opioid supply. The US ranks first of the top 25 countries that consume the most opioids, with a standard daily dose per million people at 50,000 doses a day.

Why do we appear to prescribe opioids at a much higher rate than other countries? A few possible causes include the idea that Americans are much more pain-averse than in other countries. Much of Europe has similar cultural views of pain as the United States: that it should be treated if possible. But researchers found that prescriptions in Europe are still at about half of what Americans consume.
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Medically Assisted Treatment: what’s healthy, effective, and affordable?

Research concerning opioid maintenance therapy in the U.S. began in 1962 when the Health Research Council of New York established  a research unit to investigate the feasibility of opioid maintenance. It took several decades before short-acting opioids were eliminated as options for maintenance therapy, and researchers began to focus on methadone. Other medications that have also since been developed include Buprenorphine and Naltrexone. Overall, it has been found that medications for the treatment of opioid use disorder are both clinically and cost-effective.
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Drug Courts vs. Business-as-Usual: exploring the effectiveness of a new system

Ohio currently has a total of 124 drug courts. However, these courts are only in 42 out of the 88 counties in Ohio. They range from Adult, Juvenile, Family, and Veterans Treatment. The purpose of drug courts are to guide offenders into treatment instead of prison, with the goal of reducing drug dependency and chances of reoffending; as well as to improve the quality of life for the offender and their families.
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Peer outreach, community programs, PSAs, and more: exploring youth opioid education and prevention

Conversations around the opioid epidemic necessarily focus on adult rehabilitation and prevention efforts, but this isn’t the only affected demographic. According to a report by the Substance Abuse and Mental Services Administration, around 122,000 teens under age 17 suffered from a pain reliever use disorder in 2015 – and the numbers continue to grow. Youth addiction, like others, can be caused by a number of reasons. Whether drugs are used for experimentation, mental health issues, or legally obtained prescription pain relief, there’s no question that it’s affecting our youth. Just last week, Ohio Attorney general Mike DeWine recommended that the state implement drug education in kindergarten through 12th grade.  

As part of our ongoing project with local media across Ohio, we took a closer look at current programs working on curbing youth opioid use. Here are a few of the resources we found:

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Ohio media folks change role in community

Imagine this: News media setting aside competitive instincts because they want to do good in their communities.  Here’s what’s happening in the long-disrespected Youngstown-Warren area of Northeast Ohio, ravaged by the opioid crisis. These are rustbelt communities that were devastated by steel-mill closing more than 30 years ago, and they are still waiting for help.

Reporters and editors will sit at tables with citizens and discuss what we’ve seen regarding the opioid/heroin crisis and discuss solutions that are available to us. Does that  cross ethical guidelines, or is that a new way for journalists to share what they know?

Is it possible that we’ll see citizens seizing power? Here’s a story we published in the Mahoning Valley at the beginning of October:

Three reporters in the Mahoning Valley, Renee Fox, Jordyn Grzelewski, and Lindsay McCoy, have worked aggressively in recent years exposing the death and destruction wrought by the heroin crisis, yet despite their dire warnings on television, on the web and in newspapers, the situation here has worsened dramatically.

In Trumbull County, opioid deaths grew at a rate far faster than the state from 2013-15 and Trumbull now is the seventh-worst county in one of the four worst states in the country. Mahoning is only slightly better.

Lest you think the more than 700 deaths – yes, 700 — in the two counties since 2010 are not your concern, consider: More than a dozen of those were truck drivers. At least 19 prepared food for public consumption. More than 20 were in the health care industry working as nurses, pharmacists, health aides and drawing blood.

There were police, security guards and more than a dozen who assembled automobiles. For every user who died there may be scores of users still working those jobs.

What are opioids? They include prescription pain killers, heroin and fentanyl.

Worried yet? Wonder what can be done?

The three reporters from the Warren Tribune Chronicle, Youngtown Vindicator and WFMJ-TV view themselves as part of the community and want to be part of the effort to turn the opioid crisis around.

Their editors and news directors share the concern.

In an effort unique to U.S. journalism, the Tribune Chronicle, Vindicator and WFMJ are setting aside their competitive instincts on this issue to launch a community conversation aimed at solutions. Those sessions will occur Oct. 22-24 in Struthers and target neighborhoods in Warren and Youngstown –selected because maps of deaths show they have been deeply affected.

Covering the media collaboration as well as assisting in the coverage will be reporter Tim Ruddell at WKSU National Public Radio at Kent State University.

The community sessions start with the assumption that public policy decisions and adequate funding from the state and national levels aren’t going to happen soon. There must be a community vision with more citizens taking responsibility. People will be asked whether opioids have affected their lives and how. They’ll be asked how the valley would look if it were successfully turning the crisis around and what must be done to do so.

The Mahoning  Valley media initiative is part of a larger Your Voice Ohio/Ohio Media Project. What is learned in the Mahoning Valley will be transferred to other communities around the state – Dayton, Middletown, Akron-Canton among them. The funding and organizational leadership comes from the Jefferson Center, a non-partisan public engagement organization in St. Paul, Minn.

The Jefferson Center has secured $250,000 in support from the Democracy Fund and $75,000 from the John

  1. and James L. Knight Foundation for Your Voice Ohio and a companion project in Appalachian

Southeast Ohio, led by Journalism That Matters.

Andrew Rockway, the Jefferson Center’s Program Director, is leading the initiative in Ohio. “To address the opioid epidemic, we need to better understand it. We can only do that if we’re listening to community members, engaging community members, and providing communities with the information they need to take productive action,” he said.

There are several leadership groups watching the media effort to determine how best to aid the attack on opioids. Among them are the local judicial system, the Youngstown City Club, the Ohio Civility Consortium. and the National Institute for Civil Discourse, a national nonpartisan organization that has identified Ohio as a state ripe for constructive citizen action.

“This is the type of forward-thinking and collaborative approach that Revive Civility Ohio encourages, said Lauren Litton, coordinator of the program, sponsored by NICD. “People with diverse perspectives must find ways to collectively explore solutions to pervasive issues, like the opioid epidemic, that are eroding our communities.”

Planning this project already has required a change among media partners. The three reporters and TV news director Mona Alexander, Youngstown editors Todd Franko and Mark Sweetwood and Warren editor Brenda Linert have winced on occasion as they’ve thought setting aside their desire to have better stories than their competitors. For this project, they’re willing to share each other’s work.

They see this as a life-or-death situation too important to let their own competitive spirits get in the way.

To help the journalists prepare answers you need and to begin collecting ideas, email your thoughts on root causes of the crisis and your solutions to me at or the local reporter at your news organization, (Insert email address for Renee, Jordyn or Lindsay, depending on news outlet.)

Coming next week: Solutions that have worked in other communities and could be applied in the Mahoning Valley.



Mainstream media in Ohio — what should they do with and for the public?

Engagement ideas applicable to Ohio news outlets

Journalists are exploring new ways to better represent people in their communities. Below are some Ohio and national examples. Anyone have suggestions for topics? Have questions for the news outlets in your community? Ask and we’ll forward to the news organization.

Next week, a Mansfield news startup will hold a party to battle infant mortality

The Richland Source is receiving support from the Solutions Journalism Network for an educational event on healthy babies – a community-wide baby shower. SoJo encourages media to find  proven best practices and present them to the community,  and cover the citizens as they put those practices into their lives.

Equipping inmates to do journalism (No, this is not a newsroom joke)

The folks at WYSO, an NPR affiliate in Yellow Springs, produced a powerful series of audio reports on women in prison by training the women to interview each other. Inmates had a bond that allowed them to ask powerful questions and receive honest answers. As station manager Neenah Ellis said, this was a lot of work; not something you do on a whim.

If you have only a few minutes, listen to this one about a high school athlete who became hooked on opioids after a sports injury, or this high school teacher, who will never stand in a classroom again.

Better: Listen to the entire project. About 59 minutes.

Examples of community engagement projects for your local news outlet, from the Democracy Fund:

  • What’s With Washington? WAMU crowdsources questions specific to the Washington, D.C. metro area for investigation. Listeners and readers vote on questions and can join reporters to work on the story.
  • Dirty Little Secrets. The Center for Investigative Reporting (CIR) is leading this large-scale collaborative investigative reporting project in New Jersey focused on “the local impacts of New Jersey’s toxic legacy.” Contributors include New Jersey Public Radio/ WNYC, WHYY, NJTV, NJ Spotlight, Jersey Shore Hurricane News, WBGO, New Brunswick Today, and the Rutgers Department of Journalism and Media Studies. WFMU additionally commissioned comedians to create stand-up routines sourced from the stories about contamination. They performed in a Toxic Comedy tour that included discussions with reporters.
  • Here’s the complete report and list of ideas.

Kudos to the Your Voice Ohio engagement leaders at the Jefferson Center.

ABC News Australia reported on citizens juries and their role in redefining one of the most controversial and explosive topics people can discuss: Health care. The Jefferson Center is among the first to experiment with carefully selected, representative bodies of citizens to deliberate on a topic and arrive at workable solutions. Jefferson Center secured our funding last year and this year. Program Director Andrew Rockway is designing the heroin conversations that will occur in the Mahoning Valley.