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

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Peer support worker Jesse Johnson of the Family Resource Center looks to her client Tyler Baker as they talk in the driveway of Baker's home in Findlay, Ohio, Thursday, Oct. 12, 2023. Peer support services for people in recovery are a major component of Hancock County's strategy for addressing the opioid epidemic. Credit: AP Photo/Carolyn Kaster

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 by adding housing, a needle exchange, outreach workers and a community center.

"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.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Jesse Johnson of the Family Resource Center drives a client to Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. The organization does outreach to people in jail and overdose survivors to help them guide them through addiction recovery. Credit: AP Photo/Carolyn Kaster

"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.

"We were grossly underprepared, like I think many places across the country were, for the opioid epidemic," Stuby said.

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.

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.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Jesse Johnson of the Family Resource Center waits for a client at Hancock County Probate/Juvenile Court in Findlay, Ohio, Thursday, Oct. 12, 2023. Johnson accompanies clients in recovery to court appearances and gives them rides to key appointments in her peer recovery job, just as a worker at the same organization did for her. Credit: AP Photo/Carolyn Kaster

A lot of the pieces of the county's transformation, including aggressive outreach to people who had overdosed, were in place nearly four years ago, when an overdose put Johnson at the edge of death. By then, the crisis had shifted from prescription painkillers to heroin and then to even more potent fentanyl, an opioid produced cheaply in illicit labs.

Her mother was told to prepare for a funeral.

Johnson, then 27, survived. But when she was well enough to leave the hospital, her mother didn't let her come home. Instead, she went to Findlay's homeless shelter. She had just hospital scrubs to wear.

There, a peer support worker—someone in recovery herself—tracked her down.

"The person who was trying to find me didn't give up," Johnson said. "She took me under her arm and carried me through some of the hardest weeks that I would have."

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Jesse Johnson of the Family Resource Center, right, walks with client Tyler Baker to the Hancock County Adult Probation office for a random drug test in Findlay, Ohio, Thursday, Oct. 12, 2023. Earlier this year, Johnson started a job with the Family Resource Center, the same organization that employed the peer support worker who was so instrumental in her own early recovery. Credit: AP Photo/Carolyn Kaster

___

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.

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.

Like hundreds of U.S. communities, it's launched a drug court where people can avoid jail if they work on recovery. At a recent session in the county's historic courthouse, applause rang out as one woman advanced toward graduation. The judge also ordered an immediate drug test to determine whether one man could continue in the program.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
A person signs in, center, as Jesse Johnson of the Family Resource Center, right, waits for client Tyler Baker to complete a random drug test at the Hancock County Adult Probation office in Findlay, Ohio, Thursday, Oct. 12, 2023. Experts say establishing peer support programs to help people in recovery is one way communities should consider using money from settling lawsuits with the drug industry over the toll of opioids. Credit: AP Photo/Carolyn Kaster

Some advocates urge communities not to spend settlement funds on drug courts, saying there's limited evidence they work and that participants who return to drugs can end up with harsh jail sentences.

Kerri Kostic, who had been using drugs for 30 years, said drug court helped her stop using.

"It was just an endless, ridiculous, awful cycle," said Kostic, now a peer support worker in a neighboring county. "Thank God I went to drug court here in Hancock County."

At Stuby's urging, the University of Findlay launched classes on addiction. They can lead to an entry-level certificate for work in the field—a partial answer to a recovery workforce crunch.

There are three recovery homes and a where people can attend 12-step meetings, play video games or learn to crochet—and a similar place for teens.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Jesse Johnson of the Family Resource Center drives to pick up a client and take them to the pharmacy in Findlay, Ohio, Thursday, Oct. 12, 2023. The tattoo on her forearm reads "I love you more, Mom," is from a birthday card her mother gave her before she died. Johnson was newly in recovery when her mother died from COVID in 2021. Credit: AP Photo/Carolyn Kaster

Hancock's network amounts to a "no wrong-door" system, said Meelee Kim, a Brandeis University social scientist who evaluates some of the county's federal grants. Someone showing up at the recovery center can be connected in a "warm handoff" to a treatment provider because of personal connections between the programs.

The idea, which echoes experts' recommendations for use of the settlement money, is that people with the right support can recover from addiction. Every person who stays in recovery is a person who will not die of an overdose.

"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.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Tyler Baker retrieves fentanyl from his bedroom closet for disposal as his peer support worker Jesse Johnson of the Family Resource Center looks on at left, in Findlay, Ohio, Thursday, Oct. 12, 2023. They flushed the fentanyl. The powerful lab-produced opioid has driven the number of fatal drug overdoses in the U.S. to record levels. Credit: AP Photo/Carolyn Kaster

"That's something to be optimistic about, for families to not give up hope that their loved one will be able to get and stay in remission," he said.

____

The first step is keeping people who use drugs alive using practices known collectively as harm reduction.

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.

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, in part because critics worry they enable illegal and unsafe behavior.

Earlier this year, the staff added safe smoking supplies so people who smoke drugs can avoid burns and the release of toxic fumes. But it agreed to stop after city officials objected.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Tyler Baker flushes fentanyl as his peer support worker Jesse Johnson of the Family Resource Center stands at left, in Findlay, Ohio, Thursday, Oct. 12, 2023. After talking with Johnson, Baker, an active user, agreed to dispose of his supply of fentanyl. The powerful lab-produced opioid has driven the number of fatal drug overdoses in the U.S. to record levels. Credit: AP Photo/Carolyn Kaster

Other harm reduction measures in Hancock County include distributing naloxone, a drug that can reverse overdoses, and strips to test drugs for the powerful opioid fentanyl and for xylazine, a veterinary tranquilizer that can slow the nervous system and cause wounds that can become infected.

Stuby said she would like to send people released from jail home with naloxone, but that law enforcement officials haven't been willing to go that far.

Instead, distributing the opioid antidote happens elsewhere.

At the Family Resource Center, the quick response team compiles lists of overdose survivors and people with who are being released from jail or prison.

One afternoon, Misty Weaver, the team coordinator, went out to check on two recent overdose survivors. One who overdosed in a Walmart parking lot gave a home address that didn't exist. The person who answered the door for the other said the man had gone to a rehab facility. Weaver left a bag full of materials, including socks, naloxone, test strips, condoms and information about other services.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Tyler Baker, right, talks with his peer support worker Jesse Johnson of the Family Resource Center, left, as they look at scratch-off lottery tickets in Findlay, Ohio, Thursday, Oct. 12, 2023. Johnson drove Baker to a random drug test at the Hancock County Adult Probation office. Earlier this year, Johnson started a job with the Family Resource Center, the same organization that employed the peer support worker who was so instrumental in her own early recovery. Credit: AP Photo/Carolyn Kaster

___

Christina McCarver, then living in Toledo, did a 30-day treatment program to address her opioid addiction. Within 24 hours of being released, she relapsed and returned to the treatment center.

The center found a place for her in its Findlay facility. After that program, she moved into a room at the women's recovery home. It turned out to be an important part of her recovery.

"We keep each other in check," she said. Instead of talking about drugs with "using friends," she said, "we kind of do it the other way, where we talk ourselves into, 'Let's go to a meeting instead.'"

For the 49-year-old McCarver, who's survived a half-dozen overdoses in a life rife with trauma, being in the house made her feel like she was trusted and needed again.

After eight months living there, McCarver became the on-staff coordinator for the house. After three years with that job, she recently moved to a similar position at the home for mothers.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Jesse Johnson of the Family Resource Center drives a client to Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. Advocates in Hancock County say that transportation can be especially challenging for people in recovery, in part because they don't want to ask drug dealers for rides. Credit: AP Photo/Carolyn Kaster

The homes, in residential neighborhoods, require people to be in recovery for 30 days before moving in. Rules include doing jobs around the house, attending mandatory meetings and events—and drug test requirements.

In the men's house, William Mull appreciates having structure and a mentor, Cory Kinn, who's a few years further along in recovery.

"That's always better than having someone who's just trying to tell you something they've read out of a book," said Mull, 38.

When the first home was planned in 2015, it faced strong community opposition.

After that, Stuby said she increased her efforts to keep Findlay officials and the public in the loop. The newer homes haven't caused a stir.

Kinn, a former construction worker who got into recovery work after a stint in jail on a drug conviction, spends his nights as the live-in coordinator at the men's recovery house and his days working with clients involved in the criminal justice system.

As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
Tyler Baker packs his cigarettes as he talks with his peer support worker Jesse Johnson of the Family Resource Center after she drove him to take a random drug test at the Hancock County Adult Probation office in Findlay, Ohio, Thursday, Oct. 12, 2023. Peer support services are one key element of Hancock County's response to an opioid epidemic that has touched every part of the U.S. Credit: AP Photo/Carolyn Kaster

Even early in his recovery, he said, he didn't care if he stayed alive. Now? "I've built a life that I don't have to escape from."

The community could use more recovery housing, he and others say.

And it's hard for clients to get to probation meetings, medical appointments, 12-step meetings and other places they need to be. In a spread-out community with no bus system, getting around is an issue for people who don't have cars or aren't allowed to drive.

If they call someone they know for a ride, it could be "the dope man" or drug dealer, he said.

___

In November 2021, when Jesse Johnson was about a year into recovery, her mother let her come to her home for double festivities: Thanksgiving and her daughter's birthday.

The next day, Johnson said, her mother was in a hospital with COVID-19. She died within weeks.

  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jodi Ferdinandsen, a client of Jesse Johnson of the Family Resource Center, pushes her grocery cart through Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. The Family Resource Center provides peer support workers to help clients during early recovery. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jodi Ferdinandsen looks to Family Resource Center peer support worker Jesse Johnson as she helps her check out at Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. Peer support workers help people in early recovery in a variety of ways. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jesse Johnson of the Family Resource Center helps her client Jodi Ferdinandsen check out at Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. Peer support services for people in recovery are a major component of Hancock County's strategy for addressing the opioid epidemic. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jodi Ferdinandsen holds up her receipt after checking out with the help of Family Resource Center peer support worker Jesse Johnson at Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. In addition to peer support, Hancock County has launched recovery housing and college classes on addiction. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jesse Johnson, left, of the Family Resource Center helps her client Jodi Ferdinandsen check out at Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023. Peer support services for people in recovery are a major component of Hancock County's strategy for addressing the opioid epidemic. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jesse Johnson, left, of the Family Resource Center helps her client Jodi Ferdinandsen load groceries into the trunk at Walmart in Findlay, Ohio, Thursday, Oct. 12, 2023, before driving her home. Johnson said a peer support worker from the same organization was instrumental in helping her with her early recovery. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jesse Johnson of the Family Resource Center carries groceries into client Jodi Ferdinandsen's garage after helping her shop at Walmart and driving her home in Findlay, Ohio, Thursday, Oct. 12, 2023. Earlier this year, Johnson started a job with the Family Resource Center, the same organization that employed the peer support worker who was so instrumental in her own early recovery. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jesse Johnson shops for Halloween costumes with her children at Spirit Halloween in Findlay, Ohio, Friday, Oct. 20, 2023. Earlier this year, Johnson started a job with the Family Resource Center, the same organization that employed the peer support worker who was so instrumental in her own early recovery. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Jesse Johnson pauses before closing the van door after shopping for Halloween costumes with her children at Spirit Halloween in Findlay, Ohio, Friday, Oct. 20, 2023. Earlier this year, Johnson started a job with the Family Resource Center, the same organization that employed the peer support worker who was so instrumental in her own early recovery. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Cory Kinn, men's home coordinator and criminal justice liaison at FOCUS Recovery and Wellness Community, sits in the men's recovery house living room in Findlay, Ohio, Friday, Oct. 20, 2023. FOCUS offers free support and resources to anyone impacted by mental health, addiction, or trauma issues. The group runs three recovery houses. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Cory Kinn, men's home coordinator and criminal justice liaison at FOCUS Recovery and Wellness Community, poses for a photograph at FOCUS in Findlay, Ohio, Friday, Oct. 20, 2023. Kinn, a former construction worker who got into recovery work after a stint in jail on a drug conviction, spends his nights as the live-in coordinator at the men's recovery house and his days working with clients involved in the criminal justice system. FOCUS offers free support and resources to anyone impacted by mental health, addiction, or trauma issues. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    A client plays pool on a quiet afternoon at FOCUS Recovery and Wellness Community Center in Findlay, Ohio, Friday, Oct. 20, 2023. FOCUS offers free support and resources to anyone impacted by mental health, addiction, or trauma issues. The community center hosts 12-step meetings, serves meals and helps connect people with other services. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Cory Kinn, men's home coordinator and criminal justice liaison at FOCUS Recovery and Wellness Community, sits in the men's recovery house living room in Findlay, Ohio, Friday, Oct. 20, 2023. FOCUS offers free support and resources to anyone impacted by mental health, addiction, or trauma issues. Kinn, a former construction worker who got into recovery work after a stint in jail on a drug conviction, spends his nights as the live-in coordinator at the men's recovery house and his days working with clients involved in the criminal justice system. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Clients and staff gather at FOCUS Recovery and Wellness Community Center in Findlay, Ohio, Friday, Oct. 20, 2023. FOCUS offers free support and resources to anyone impacted by mental health, addiction, or trauma issues. FOCUS also runs a center for teens in Hancock County. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    A client plays pool on a quiet afternoon at FOCUS Recovery and Wellness Community Center in Findlay, Ohio, Friday, Oct. 20, 2023. FOCUS offers free support and resources to anyone impacted by mental health, addiction, or trauma issues. The community center hosts 12-step meetings, serves meals and helps connect people with other services. Credit: AP Photo/Carolyn Kaster
  • As billions roll in to fight the US opioid epidemic, one county shows how recovery can work
    Precia Stuby, Executive Director of Hancock County Alcohol, Drug Addiction & Mental Health Services, is photographed in her office in Findlay, Ohio, Wednesday, Oct. 11, 2023. "People recover in a community," said Precia Stuby. "We have to build recovery-oriented communities that support individuals." Credit: AP Photo/Carolyn Kaster

It was a stressful period, but Johnson did not return to using drugs.

"I still sometimes wonder how I didn't turn back to what I knew best," Johnson said.

Instead, she's persevered and has relationships she thought she never would: Her 16-year-old daughter and 2-year-old son live with her, and she often sees her two other sons, who live with her stepfather.

Earlier this year, she started a job with the Family Resource Center, the same organization that employed the peer support worker who was so instrumental in her own early recovery. She's working with jail inmates and people on the outside.

"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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