Opioid crisis: Can Dayton go from 'overdose capital' to recovery?

Our city was once a national leader for innovation. Last year Dayton got a different label: overdose capital of the nation.

The numbers didn’t entirely support that, but pictures have power — and instead of Wilbur and Orville on a flying machine, Dayton’s iconic photo felt overtaken by an image of a passed-out person on the street getting revived by Narcan.

People are still dying from overdoses here, but not nearly as many as a year ago. Yet fewer deaths doesn’t mean fewer addictions, and we’re still dealing with the fallout from the opioid crisis: more children in foster care; families in turmoil, struggling with broken relationships; a depleted workforce; fatigued first responders.

Our biggest challenges may still be ahead: How can the so-called overdose capital become a model for recovery and hope? And how would we get there?

Starting today, the Dayton Daily News will help find the answers. We are investigating all facets of the epidemic and seeking solutions – and your ideas — as we move from the bleakness of the drug crisis toward a recovered community.

The Path Forward: Addiction in Dayton

“This (has been) devastating to our collective psyche, to our workforce, to our neighbors and friends who have lost loved ones, to our future in many ways. Our circumstance in this matter has also caused a loss around the perception of our city as a vibrant, innovative, healthy community,” said John Baldasare, a local author and public speaker on addiction.

“We deserve a better fate.”

Changing landscape

The label “overdose capital” came after powerful drugs such as fentanyl and carfentanil — an elephant tranquilizer — began to saturate the streets of Dayton and its nearby suburbs. In a single month — May 2017 — Montgomery County logged 81 drug overdose deaths, more than half the usual total for an entire year.

At the rate people were dying, some predicted the number of fatal ODs could reach 800 to 1,000 by the end of 2017, an unprecedented rise that fueled the biggest public health crisis anyone could remember.

Then the numbers turned. All summer, the data showed fewer deaths and fewer overdose calls for EMS and police to handle.

In October, Dayton’s Deputy City Manager Joe Parlette received a daily overdose call log that was blank. He called around to confirm there wasn’t an error. It wasn’t unusual in the past for those daily logs to be five or six pages long.

There was no error. For the first time in recent memory, there hadn’t been any overdose calls in the city the previous day. Blank reports have been more frequent in 2018, Parlette said.

No single factor likely caused the decline in deaths, though the landscape has changed some in recent months. For example, various programs have increased the availability of naloxone — the nasal spray often branded Narcan that reverses the effects of opioids by blocking the drugs from attaching to receptors in the brain, effectively stopping overdoses before they become fatal.

Law enforcement efforts also have slowed the flow of powerful fentanyl and its synthetic cousins into Ohio.

Finally, a growing army of non-profits, government agencies, churches and grassroots groups have stepped in — often with very little resources — to fill gaps in treatment that left many people without options for getting help. There are signs, too, some users have switched to other, less lethal, drugs and away from opioids.

But anyone celebrating or saying that Dayton has solved its drug problem will be met with a quick rebuke from those in the trenches. Fewer people are dying now, but no one knows if that will continue. And even if it does, the tug of addiction has ripple effects that will be widely-felt and long-lasting — not just to the families that have been torn apart, but to all of us.

“Because the addiction of opioids has affected everyone in the community, it has changed the conversation,” Dayton Mayor Nan Whaley said. “We don’t want to waste that opportunity.”

Negative label

Google “overdose capital” and you’ll find a couple of mentions about Huntington, W.Va., sprinkled among dozens of headlines about Dayton and Montgomery County.

It doesn’t matter that Montgomery County did not have the most overdose deaths per capita last year, or any year for that matter. Many stories about the region, even positive ones, include that moniker.

When the New Yorker magazine highlighted the photography of Kettering Fairmont student Colin Combs, the second sentence announced his home town "is sometimes called the heroin capital of the United States."

The Dayton region also figured prominently in the March 5, 2018, issue of Time, which devoted its entire magazine to the opioid crisis.

Miamisburg resident Chad Colwell, who was shown being revived by Narcan-carrying EMTs in the front seat of his truck, told the magazine he got hooked on prescription painkillers “and it just kind of took off from there.” A pregnant Dayton woman who later lost custody of her baby was quoted saying, “I want my daughter. I shouldn’t have used with her.” Another passed out man in his 60s was shown being transferred from a bedsheet to a stretcher after overdosing at his sister’s house. Yet another was captured having what appeared to be a drug-induced episode.

How to get help: An opioid addiction resource guide

The stark, heartbreaking images show a side of Dayton that unquestionably exists. But it’s not all there is, and some in the community are determined to show another side.

Shannon Joyce Neal, whose role as the director of strategic communications for the Dayton Development Coalition includes spotlighting positive news in the region, says stories about Dayton inevitably focus on the "dark center of a crisis. They'll sometimes touch on the economy and jobs, but a lot of the way they present our economy is that we're still in 2008 or 2009," she said.

Yet the Dayton metro area saw a nearly 3 percent job growth rate from 2016 to 2017, according to the DDC, highest of any metro in the state.

“That makes it nowhere in the story,” Joyce Neal said.

Phil Parker, president and CEO of the Dayton Area Chamber of Commerce, said the addiction crisis makes it more difficult for companies to find and retain workers, and also depletes the amount of money available for education and job training that could be used to plug that gap.

“There’s a monetary cost to society and to the community,” he said. “There are so many other issues in the community we could use those public resources for.”

Those on the front lines say the negative perception many people have of Dayton because of the drug crisis obscures the number of success stories that have happened and continue to happen.

"The Time Magazine thing, that is exactly why we exist," said Casey Steckling, a social worker who founded the non-profit, Dayton Recovers, earlier this year. "I haven't used drugs or alcohol for over 12 years. Since that time, I've become a husband, I've went back to school twice, I've become a father, an active member of my church community and then eventually a chemical dependency counselor and international missionary and a licensed social worker."

Steckling estimates as many as 100,000 people in the Miami Valley are dealing with substance abuse disorders. Others put the estimate at anywhere from 8 to 10 percent of the population.

If even 10 percent of that group received treatment and successfully moved into long-term recovery, Steckling said, Dayton would look drastically different.

“If the recovery of Dayton means that we all step up and start to tell a different story, then thank God I guess that the (negative) story got told in the first place,” he said. “Because the public needs to know the reality. That there isn’t someone falling out on the corner right here, but there is somebody in recovery sitting right here.”

New approach

People talk about the opioid crisis as if it’s a new phenomenon, but addiction specialists say it’s a continuation of a long-term problem.

"We historically both in the nation and in the state and in Montgomery County, have struggled with addiction for decades," said Jodi Long, director of treatment and supportive services for the Montgomery County Alcohol, Drug Addiction and Mental Health Services board. "What brought addiction to the forefront was the number of people dying."

Before fentanyl started killing people in record numbers, it was easier for people not to pay attention, she said. But it became impossible to ignore in Ohio when people young and old, black and white and from every conceivable educational background began dying at a rate of 11 people a day, throwing whole families into chaos and stretching the ability of communities to provide basic public services.

The overdose totals from the Miami Valley show how pervasive and devastating the epidemic has been. Of 676 deaths in Montgomery County since January 2017, more than half occurred outside of Dayton, including 39 in Miamisburg, 33 in Kettering and 19 in the Centerville/Washington Twp. area.

Greene, Warren, Clark and Butler counties reported a combined 491 overdose deaths last year, a 33 percent increase over 2016. Fortunately, just as in Montgomery County, the record-setting pace slowed in the year’s second half.

People like Long say the silver lining from the opioid crisis, if there is one, is that money and programs are now in place to deal with the underlying problem of addiction. But some worry whether that same commitment will be there when people stop dying at the same rate, and whether the intense focus on opioids pushes aside resources to deal with other problems.

Long said the lessons learned from dealing with the opioid problem, including the need to address the stigma of addiction, must be aimed at other types of addiction as well.

One local effort involves knocking on the doors of residents with a history of drug use. Officials say outreach efforts like these are a new approach to dealing with addiction, offering help and information instead of handcuffs and a ride to jail.

Dayton is so committed to the countywide program — called GROW (Getting Recovery Options Working) — a police officer and an emergency medical technician work full-time interacting with residents in their homes and on the street. Miamisburg also has a full-time GROW position, while several other jurisdictions in the county dedicate staff on a part-time basis.

The man answering the door at an apartment on Beckman Street in Dayton on June 12 had overdosed just a week earlier and was revived with Narcan. Defensive at first, he later admitted to having a problem with alcohol.

“I’m tired of this lifestyle,” he repeated several times to Police Officer Jason Olson and Emergency Medical Technician Amy Dunkin.

Later that morning, Olson and Dunkin responded to an overdose in progress: a 38-year-old man face down on the sidewalk at a gas station on Keowee Street. A passing firefighter had stopped to help but didn’t have Narcan with him, so police cruisers arrived and revived him.

He thanked the first responders for saving his life, but declined a trip to the hospital and walked back toward his hotel room.

Olson and Dunkin spoke with the man and his companion, handed out cards with their cell phone numbers on them, and put them on a list for a future door knock.

Dunkin believes the intervention is having an impact.

THE PATH FORWARD: Dayton Daily News Investigates digs into the region’s most pressing issues

“Before I think across EMS, fire, police, there was kind of a burnout,” she said. “It was frustrating to give Narcan over and over again to that same person without there ever being anything else past that.

“Now I feel like we’re actually helping people. There’s something past the Narcan to be able to help someone get that treatment.”

Switching the narrative

The addiction crisis and its many tentacles is extracting a huge public price tag. Congress spent the better part of the past two weeks debating funding measures — efforts that will no doubt add to the more than $1 billion sent to the states over the past two years to cover treatment costs.

Yet those who live the crisis every day say money is only one side of the equation.

“I think the biggest problem that we have in terms of switching the narrative from being an addicted community to being a recovering community is an education about what exactly is this thing we’re wrestling with and being able to humanize it to some degree,” said Greg Delaney, a Xenia pastor in long-term recovery who has been helping lead other faith-based groups to embrace the recovery movement. “We go ahead and we label the addict. We label the prostitute… We never take any time to pull the lens back and say how did they get there?”

Lori Erion, whose daughter's addiction led the Enon mother to found the group Families of Addicts, says even after all the attention given opioids in recent years, many people still believe it won't happen to them.

“It’s important for people to realize that two-thirds of American families are touched by addiction in one way or another. Still, it’s not being talked about in lots of places, and so people going through it can feel isolated,” she said.

“It’s not like anybody brings over a casserole when your loved one relapses.”

MORE FROM THE PATH FORWARD:

Mother of 7 rebuilding family after addiction

A day with Dayton’s overdose response team

Q&A: Learning from addicts, helping families

ExploreDayton Recovers leader envisions brighter future for region after opioid crisis

Where to get help

Area counties all have crisis hotlines. Those numbers are below. The Dayton Daily News has also compiled an opioid resource guide that includes treatment and support programs throughout the region. To access that list, go to mydaytondailynews.com/opioidresources

Crisis hotlines

Statewide text hotline: Text “4hope” to 741741

Montgomery County: 937-224-4646

Clark County: 937-399-9500

Butler County: 1-844-427-4747

Greene County: 937-376-8701

Preble County: 1-866-532-3097

Miami, Darke and Shelby counties: 1-800-351-7347

Warren and Clinton counties: 1-877-695-NEED (6333)

Champaign and Logan counties: 1-800-224-0422

In most counties you can also dial 2-1-1 to be connected to mental health and addiction services.

National Suicide Prevention Hotline: 1-800-273-TALK