Combating Ohio's Opioid Crisis

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Opioids killed 4,050 Ohioans in 2016, ranking Ohio No. 1 in the nation in terms of opioid-related overdose deaths, according to the Ohio Department of Health. That’s a 33 percent increase from 2015.

The College of Food, Agricultural, and Environmental Sciences is hitting the problem head on, with efforts designed to combat Ohio’s opioid crisis underway in all 88 Ohio counties through its Ohio State University Extension offices, which is the outreach arm of CFAES.

From first aid training for OSU Extension employees — to learn to identify, understand and respond to signs of mental health and substance/opioid abuse — to working with 4-H youths to empower them to speak out against opioids, CFAES is working to fulfill its land-grant mission.

Mental health first aid training

OSU Extension professionals are undergoing training in how to identify and handle situations such as someone having a panic attack, experiencing delusions, having suicidal thoughts or suffering from an overdose of alcohol or drugs.

Mental Health First Aid, offered by the National Council for Behavioral Health, is being offered to OSU Extension staff statewide. The goal is to help employees gain the skills needed to identify, understand and respond to signs of mental health and substance/opioid abuse challenges and crises, said Roger Rennekamp, director of OSU Extension.

OSU Extension professionals are in all 88 Ohio counties, making them perfectly positioned to assist in the opioid crisis, Rennekamp said.

Mental Health First Aid trains people to detect the early warning signs of a mental health crisis, including training them to know when to make referrals for resources to help, Rennekamp said. “The training is designed to help agency professionals and community members spot warning signs of mental illnesses and make appropriate referrals for assistance.

It just provides us with helpful ways to respond to a mental health or opioid crisis, including how and when to offer help and where to go for assistance.” The training includes two courses: adult Mental Health First Aid and youth Mental Health First Aid, said Jami Dellifield, an OSU Extension educator who has undergone the certification and is now a certified instructor in both courses.

The adult course offers insight into several mental health disorders: depression, anxiety/trauma, psychosis and psychotic disorders, substance abuse disorders, and self-injury. In addition to the mental health disorders covered by the adult course, the youth course includes insight into adolescent development and mental health, Dellifield said.

The certification includes the ALGEE method, a five-step, triage-style response plan for nonprofessionals. It teaches people to assess for risk of suicide or harm; listen nonjudgmentally; give reassurance and information; encourage appropriate professional help; and encourage self-help and other support strategies.

Tackling the opioid crisis through policy briefs

CFAES researchers and analysts are also focusing on Ohio’s opioid crisis from a policy perspective.

Mark Partridge, a professor in Ohio State’s Department of Agricultural, Environmental, and Development Economics, writes in a recent report, that one effective way to combat the state’s growing opioid crisis is to prioritize treatment in underserved areas across the state because those are among the areas struggling most with opioid abuse.

“As it now stands, Ohio likely only has the capacity to treat 20 to 40 percent of the estimated 92,000 to 170,000 Ohioans who are abusing or dependent on opioids,” he said.

Partridge, chair of the C. William Swank Program in Rural-Urban Policy at The Ohio State University, wrote in the 2017 analysis, “Taking Measure of Ohio’s Opioid Crisis,” that medication-assisted treatment is the most clinically effective and cost-efficient method for reducing opioid addiction, abuse and overdose death.

4-H conversations on opioids

The opioid crisis isn’t limited to adult Ohioans – it impacts young people, too.

It’s in their schools, their communities, and in many cases, their homes. But for many young people, the answer of what to do about Ohio’s opioid crisis isn’t clear, said Theresa Ferrari, a 4-H youth development specialist with OSU Extension.

“A lot of young people are concerned about the issue but aren’t sure what steps they can take to be part of the solution or to make sure they don’t become part of the problem,” she said. “Most teens know the issue is going on: They know if kids in their schools are doing drugs.”

To help teens learn who to talk to about opioids and how to prevent themselves and others around them from using opioids, Ohio 4-H held the Hope for Ohio: Teen Forum on the Opioid Crisis last Dec at Ohio State’s Nationwide and Ohio Farm Bureau 4-H Center on the Columbus campus.

Ohio 4-H, the youth development program of OSU Extension, and other partners including Ohio Farm Bureau, Ohio FFA and Prevention Action Alliance, a Columbus-based certified prevention agency, convened the teen forum.

Some 50 people attended the forum, which was designed to educate and prepare both teens and adults to take action against drug abuse in their communities, Ferrari said.

It’s important to speak to teens about an issue that, for many, is life-threatening, she said.

“Teaching teens to take a leadership role in helping to prevent themselves and their peers from abusing opioids fits into what we do every day with 4-H: preparing young people to be leaders and to understand what is going on in their communities.

“But you have to arm them with research-based knowledge so they know the facts.”

The facts are alarming.

Some 122,000 teens under age 17 and 427,000 adolescents between 18 and 25 had a pain reliever use disorder in 2015, according to a study from the Substance Abuse and Mental Health Services Administration. And one in eight U.S. high school seniors in 2013 reported using opioids for nonmedical reasons, according to a 2015 study funded by the National Institute on Drug Abuse.

Ohio law now requires K-12 schools to provide drug education, to teach students about the harmful effects of and legal restrictions against the use of drugs of abuse, alcoholic beverages and tobacco, said Carol Smathers, field specialist in Youth Nutrition and Wellness for OSU Extension, who is also worked to organize the 4-H opioid forum.

A big part in reversing this epidemic is to give kids a platform to discuss the realities of the issue, to treat it as a disease and to teach compassion for people who have it,” she said. “They can reach out and be a support to friends who are struggling and to get the word out about how to prevent it in their communities.”

4-H mirror educates on opioid abuse

Sometimes it just takes looking into a mirror to get a clearer understanding of an issue.

At least that’s what a group of 4-H students hope is the case in the ongoing fight against the opioid crisis in Ohio.

The traveling display created by 4-H members may seem innocuous enough — a simple pedestal sink with a mirrored medicine cabinet mounted above, similar to what could be seen in bathrooms in almost any home in the region.

But the question accompanying the display —“What’s in your medicine cabinet?” —may not be as easy for some Ohioans to answer.

Experts say misuse of prescription opioids is one of the strongest risk factors for starting heroin use, with three out of four new heroin users reporting that they abused prescription opioids.

The 4-H members who created the medicine cabinet display want to prevent the next potential user from adding to Ohio’s growing opioid crisis. The cabinet includes prescription bottles labeled with drug abuse facts and information as part of their work as Ohio 4-H Health Heroes.

The goal, said 15-year-old Molly Rubio, a 4-H member from Greene County who works with the medicine cabinet display, is to attract attention about the issue and engage the public in discussions on how to prevent opioid abuse.

“The message is clear — look in the mirror — the face of opioid addiction staring back at you could be yours,” Rubio said. “Open the medicine cabinet and those prescription pain pills could be your entry to addiction.”

Rubio is among a group of high school and college students who make up the Ohio 4-H Health Heroes.

The medicine cabinet display is a project of the Ohio 4-H and was funded through a grant from the Robert Wood Johnson Foundation through the National 4-H Council. It’s now being used by 4-H members at fairs and other events around the state as a means of encouraging talk among young people about the opioid crisis.

Madelyn Smith, a 4-H student in the 9th grade from Blacklick, Ohio, said the interactive medicine cabinet display has been a really effective way for her and other 4-H members to talk to teens across the state.

“While people generally seem to be aware about the opioid issue, they are shocked when they hear the numbers of how many people the issue actually affects and by how many people are dying,” Smith said. “This is something that we need to talk about, especially to our peers, who seem to respond better when they hear this kind of information from people their own age.”

The display is even more effective because 4-H members who are trained to advocate about medication safety and drug abuse prevention staff it, Ferrari said.

“Teens listen to each other better than they listen to adults,” she said. “We aren’t health providers so we don’t offer treatment.

“Rather we focus on prevention and advocacy. This is 4-H’s niche – we work to educate teens to be leaders and help them learn how to make a difference.”

More information on the medicine cabinet display can be found at ohio4h.org/4-HMedicineCabinet.

CFAES safety personnel reach beyond Wooster campus

In 2015, Ohio emergency management services personnel administered 19,782 doses of naloxone, the opioid reversal drug. That accounts for 7,207 more doses than in 2013.

At least two of those doses were administered by CFEAS public safety officers.

Justin Estill, a public safety officer for the CFAES Wooster campus is credited with using Narcan to revive a young woman who overdosed at a gas station near the campus. Although Estill’s main responsibilities are to keep the campus safe, he and other officers can assist with community calls.

That was the second time in six months that Estill had reversed an opioid overdose – the other time to a woman who overdosed in a home a few miles south of campus.

Whenever possible, CFAES security personnel try to assist with emergencies beyond the Wooster campus because the college is part of the Wooster community, said Seth Walker, public safety manager for the Wooster campus.

“These are two lives that could have been lost here,” Walker said. “Maybe it’s the ‘one more time’ they needed to try to turn everything around.”

CFAES researchers and analysts are also focusing on Ohio’s opioid crisis from a policy perspective.

Mark Partridge, a professor in Ohio State’s Department of Agricultural, Environmental, and Development Economics, writes in a recent report, that one effective way to combat the state’s growing opioid crisis is to prioritize treatment in underserved areas across the state because those are among the areas struggling most with opioid abuse.

“As it now stands, Ohio likely only has the capacity to treat 20 to 40 percent of the estimated 92,000 to 170,000 Ohioans who are abusing or dependent on opioids,” he said.

Partridge, chair of the C. William Swank Program in Rural-Urban Policy at The Ohio State University, wrote in the 2017 analysis, “Taking Measure of Ohio’s Opioid Crisis,” that medication-assisted treatment is the most clinically effective and cost-efficient method for reducing opioid addiction, abuse and overdose death.

For more information contact: 
Tracy Turner
614-688-1067