Last year, Dayton, Ohio was considered one of the epicenters of the drug epidemic. The area had one of the highest opioid overdose death rates in the nation in 2017 and the worst in Ohio. Now, Dayton is the fastest-recovering area in the nation. How did they do it?
According the The New York Times, Montgomery County had 548 overdose deaths by the end of November 2017; so far this year there have been 250, a 54 percent decline. Now, says the Times, Dayton “may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands of people in the United States over the last decade, including nearly 50,000 last year.”
The New York Times spent several days in Dayton, interviewing police and public health officials; doctors, nurses and other treatment providers; people recovering from opioid addiction and people who are still using heroin and other drugs. Each of these groups is on the front lines of the drug epidemic and are directly involved, in one way or another, with the crisis.
The 54 percent decline in overdoses is largely due to organizations, policy makers, leaders, and other groups listening to suggestions from people with lived experience in recovery. The role of recovery advocates cannot be underestimated. The declining deaths in Dayton show that when leaders listen to people in recovery, we save lives.
Medicaid expansion greatly increased access to substance treatment. Nationally, less than ten percent of people ever seek medical help of any kind for substance use-related problems. That number has decreased very slightly for opioid users, according to a recent report from the CDC. Ohio Governor John Kasich expanded Medicaid in 2015, a move that gave nearly 700,000 low-income adults access to free addiction and mental health treatment. In Dayton, that’s drawn more than a dozen new treatment providers in the last year alone, including residential programs and outpatient clinics that dispense methadone, buprenorphine and naltrexone, the three medications approved by the F.D.A. to treat opioid addiction.
Dangerous synthetic opioids like carfentanil are dwindling as street drugs. Police and public health workers are cooperating in spaces where their work overlaps, such as syringe exchanges. The Times reports that “the city secured a federal grant for a pilot program that distributes fentanyl test strips, which can be used to check street drugs for the presence of various fentanyl analogues. Only a handful of cities are sanctioning the test strips at this point. Sheila Humphrey, the Dayton director for Harm Reduction Ohio, a nonprofit group, has given out thousands of strips, often at parks and community events.”
Naloxone is everywhere. Easy access to naloxone, an overdose-reversing medication, has also made huge gains in Dayton. According the The Times, Richard Biehl, the Dayton police chief, directed all his officers to carry naloxone starting in 2014. Also, “Montgomery County agencies distributed 3,300 naloxone kits last year, and are on course to more than double that number this year, holding trainings at treatment centers and 12-step meetings as well as at local businesses and schools.”
Post-acute care for people is improving, and there are more options for people leaving treatment. Since recovery spectrum care has historically focused on detox programs and 28-day treatment programs, this is a key innovation. Dayton has an unusually large network of recovery support groups. The New York Times says “the city is also investing heavily in peer support—training people who are far enough along in their recovery to work as coaches or mentors for others who are trying to stop using, including in emergency rooms.” Meeting people wherever they are in their recovery is crucial to sustaining recovery and creating life-saving connections for people in need.
Harm reduction, better support, and a compassionate approach to recovery are changing outcomes for people in Dayton. This is not the result of passive action; it’s because Dayton’s people raised their voices and made recovery a priority. The New York Times optimistic coverage validates the heroic efforts of the Dayton community. Dayton, as a test case for a “recovery city,” is a strong example of what’s possible when we put recovery first and commit to helping people get better.