ECI- Empowering Communities to Reduce Fatal Opioid Overdoses in Rural Ohio
The State of Ohio is in the midst of an opioid epidemic as it has ranked within the top four states for the highest number of opioid deaths, synthetic opioid deaths, and heroin deaths between 2014 and 2017. The state has experienced a 30.8% increase in drug overdose deaths from 2015-2016 and 18.4% increase from 2016-2017. In 2017 alone, Ohio there was 5,111 drug overdose deaths (CDC, 2018). A persistent challenge is that the availability of opioids has changed from prescription drugs, to heroin, and now to fentanyl. According to the CDC, fentanyl is a synthetic opioid that is 50 times more potent than heroin and nearly 100 times more potent than morphine. Fentanyl can be mixed with other drugs such as heroin. In 2017, Ohio was ranked among the top three states for synthetic opioid overdose rates with 3,523 deaths compared to 2016 with 2,296 deaths (CDC, 2018). Further, many of those suffering from addiction are parents.
Not only has the state had record breaking numbers of deaths from opioids, but Ohio’s rural counties appear to be disproportionately affected by the opioid crisis (insert citation). Ohio has witnessed their rural communities desperately need public and social service systems. Compared to Ohio’s urban and suburban areas, rural communities experience higher rates of poverty and have fewer formal services to address community needs such as behavioral health care services (Cummings et al 2012).
In Ohio, the child welfare system has been burdened by the cost of caring for children whose parents have substance use concerns. A survey conducted by the Public Children Services Association of Ohio (PCSAO), one in four children placed in out-of-home care are placed because of opiate abuse. A staggering 70% of children under the age of one enter the foster care system due to parental opioid misuse. In addition, since 2010, the State of Ohio has seen has experienced an 11% increase in placement rates and children are staying in care over a month longer (Public Children Services Association of Ohio [PCSAO], 2017). Many of the children who are placed in care outside of their homes are taken into kinship placement which are relatives that care for children who, in these cases, have a parent who misuses opioids.
Given the extent of the opioid problem for the child welfare system in Ohio, the Ohio Attorney General;s Office (OAG) has provided funding to 18 counties in Southeast Ohio for an intervention referred to as Ohio START (Sobriety, Treatment, and Reducing Trauma). Ohio START is funded under the Victims of Crime Act and is intended to focus on reducing trauma in families involved with the child welfare system that have been affected by substance use. The county agencies are required to work with families by connecting them to peer recovery supporters (i.e., recovery coaches).