Purdue Pharma Offers Reparations for Individuals Affected by Opioid Crisis

The aggressive marketing and pharmaceutical sales of opioids in the past decade have left a devastating wake of addiction and death in the United States. Now, individuals who have been harmed by prescription opioids have the chance to file claims against Purdue Pharma, the maker of the painkiller OxyContin. Until July 30 of this year, people who have suffered from the effects of prescription opioid use will have the opportunity to seek compensation.

As of June 11, 2020, about 17,800 personal-injury claims have been filed by people who believe they or their loved ones were harmed by these prescription opioids.

Purdue Pharma is widely believed to be the instigator of the opioid epidemic. In 2019, the company declared bankruptcy which brought the more than 2,000 lawsuits against the company to a halt. “Purdue Pharma and its owner, the Sackler family, reportedly set aside $10 billion or more and put the company into a public trust to pay individual victims’ claims,” according to Newsomelaw.com. The company launched a $23.8 million advertising campaign to announce its opportunity for individuals to file claims.

This bankruptcy is unusual in that the implications of this company’s actions have spurred a national health crisis that has taken hundreds of thousands of lives and created a case for reparations beyond what can be quantified. It cemented a systemic crisis that will take years to undo.

It was also complicated by the sordid actions of the Sackler family, Purdue Pharma’s owners, who had transferred about $1 billion to foreign locations prior to filing bankruptcy. The case which involves Purdue Pharma filing for bankruptcy, also proposes a settlement worth more than $10 billion over time, plus $3 billion from the Sackler family over the next seven years, and an additional $1.5 billion from the sale of the family’s global pharmaceutical business, Mundipharma. It would also require that the family give up ownership of Purdue Pharma.

If you or a loved one has been harmed by the effects of opioids sold by Purdue Pharma, you can access a list of instructions on how to file a claim here.

Hotline Calls Spike During Stay-at-Home Orders

In a time of stay-at-home orders, heightened financial stress, and a lack of in-person resources that usually exist, incidents of child maltreatment and domestic abuse are increasing while reported cases are falling. Children are not receiving access to educators, who are often the front-line defense in keeping children safe. Child welfare workers are scrambling to ensure that children continue to receive the care they need despite the desperate circumstances.

An article by USA Today reported that educators including teachers, administrators, and counselors report about one in every five claims of child mistreatment. With children sequestered to their homes and limitations placed on who can visit them, reporting a case of mistreatment is becoming a task that is more precarious than ever. While child caseworkers are limiting visits to their clients’ homes for fear of spreading the virus, they will not become absent from these children’s lives.

Welfare officials are adapting to the virtual environment and setting up video calls to do walkthroughs of children’s home environments. They are also arranging in person visits with higher risk cases, or children who may be in immediate danger. These cases may be addressed through visits in the child’s backyard.

Parents are also facing heightened stress as they learn to manage 24/7 childcare, whether they are working remotely and/or are required to go into the office as essential workers. According to USA Today, “Calls to the group’s National Parent Helpline for families in crisis have spiked 30% in the past week, Pion-Berlin said. They’re coming from mothers and fathers stressed about child care, food insecurity and other fears arising from the coronavirus crisis.”

The Columbus Police Department has also seen an “alarming increase” of domestic violence calls since the stay-at-home order has been in place.

If you are dealing with a difficult home environment, you are not alone. Here are some resources that are available and ready to help during this time of crisis:

Franklin County Children Services Child Abuse Hotline: 614-229-7000

Ohio Domestic Violence Network

CAP4KIDS

National Child Abuse Hotline: 800-422-4453

Generation O: Trapped in a Cycle of Addiction

In 2019, a New York Times reporter, Dan Levin, detailed the horrific experiences of children in Ohio who were removed from their homes after years of neglect, abuse and traumatic childhood experiences. He leads the story by writing that, “Nearly 27,000 children in Ohio were removed from their homes last year, many because of the opioid crisis. More than a quarter were placed in the care of relatives.”

The stories Levin recounted were those of children sent outside without sufficient food and water while their parents use drugs, as sister and brother Hannah and James experienced each summer. These children were also exposed to traumatic violence between their parents, as seven-year-old Hannah called 911 after her mother chased her father with a knife. Hannah’s father was later killed by her mother’s boyfriend.

Stories like these paint the picture of the lives of many of these 27,000 children. Parents in rehab, sick or dead from drug addiction are circumstances that young children are exposed to far too commonly. So commonly, that a name was dedicated to children trapped in these vicious cycles of addiction – Generation O.

Certain geographic areas are more dense with these concerns.

“In Portsmouth, Ohio, at least a quarter of the school district’s nearly 650 junior high and high school students have a close relative who uses drugs.”

As written in another NYT article by Dan Levin, this will have a long-lasting impact on the communities with heavy users, as more children are being born with a dependency on opioids, and many with severe learning disabilities and other types of disabilities. This poses a new challenge for educators as schools increasingly become places of refuge in the lives of maltreated children.

“Many students frequently come to school wearing the same, unwashed clothes days in a row, so shelves are stocked with clean garments, along with fresh shampoo, bars of soap and deodorant.

Yet some of the teenagers change back into their own clothes after the final bell rings and the last class ends, ‘because parents will take new clothes and sell them for drug money,’ said Drew Applegate, an assistant principal.”

In a sobering reality of family life in Portsmouth, an art teacher cannot think of any student who paints a two-parent family during their family portrait lesson.

As long as the opioid crisis presides over these communities, there will continue to be a shift that emphasizes the role of educators in children’s lives.

Stress and Isolation Can Impact Substance Use

People who have a history or are currently dealing with addiction are especially vulnerable to relapse when faced with isolation, and this is especially worrisome given the intensity and duration of isolation associated with the COVID-19 crisis. With restrictions on travel and unusually stressful economic and social changes, people across the world are forced to find ways to pass time and to cope with stress. Substance use can be a maladaptive coping strategy that many people may fall back on during these difficult times.

A Forbes article noted that the sales of spirits spiked about 50% the week of March 21, a week when the onset of the pandemic began to overwhelm the United States.

“Nationally, tequila saw the biggest spike, up more than 75%, underscoring its status as the fastest growing spirits segment in the U.S,” said Forbes contributor, Joseph V Micallef. “It was followed closely by gin. Wine sales were up 66% and beer sales, in a reversal of the usual recession consumption pattern, lagged even though they still rose 42%.”

A study was conducted by the Pacific Neuroscience Institute (PNI) on the effects of stress and isolation on relapse. The results indicated that the effects of people who struggle with drug or alcohol use are at increased risk of relapse in isolation. “Preclinical studies show that animals kept in isolation are more likely to press a lever to receive a dose of drug or alcohol than animals able to interaction with other animals.”

The connection between isolation and an increased need for stress-relieving rewards is proven to be a chemical reaction. The PNI recommends that those who are struggling seek out regular social interactions with sober family members, friends or other people who can offer support. There are online platforms set-up to support individuals who are struggling and cannot receive in-person help during the pandemic.

AA and SMART Recovery are two recovery platforms that have online services including specialized group forums, peer support groups, meetings, and other events designed to create remote support systems for individuals in need.

Doctors and mental health specialists are also accessible throughout this time and available to ensure that everyone has the resources they need during this global health crisis. Personal health is of the utmost priority during this time and is something we could all focus more time on.

Reach out to any people or organizations who can help you get through this difficult time, and don’t forget to make your support available to others as well. We’ll all get through this together.

COVID-19 is Especially Tough on Kids in Need

Children in foster care are highly at risk

By, Jennifer Vickers
Guest columnist at The Columbus Dispatch
Published 4/21/20

Home has taken on new meaning the past few weeks. We stay home to protect the broader community. We’re working from home. Having birthdays at home. And for many, a stable place to call home might be something we take for granted.

But for children in foster care who are waiting for permanent, loving homes, the COVID-19 crisis has brought more uncertainty and instability. As an adoption professional, I see the impact the current environment is having on children waiting in foster care. While our communities and leaders look for ways to support those most vulnerable in this crisis, it is critical that our children in foster care remain in focus.

Children in foster care are particularly vulnerable to the negative health and social impacts of the coronavirus. Due to trauma and the ever-present stress it causes, these children experience higher rates of acute health conditions than the general population, making them more at risk for contracting the virus. Those living in institutional or congregate care settings might also be at an increased risk of becoming infected.

Children in foster care might also be particularly affected by the isolation of social distancing. They often have less dependable access to technology to connect with friends or family and might move from place to place as foster families manage illness and financial uncertainty. For all these reasons, the current environment is a trigger for the trauma, stress and anxiety that many of these children have experienced in their short lives.

In my role with Wendy’s Wonderful Kids, a program of the Dave Thomas Foundation for Adoption, I have served children at the highest risk of aging out of foster care without an adoptive family. This includes teenagers, children with special needs and siblings. I meet with them regularly to hear about their lives and make sure they know someone is in their corner. We play games, go for a walk, work on their homework or just talk about what’s on their mind. And most importantly, I work to find them safe permanent homes.

There are already more than 125,000 children in foster care waiting to be adopted across the United States. Last year, nearly 20,000 older teens aged out of the system with nowhere to go — putting them at significantly increased risk for homelessness, unemployment, having children before they’re ready and continuing the cycles that placed them in foster care in the first place. I fear these numbers might go up if fewer families agree to foster or adopt in this environment.

The uncertainty of this time takes an emotional toll and brings back memories of their loss and trauma and increases feelings of loneliness and not being wanted. They worry about the health and safety of their birth families, and misinformation about the virus adds to their fears.

With in-person meetings on hold, video conferencing tools and other technology that allows me to connect with children and prospective families have become essential. These touch points are especially critical now to help lift their spirits and ensure that we can continue working diligently to keep the placement process moving forward. For some children, communicating virtually has been an easier transition. But for others, including children with special needs, not being able to meet in person has been much harder. Through this all, though, my colleagues and I are committed to finding creative ways to remind young people we serve that someone is here for them.

The urgent need to find permanent homes for our children and youth in foster care is more important than ever. We also need people to stay committed to opening their homes as foster or adoptive parents.

Adoption professionals, online resources and support networks are available to prepare prospective parents and help them begin the journey to providing a safe, loving home. In these difficult times, we simply cannot forget about the children who need our help the most.

Jennifer Vickers is a Wendy’s Wonderful Kids adoption recruiter in northwest Ohio.

Peer Recovery Supporters: Benefits and Best Practices

The approach to treating substance use disorder (SUD) has been changing to be more recovery-oriented. There is a shift from treatment and control of symptoms to treatment focused on approaches that empower the client to maintain long-term recovery.  Peer recovery supporters (PRS), trained individuals with their own recovery experience, are thought to provide significant advocacy and support for individuals struggling with addiction. PRS support and advocate for their clients as they navigate the successes and setbacks of the recovery process.

Some of the advantages of using PRS are that clients paired with PRS:

  • Formed better relationships with their treatment providers and greater utilization of social supports
  • Stayed in treatment longer and reported higher satisfaction with treatment
  • Had reduced substance use and were less likely to relapse

Peer Recovery Supporters, in turn, express that having the opportunity to share their lived experience with addiction and recovery with others helps them to:

  • gain better insight into their own symptoms
  • increase social engagement and
  • improve their sense of life satisfaction

The use of PRS as a component of a recovery-oriented treatment model is showing promise for promoting long-term recovery. It is expected that the use of PRS in SUD recovery will continue to grow, and agencies may need to make additional adjustments to support PRS. Cultivating agency culture to embrace and promote the inclusion of peers in SUD treatment is vital to having a successful PRS program. Further, agencies should consider the expansion of peer occupational growth opportunities as well as professional development efforts that allow PRS to qualify for advanced positions. Considering the PRS as a valued professional member of the SUD treatment team will help maximize their ability to help clients engage in treatment and work toward long-term sobriety.

References:
Eddie, D., Hoffman, L., Vilsaint, C., Abry, A., Bergman, B., Hoeppner, B., … Kelly, J. F. (2019). Lived experience in new models of care for substance use disorder: A systematic review of peer recovery support services and recovery coaching. Frontiers in Psychology, 10(JUN), 1–12. doi:10.3389/fpsyg.2019.01052
Ahmed, A. O., Hunter, K. M., Mabe, A. P., Tucker, S. J., & Buckley, P. F. (2015). The Professional Experiences of Peer Specialists in the Georgia Mental Health Consumer Network. Community Mental Health Journal, 51(4), 424–436. doi:10.1007/s10597-015-9854-8
Chapman, S. A., Blash, L. K., Mayer, K., & Spetz, J. (2018). Emerging Roles for Peer Providers in Mental Health and Substance Use Disorders. American Journal of Preventive Medicine, 54(6S3), S267–S274. doi:10.1016/j.amepre.2018.02.019

Grandparents Raising Grandchildren: Opioid Prescribing Rate Matters

Research from the U.S. Census Bureau has found that states with higher opioid prescribing rates have higher numbers of grandparents raising grandchildren, even after taking into account other socio-economic factors such as poverty. Data from the 2012-2016 American Community Survey allowed researchers to study the relationship between opioid prescription rates at the state and county level and the number of grandparents raising grandchildren. The study found that opioid misuse was involved in 46% of cases where grandparents are caring for grandchildren in rural areas, compared to 32% in urban areas. Nationally, 32% of children in foster care are being raised by relatives with many more are being raised by relatives outside of the foster care system. Currently, 2.7 million grandparents are raising grandchildren. According to the Public Children Services Association of Ohio, about 100,000 grandparents are currently raising their grandchildren in Ohio.

Ohio is making progress in reducing its opioid prescribing rates, but rates are still high. Since 2010, Ohio’s overall opioid prescribing rate has dropped from 102.4 to 63.5 per 100 persons, which is still higher than the national rate of 58.7. Cuyahoga is the only urban county, at 50.1 per 100 persons, have an opioid prescribing rate lower than the national rate. In rural counties, the prescribing rate ranges from Nobel the lowest (17.8) to Jackson the highest (112.5). Ohio continues to be challenged by the misuse of opioids with the second-highest opioid overdose death rate of 39.2 deaths per 100,000 persons.

Grandparents raising grandchildren face many special challenges including mental health concerns for themselves and their grandchildren due to the death or temporary loss of their grandchild’s parent (their son or daughter), financial obligations, navigating the school system, and building networks of social and other supports. To respond to the impact of the opioid crisis on grandparents, the federal government enacted The Supporting Grandparents Raising Grandchildren Act in July of 2019. The act created a federal task force to identify and share information to help grandparents raising grandchildren.

Anderson, L. (2019). The opioid prescribing rate and grandparents raising grandchildren: State and county-level analysis. Retrieved from https://www.census.gov/content/dam/Census/library/working-papers/2019/demo/sehsd-wp2019-04.pdf

Centers for Disease Control and Prevention. (2017). U.S. Opioid Prescribing Rate Maps | Drug Overdose | CDC Injury Center. Retrieved May 31, 2019, from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

Cole, P. E., Clausen, K. A., Cook, L., Johanson, M., Cunliffe, J., Associate, R., Rostan, M. (2016). 2016 state of poverty: A portrait of Ohio families. Retrieved from www.oacaa.orgwww.researchpartners.org

National Institute on Drug Abuse (NIDA). (2019). Opioid summaries by state. Retrieved May 31, 2019, from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state

Public Children Services Association of Ohio. (2019). PCSAO – Factbook. Retrieved May 31, 2019, from http://www.pcsao.org/factbook

Drug Overdose and Ohio’s Good Samaritan Law

Good Samaritan laws are meant to protect someone from legal liability when providing help to a person in distress. Ohio has had a Good Samaritan Law since 1977 to protect people from malpractice lawsuits when providing emergency medical and non-medical care to someone in need. This protection is not just for off-duty medical professionals but also for any citizen. This law does not protect someone who deliberately acts in a way that they know can cause further harm, or who accepts money, gifts, or any form or payment for helping.

Do you have to help someone in distress? Ohio does have a “duty to rescue” rule and requires you to help someone in distress if:

  • You are responsible for the welfare of a child. This includes parents, guardians, teachers, and any adult responsible for the child.
  • Your actions caused the danger.
  • You started to help – you must continue to help unless the situation changes to put you in danger.

In 2016, Ohio revised its Good Samaritan laws (Ohio Revised Code Section 2925.11) to encourage people to call 911 when they see someone who overdoses. What this law does is provide immunity for minor drug possession, amounts considered to be a misdemeanor or fifth-degree felony, to individuals who seek emergency help for themselves or another person during a drug overdose. The 911 operator receiving the overdose call can help explain this immunity if asked. You cannot be arrested or prosecuted if:

  • Law enforcement found the drugs as a result of seeking medical assistance for a drug overdose.
  • The person has a drug test and receives referral for treatment from an accredited addiction treatment program or professional within 30 days.
  • The person provides documentation, when requested by a prosecutor, verifying the date and time of the drug test and receiving the referral.

This immunity can be used twice and people on parole or probation are not eligible. The immunity is limited to possession of controlled substances. House Bill 205 is currently in the Ohio Legislature and, if approved, it will expand immunity to include drug paraphernalia.

Peer Recovery Support Services: Helping Child Welfare Families with Substance Use Disorder

Parents involved with child welfare that have substance use (SUD) are often engaged with multiple systems including child welfare, SUD treatment, and the courts. To help families navigate these services and requirements, they can be assigned a Family Peer Mentor (FPMs). What is an FPM, what do they do, and are they helping families with parental SUD stay together?

An FPM is someone in long-term SUD recovery1 who also has experience with the child welfare system. They also complete a certification training program1 to learn how to apply their own experiences to help other families. The FPM is the family advocate, connecting the family to needed services and as emotional support promoting sober parenting. The relationship between the FPM and the family is collaborative with the shared goal of achieving parental sobriety and family safety and stability. FPMs are uniquely positioned not only to help families navigate the child welfare system, but also to provide the hope and motivation needed to achieve and maintain sobriety.

To better understand how FPMs help child welfare involved families, a study2 was conducted of the services and outcomes of 28 FPMs involved in the Sobriety Treatment and Recovery Teams (START) in Kentucky. Each FPM was partnered with one child welfare caseworker, and this FPM/caseworker team served 12-15 families. This study shows the importance of FPMs in promoting family unification and parent sobriety:

FPM Study ResultsThe study also highlights the importance of supporting FPMs’ own sobriety as they transition from child welfare client to an employee supporting families through a very stressful situation. Of the 28 FPMs, 10 had a relapse or other ethical/policy violation that resulted in their removal; however, the remaining 18 FPMs realized stability and growth either with the child welfare agency or with other, more advanced positions.

With the goal of parental sobriety and family unification, the use of FPMs shows excellent promise. Kentucky START and programs using FPMs or peer supporters are not only helping families; these programs are keeping more children from entering out-of-home care while also giving individuals in recovery an opportunity for steady, full-time employment that appreciates their child welfare and SUD experience to help others.

1Click here for more information on The Ohio Department of Mental Health and Addiction Services (OhioMHAS) certification for Peer Recovery Supporters in Ohio: (https://workforce.mha.ohio.gov/Workforce-Development/Job-Seekers/Peer-Supporter-Certification).

2Huebner, R. A., Hall, M. T., Smead, E., Willauer, T., & Posze, L. (2018). Peer mentoring services opportunities and outcomes Huebner 2018.pdf. Children & Society, 84, 239–246.