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Wednesday, September 27, 2017

Building community as a way to combat opioids was a resounding theme at Foundation for a Healthy Kentucky's annual policy forum

By Melissa Patrick
Kentucky Health News

What if ending the opiod epidemic boiled down to re-building local communities, and re-thinking how we raise our children?

That may sound like a pie-in-the-sky ideal, but it resonated with many who attended the Foundation for a Healthy Kentucky's Howard L. Bost Memorial Health Policy Forum in Lexington Sept. 25.

Ben Chandler and Sam Quinones at Bost Forum
(Foundation for a Healthy Kentucky photo)
Keynote speaker Sam Quinones, author of Dreamland: The True Tale of America's Opiate Epidemic, told the sold-out crowd that the opioid epidemic is about so much more than drug trafficking and drug marketing; it is also about the isolation that has resulted from the loss of community.

Quinones talked about how we've moved away from the desire to invest in places that allow us to come together, likely referencing a now-closed community swimming pool called Dreamland that had once been the social epicenter of Portsmouth, Ohio, a town that is now ravaged by the opioid epidemic -- and the namesake of his book.

"Heroin is the perfect symbol for how isolated we have become as Americans, and how much we have killed off or ignored what would bring us together," he said. "I believe therefore more strongly than ever that the antidote to heroin is not Naloxone, it is community."

Ben Chandler, president and CEO of the foundation, passionately agreed with Quinones. He said improving communities would improve the overall health of Kentuckians.

"Every man for himself is unhealthy," Chandler told reporters. "We are social animals. We need each other desperately and when we are isolated from each other, which has become more and more the case in our society, we are less healthy on a number of different fronts."

He added, "But I can tell you we need to get the resources necessary to create community -- and you say the word tax, say it one time and immediately in this country we think it is a nasty word."

Chandler, a former congressman and state attorney general, said that now that he is out of politics he can talk about that "nasty word" and said it's time for a much higher cigarette tax in Kentucky.

"We need more funding for a lot of things and we need more funding for these heath matters," he said. "The cigarette tax is a beautiful tax for a state like Kentucky. We lead the country in smoking. We lead the country in cancer. What's better than to try to cut our health problems with smoking cigarettes and cancer and at the same time provide $260 million annually to the budget. We can do that. The General Assembly can do that in January."

Van Ingram, executive director of the Kentucky Office of Drug Control Policy, noted that while state and federal support is necessary, the real work of fighting this opioid epidemic is often done one community at a time, adding that some towns are more ready than other.

"When the community is behind these efforts, the folks who are elected get behind these efforts," he said.

Harvey Milkman
(Foundation for a Healthy Ky. photo)
Harvey Milkman, a professor of psychology at Metropolitan State College of Denver, told the group about an initiative in Iceland that has dramatically decreased the drinking and smoking rates of its high-school students and suggested that it could be replicated anywhere.

"I'd rather build a child than repair an adult," he said.

In addition to maintaining a regular student survey that pinpoints risky behaviors, the initiative centers around local programs that provide regular, organized, after-school activities for students as well as community efforts that promote family time, positive peer interactions and a sense of general well being.

Since Iceland instigated this initiative, the percentage of high-school students who had been drunk in the previous month dropped from 42 percent in 1998 to 5 percent in 2016; the percentage who had ever used marijuana is down from 17 percent to 7 percent; and the smoking rate fell from 23 percent to 3 percent.

Milkman added that his own research found that people who use drugs are addicted to changes in their brain chemistry and will often choose one that complements how they naturally deal with stress. For example, people who choose heroin want to shut down, and those who choose an amphetamine tend to be more hyper-active.

From this research, he created a program that took kids who had problems with drugs and offered to teach them anything they wanted to learn -- like music, hip-hop or martial arts -- with the idea that these activities could also alter their brain chemistry. At the same time, they were given life-skill training. Milkman said the program, which lasted 10 years, had "significant positive results," which were instrumental in informing the Iceland project.

"So it's really a social engineering project. How do you engineer communities that provide the needs that are really conducive to healthy living," Milkman said, adding that it can be done, but requires a collaboration between research, policy and practice -- along with ongoing dialogue.

Quinones advised parents to stop trying to protect their children from pain, both physical and emotional, noting that our desire to not feel any pain has only fed the opioid epidemic.

"You want to keep your kids off heroin, make sure people in your neighborhood do things together in public often. Make sure you kids ride bikes outside. Let them skin their knees. Don't protect them, let them fail. Don't protect them from the consequences of their failure," he said.

He added: This epidemic "is a powerful force for change in our society. It seems to me to be calling us as Americans to really examine how we've been living -- and we would be foolish to miss the opportunity that it provides."

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