Rural Ohio has a heroin problem.
The subject has been coming up more often lately in conversation and it even found its way into state policy for some of Ohio’s farm organizations. Heroin used to be considered more of an inner city drug, but now it is affecting the suburbs and rural areas of Ohio as well due to a number of factors.
“This affects every rural community in the state of Ohio. Unlike other drug epidemics that we saw mostly focused in the cities, this is everywhere. It is in the suburbs and rural areas and it is many times more likely to be in the rural areas than in the cities. It kills four, five or six people a day in Ohio. It does not discriminate gender, race, income — everybody is susceptible to this. Your community has a heroin problem and you may not know it. It has swept across Ohio and we don’t know exactly why,” said Mike DeWine, Ohio Attorney General. “The Mexican drug cartels have a great business model. They grow the poppies in Mexico and transport the heroin across our southern border and then market it very well. You can get heroin delivered to you as easy and quickly as buying a pizza. What starts as a $15 a day habit may go to a $1,500 a day habit. Late stage heroin addicts may need 100 times more heroin than an early stage addict. Around 90% of the crime in every county in the state of Ohio is caused directly or indirectly by drugs and there is no easy way to fix it.
“We need to be doing a much better job with education and prevention. We have had a cultural change in Ohio. When I was a county prosecutor in the late 1970s in Greene County, heroin was something that was not very often in our rural areas and suburbs. There was some psychological barrier that stopped people from doing heroin. Today that barrier is flat and we have to put that barrier back up. That will take a grassroots effort in local communities to rise up and do something about this. This issue is so bad that I have six people on my staff focused on working at the local level and education, prevention and treatment.”
Andrea Fox from rural Fairfield County has seen the devastating impact of heroin first hand.
“My daughter was born with a congenital kidney defect. It wasn’t identified until she was around 12 and by then a lot of damage had been done. She has been in chronic pain for a good portion of her life. The doctors prescribed narcotic pain medication from the time she was pretty young. She built a tolerance and she had multiple surgeries, which they said fixed the problem, but it was not fixed. After that, the doctors treated her as if all of her pain related behaviors were drug-seeking behaviors. And likely some of them were, though she did have legitimate pain. They were not giving her any more pain meds and she took matters into her own hands,” Fox said. “It started out with her trying to find prescription drugs in her early to mid 20s. Eventually those drugs didn’t work any more because she had built up a tolerance. When you compare the street price of oxycontin to a bag of heroin it is significant. You can get a bag of heroin for as little as $5. It ultimately becomes a financial decision and heroin is everywhere.”
Finding resources for help with addiction can be particularly challenging in rural areas.
“Trying to address this issue becomes very difficult. Franklin County has quite a few services in Columbus but even they don’t have enough resources and services. The outlying counties are very resource poor. Living in rural Fairfield County where there is an enormous heroin problem, but trying to get a child into treatment is difficult if you do not have money laying around to spend or extremely good health insurance. It gets really hard because there isn’t much assistance out there,” Fox said. “In Fairfield County I am not aware of any medication assisted treatment programs that take health insurance. They only take cash. Many people on heroin want to get sober but withdrawal makes them sick. So they continue to use to avoid being sick, and the resources to get sober are largely unavailable.”
Along with the physical addiction, heroin can be mentally and socially devastating as well.
“There are a lot of different behaviors associated with heroin. It is not always just the drug they are addicted to. It is also these behaviors. You really have to compromise yourself to do a lot of the things people do to obtain heroin. Many people compromise themselves and their principles to obtain heroin. It takes your self-esteem. It takes away your everything. Heroin kills your soul,” Fox said. “It is not a party drug. It is often a drug people come to as a last ditch effort. Chronic pain issues are a big reason many people start with heroin. A lot of people also come to it through mental health disorders and other substance abuse issues. Some families are raised this way and that is all they know.
“My daughter was doing it and my two boys saw it and kind of followed the same path. Their father is an alcoholic and that put them at much greater risk for addiction. Now they are both addicted as well.”
The challenges in her family’s struggle with addiction led to the need for a career change for Fox.
“I had custody of my daughter’s four children and I still had my youngest daughter who was a teenager. I was working mostly as a freelance artist, which was not a steady source of income. With the kids, I needed more steady income and I was thinking about how difficult this journey had been for me as a parent trying unsuccessfully to get help for my children struggling with addiction. There are so many things that go along with that —like not sleeping at night because you don’t know where your kids are. It is a heartbreaking situation for everyone,” she said. “I thought if I had to make a career change, it should be something that will do some good and something that I am good at. It seems like I have always been able to help everyone except my kids. I decided to look into the field of addiction studies.”
She went back to Columbus State to get a certificate in addiction studies and complimentary health studies to accompany the bachelor’s degree she had already gotten. She graduated last year. Now she works as a mentor for the Stable Cradle Program of Maryhaven in Columbus and has certification as a chemical dependency counseling assistant.
“I work with opioid-dependent women who are expecting. I am with them through their pregnancies and one year postpartum. I pick them up and take them to appointments. I also help connect them to community resources, provide some counseling and recovery support, help them discover new tools that they can use to help them stay strong in their recovery, and in a couple of cases, provide support during labor and delivery. I am their all-around resource person,” Fox said. “If there is any way I can help them get anything they need that is what I do. Right now I have 24 clients in Franklin County. It is a challenge that takes a lot of creative time management.
“One of the biggest issues that is not addressed for these women is that it is hard to find stable, safe housing. Some are homeless. Some are living in houses with other substance users, which makes it extremely difficult to stop using in that situation. These women often do not have any community or a good positive support network they can count on when they need something. Sometimes they just need someone to talk to. I do what I can but ultimately what helps them the most is good, positive people they can go to when they are having a problem.”
The job is challenging and, some days, very rewarding.
“As hard as it can be sometimes, I don’t take my clients recovery or non-recovery personally. I give them the best services I can in a non-judgmental way. I treat them the same when they are using as I do when they are not. I try to never be negative about anything that is going on in their life. I search for the positive and sometimes it makes me really tired. Some days are really sad and I just need a hug,” Fox said. “I have seen some people make some really dramatic changes in their lives. I have seen women give birth to healthy babies and get to keep them. For me even if it is one person that changes their life it is a success. And it has been much more than one person. I think the Maternal and Infant Recovery Clinic and the Stable Cradle program does a lot of good and I am really proud to be a part of it.”
In terms of addressing the drug problem on a larger scale, Fox said there are no easy answers.
“A good place to start is with families and communities sticking together. I feel like there has been a trend for quite a long time when someone exhibits all of these negative behaviors that you put a lot of distance between you and them,” she said. “While that can seem like a really good thing to do, I don’t know that it always is. It only adds to the hopelessness for the individual struggling with addiction. I know how difficult it is to deal with people who struggle with substance use disorders and sometimes it can even be dangerous. Often, addiction stems from trauma or inner turmoil of some kind that has not been addressed. The behaviors of individuals struggling with addiction often leads to families and friends stepping away from the individual, which adds another layer of trauma. If at all possible, it is helpful when the whole family can get help, which helps them positively support their loved one with the substance use disorder.”
And, though it has been a long and bumpy journey, Fox has not given up on her family either.
“My daughter is doing amazingly well. She just turned 30. She is no longer incarcerated and she is making huge steps to getting her life back on track. She is excited about starting her life over sober. I think my boys are going to follow suit. It takes time. This problem didn’t happen over night and it won’t be fixed overnight either.”