1. Naloxone is an “opioid antagonist,” which means it can bind to opioid receptors and block the effects of other opioids. It can be given by intranasal spray, intramuscularly, subcutaneously, or intravenously.
2. Indeed, in recent years there has been a notable increase in people going to food pantries in central Ohio as incomes are stagnating, making it hard for people to pay for housing, health care, and childcare. See Karen Kasler, “Food Pantries Serving More Customers, with Bad Economic Signs Ahead,” WOSU Public Media, September 3, 2019, radio.wosu.org/post/food-pantries-serving-more-customers-bad-economic-signs-ahead#stream/0.
3. Joe Ebel, “Hepatitis A Cases on the Rise in Licking County,” Newark Advocate, March 2, 2019, www.newarkadvocate.com/story/news/2019/03/02/joe-ebel-hepatitis-cases-rise-licking-county/2979528002.
4. Kent Mallett, “Ohio Magazine Selects Newark One of Ohio’s Best Hometowns,” Newark Advocate, July 25, 2019, www.newarkadvocate.com/story/news/2019/07/25/ohio-magazine-selects-newark-one-ohios-best-hometowns/1808298001.
5. Mara Kilgore, “Newark Think Tank on Poverty to Host Up to P.A.R. Community Workshop,” Newark Advocate, April 29, 2019.
6. Jeff Brand, “The Opioid Epidemic as Collective Trauma: An Introduction to the Crisis,” Group 42, no. 4 (Winter 2018): 291–309.
7. Ibid., 300.
8. Ibid., 301.
9. Ibid.
10. Ibid., 303.
11. Ibid., 304.
12. Ibid.
13. See “Harm Reduction,” Drug Policy Alliance, www.drugpolicy.org/issues/harm-reduction.
14. U.S. Centers for Disease Control and Prevention, “U.S. Drug Overdose Deaths Continue to Rise; Increase Fueled by Synthetic Opioids,” press release, March 28, 2018, www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html.
15. U.S. Centers for Disease Control and Prevention, “Drug Overdose Deaths,” www.cdc.gov/drugoverdose/data/statedeaths.html.
16. Abby Goodnough, Josh Katz, and Margot Sanger-Katz, “Drug Overdose Deaths Drop in U.S. for First Time Since 1990,” New York Times, July 17, 2019, www.nytimes.com/interactive/2019/07/17/upshot/drug-overdose-deaths-fall.html; and U.S. Centers for Disease Control and Prevention, “NCSH Releases Provisional Drug Overdose Death Data and Several New Reports,” Statcast, week of July 15, 2019, www.cdc.gov/nchs/pressroom/podcasts/20190718/20190718.htm.
17. I found conflicting numbers for deaths in 1995, but it seems to be between 48,000 and 50,876. See Dennis H. Osmond, “Epidemiology of HIV/AIDS in the United States,” HIV InSite, University of California, San Francisco, March 2003, hivinsite.ucsf.edu/InSite?page=kb-01-03; and “The HIV/AIDS Epidemic in the United States: The Basics,” KFF.org, March 25, 2019, www.kff.org/hivaids/fact-sheet/the-hivaids-epidemic-in-the-united-states-the-basics/#footnote-391348-14. Coincidentally, 1995 was also the year that the National Academy of Sciences concluded that syringe exchange programs are effective at preventing infectious disease.
18. Between 1999 and 2017, more than 700,000 people in the United States died from a drug overdose. See U.S. Centers for Disease Control and Prevention, “Understand the Epidemic,” December 19, 2018, www.cdc.gov/drugoverdose/epidemic/index.html.
19. Ohio Department of Health, “Drug Overdose,” October 23, 2019, odh.ohio.gov/wps/portal/gov/odh/know-our-programs/violence-injury-prevention-program/Drug-overdose.
20. O. Trent Hall et al., “Years of Life Lost Due to Opioid Overdose in Ohio: Temporal and Geographic Patterns of Excess Mortality,” Journal of Addiction Medicine, October 7, 2019, journals.lww.com/journaladdictionmedicine/Abstract/publishahead/Years_of_Life_Lost_due_to_Opioid_Overdose_in_Ohio_.99325.aspx.
21. I’m reporting numbers from the Licking County Coroner, though there is some discrepancy between those numbers and those reported by the Ohio Department of Health. See “Drug Overdose Death Review,” Licking County Health Department, 2018, www.lickingcohealth.org/documents/hed/2018DrugOverdoseDeaths.pdf.
22. Ohio Department of Health, “2017 Ohio Drug Overdose Data: General Findings,” odh.ohio.gov/wps/wcm/connect/gov/5deb684e-4667-4836-862b-cb5eb59acbd3/2017_OhioDrugOverdoseReport.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000.
23. Mark Rembert et al., “Taking Measure of Ohio’s Opioid Crisis,” Ohio State University, C. William Swank Program in Rural-Urban Policy, October 2017, aede.osu.edu/sites/aede/files/publication_files/Swank%20-%20Taking%20Measure%20of%20Ohios%20Opioid%20Crisis.pdf, 1.
24. Kent Mallett, “Licking County Continues to Set Records for Children in Its Care,” Newark Advocate, April 13, 2018, www.newarkadvocate.com/story/news/2018/04/13/licking-county-continues-set-records-children-its-care/511504002.
25. Rembert et al., “Taking Measure of Ohio’s Opioid Crisis,” 1. These numbers refer specifically to medication-assisted treatment, the gold standard for addiction treatment.
26. Bethany Bruner, “Drug Treatment Available, but with a Wait,” Newark Advocate, April 16, 2016, www.newarkadvocate.com/story/news/crime/high-in-ohio/2016/04/16/drug-treatment-available-but-wait/32580723.
27. Licking County Health Department, “Drug Overdose Death Review.”
28. There is ongoing research into a medication-assisted treatment option for methamphetamine use disorder. See Andrea Dukakis, “A Medication to Treat Meth Addiction? Some Take a New Look at Naltrexone,” National Public Radio, November 7, 2019, www.npr.org/sections/health-shots/2019/11/07/776135642/a-medication-to-treat-meth-addiction-some-take-a-new-look-at-naltrexone?fbclid=IwAR3HDQhsMxFWA7h5iU0nn5Kjf0cmtwVnBjHyz2AYa8OzV88c_1k6W0WcrvY.
29. “Keith Brown NYS Senate Joint Task Force Hearing,” YouTube, posted by Cortney Lovell, November 19, 2019, www.youtube.com/watch?v=LXJq7-QKnS0&feature=youtu.be.
30. Walt Whitman, “Notes Left Over,” in Whitman: Poetry and Prose (New York: Library of America, 1996), 1099.
31. “Use of Drugs,” United Nations Office on Drugs and Crime, Statistics and Data, dataunodc.un.org/drugs/prevalence_map_2017.
1. “2016 Ohio Presidential Election Results,” Politico, www.politico.com/2016-election/results/map/president/ohio/.
2. Dave Ghose, “The Longaberger Basket Case,” Columbus Monthly, April 19, 2017; and “Big Basket Building in Ohio to Be Sold,” BBC News, July 14, 2016.
3. Laura Newpoff, “Iconic Longaberger Basket Building Headed Toward Foreclosure,” Columbus Business First, March 17, 2017, www.bizjournals.com/columbus/news/2017/03/17/iconic-longaberger-basket-building-headed-toward.html.
4. See E. M. P. Brister, Centennial History of the City of Newark and Licking County Ohio, vols. 1 and 2 (Chicago-Columbus: S. J. Clarke Publishing, 1909); Chance Brockway, Images of America: Newark (Chicago: Acadia Publishing, 2004); and Gordon R. Kingery, A Beginning: Licking County, Ohio—Land of Legend (Newark, OH: Spencer-Walker Press, 1967).
5. Bradley Lepper, The Newark Earthworks: A Wonder of the Ancient World (Columbus: Ohio Historical Society, 2002).
6. “Asset Limited, Income Constrained, Employed (ALICE) Report: Ohio,” United for ALICE, Summer 2017, www.unitedforalice.org/national-comparison.
7. Affordable housing is a growing issue throughout the central Ohio region. See “All Sides with Ann Fisher: Affordable Housing and Homelessness in Columbus,” WOSU Public Media, January 23, 2019, radio.wosu.org/post/affordable-housing-and-homelessness-columbus#stream/0.
8. Gabriele Eimontaite, “Let’s Talk about the Plight of Housing Instability in Licking County,” Newark Advocate, May 24, 2018.
9. “Ohio Unemployment Rates: October 2019 (Not Seasonally Adjusted),” Ohio Department of Job and Family Services, ohiolmi.com/portals/206/LAUS/Archive/2019/ColorRateMap1019.pdf; and “Unemployment Rate in Licking County, OH,” Economic Research, Federal Reserve Bank of St. Louis, fred.stlouisfed.org/series/OHLICK0URN. See also Kent Mallett, “County Employment, Workforce Hit High,” Newark Advocate, June 21, 2016, www.newarkadvocate.com/story/news/local/2016/06/21/county-employment-labor-force-reach-all-time-highs/86184696; and Kent Mallett, “Licking County Unemployment Rate Hits Record Low of 2.8 Percent,” Newark Advocate, May 21, 2019, www.newarkadvocate.com/story/news/2019/05/21/licking-county-unemployment-rate-record-low-2-8-percent-april/3757107002.
10. Kent Mallett, “Amazon Seeks to Hire Thousands for New Etna Facility,” Newark Advocate, July 8, 2016, www.newarkadvocate.com/story/news/2016/07/08/amazon-seeks-hire-thousands-new-etna-facility/86871454. There’s also some concern that Amazon may not be paying its fair share. See Mya Frazier, “Amazon Is Getting a Good Deal in Ohio, Maybe Too Good,” Bloomberg Businessweek, October 26, 2017, www.bloomberg.com/news/articles/2017-10-26/amazon-is-getting-a-good-deal-in-ohio-maybe-too-good.
11. Mark Rembert et al., “Taking Measure of Ohio’s Opioid Crisis,” Ohio State University, C. William Swank Program in Rural-Urban Policy, October 2017, aede.osu.edu/sites/aede/files/publication_files/Swank%20-%20Taking%20Measure%20of%20Ohios%20Opioid%20Crisis.pdf, 12.
12. Ashleigh Thornton, “2018 Overdose Fatality Review Data Overview Presentation,” Licking County Health Department. Note: This presentation was compiled with the help of LCHD epidemiologist Adam Masters, Licking County deputy coroner Dr. Jeff Lee, members of the Licking County Overdose Fatality Review Board, and Licking County health commissioner Joe Ebel.
13. “Alternative Measures of Labor Utilization, Ohio—2018,” Bureau of Labor Statistics, Midwest Information Office, April 26, 2019, www.bls.gov/regions/midwest/news-release/laborunderutilization_ohio.htm.
14. See Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town (New York: St. Martin’s, 2017), which explores the effects of unfettered free-market capitalism (specifically private equity firms) on Lancaster, Ohio.
15. Kent Mallett, “Intersection Opening Completes Downtown Project,” Newark Advocate, September 11, 2018.
16. Sheridan Hendrix, “Licking County Shows Off Renovated Courthouse,” Columbus Dispatch, September 17, 2018.
17. “Newark City, Ohio, Quickfacts,” U.S. Census Bureau, www.census.gov/quickfacts/fact/table/newarkcityohio/AGE295218.
18. For conditions at Amazon, see David Jamieson, “The Life and Death of an Amazon Warehouse Temp,” Huffington Post, highline.huffingtonpost.com/articles/en/life-and-death-amazon-temp.
19. Rich Exner, “Ohio Tax Changes Under Gov. John Kasich Leave Villages, Cities Scrambling to Cope with Less (Database),” Cleveland Plain Dealer, March 9, 2016.
20. To watch the organization’s early activism, watch Up River, directed by Doug Swift (Wild Iris Films, 2015).
21. “Wasted Assets: The Cost of Excluding Ohioans with a Record from Work,” Policy Matters Ohio, December 18, 2018, www.policymattersohio.org/research-policy/fair-economy/work-wages/wasted-assets-the-cost-of-excluding-ohioans-with-a-record-from-work.
22. “Fair Hiring,” Ohio Justice and Policy Center, www.ohiojpc.org/what-we-do/policy/fair-hiring; and Eric Lyttle, “Newark Posed to Join Entities Dropping Felon Box,” Columbus Dispatch, July 13, 2015, www.dispatch.com/content/stories/local/2015/07/13/newark-poised-to-join-entities-dropping-felon-box.html.
1. Terry DeMio, Dan Horn, and Kevin Grasha, “Ohio, Kentucky Doctors Among 60 Charged in Pain Pill Bust Acted ‘Like Drug Dealers,’” Cincinnati Enquirer, April 17, 2019.
2. Jan Hoffman, “Groundwork Is Laid for Opioids Settlement That Would Touch Every Corner of the U.S.,” New York Times, June 14, 2019, www.nytimes.com/2019/06/14/health/opioids-lawsuit-settlement.html.
3. Beth Macy, Dopesick: Dealers, Doctors, and the Drug Company That Addicted America (New York: Little, Brown, and Company, 2018); and Sam Quinones, Dreamland: The True Tale of America’s Opiate Epidemic (New York: Bloomsbury, 2015).
4. For an excellent account of one “pill mill,” see Philip Eil, “The Pill Mill That Ravaged Portsmouth,” Cincinnati Magazine, July 5, 2017.
5. “Drilling into the DEA’s Pain Pill Database,” Washington Post, July 21, 2019, www.washingtonpost.com/graphics/2019/investigations/dea-pain-pill-database/.
6. Aaron Marshall, “Gov. John Kasich Announces Help for County Ravaged by Prescription Drug Abuse,” Cleveland Plain Dealer, February 21, 2011, www.cleveland.com/open/2011/02/gov_john_kasich_announces_help.html.
7. Sabrina Tavernese, “Ohio County Losing Its Young to Painkillers’ Grip,” New York Times, April 19, 2011.
8. Ashton Marra, “New Federal Data Confirms What We Already Know: Opioid Distributions Inundated Appalachia,” 100 Days in Appalachia, July 19, 2019, www.100daysinappalachia.com/2019/07/19/new-federal-data-confirms-what-we-already-know-opioid-distributions-inundated-appalachia.
9. “Mortality,” Ohio Public Health Information Warehouse, Ohio Department of Health, dataset, publicapps.odh.ohio.gov/EDW/DataBrowser/Browse/Mortality; and “Ohio 2018 Overdose Rates,” Harm Reduction Ohio, www.harmreductionohio.org/details-on-ohio-overdose-deaths-in-2018-who-died-where.
10. Nabarun Dasgupta, Leo Beletsky, and Daniel Ciccarone, “Opioid Crisis: No Easy Fix to Its Social and Economic Determinants,” American Journal of Public Health 108, no. 2 (2018): 182–86.
11. Zachary Siegel, “The Opioid Crisis Is About More Than Corporate Greed,” New Republic, July 30, 2019.
12. See also “Ex-DEA Agent: Opioid Crisis Fueled by Drug Industry and Congress,” 60 Minutes, CBS News, June 17, 2018. The subtitle for the online version of the story says it all: “Whistleblower Joe Rannazzisi says drug distributors pumped opioids into U.S. communities—knowing that people were dying—and says industry lobbyists and Congress derailed the DEA’s efforts to stop it.”
13. “Opioid Overdose Crisis,” National Institute on Drug Abuse, January 2019, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis; Kevin E. Vowles et al., “Rates of Opioid Misuse, Abuse, and Addiction in Chronic Pain: A Systematic Review and Data Synthesis,” PAIN, Volume 156.4 (April 2015): 569–576.
14. Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction (Berkeley, CA: North Atlantic Books, 2008), 142.
15. Lee N. Robins et al., “Vietnam Veterans Three Years After Vietnam: How Our Study Changed Our View of Heroin,” American Journal on Addictions 19, no. 3 (2010): 203–11.
16. “Addiction,” Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (Washington, DC: American Psychiatric Association, 2013).
17. “Definition of Addiction,” American Society of Addiction Medicine, September 15, 2019, www.asam.org/resources/definition-of-addiction.
18. L. Bevilacqua and D. Goldman, “Genes and Addictions,” Clinical Pharmacology and Therapeutics 85, no. 4 (April 2009): 359–61.
19. Maia Szalavitz, Unbroken Brain: A Revolutionary New Way of Understanding Addiction (New York: St. Martin’s Press, 2016), 36.
20. Jeni L. Burnette et al., “Mindsets of Addiction: Implications for Treatment Intentions,” Journal of Social and Clinical Psychology 38, no. 5 (2019): 367; and Abraham Gutman, “Framing Addiction as a Disease: Research Shows That Message Might Backfire,” Philadelphia Inquirer, July 17, 2019.
21. Szalavitz, Unbroken Brain, 164, 142–44.
22. Marc Lewis, Biology of Desire: Why Addiction Is Not a Disease (New York: Public Affairs, 2016).
23. George F. Koob and Jay Schulkin, “Addiction and Stress: An Allostatic View,” Neuroscience and Biobehavioral Reviews 106 (November 2018): 245–62.
24. See Maté, In the Realm of Hungry Ghosts.
25. Szalavitz, Unbroken Brain, 135.
26. Bruce K. Alexander, The Globalization of Addiction: A Study in Poverty of the Spirit (New York: Oxford University Press, 2008), 173–206. See also Carl Hart, High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society (New York: Harper Perennial, 2014).
27. See Bruce K. Alexander, Robert B. Coambs, and Patricia F. Hadaway, “The Effect of Housing and Gender on Morphine Self-Administration in Rats,” Psychopharmacology 58, no. 2 (1978): 175–79; and Szalavitz, Unbroken Brain, 132–35.
28. From a recent study on methamphetamine: “Social housing of females protects against the risk of enhanced motivation to self-administer drugs. Understanding how a positive social environment can reduce the susceptibility to drug abuse and examining the differences between high and low risk subpopulations, may provide important insight in the underlying neurobiology of addiction-vulnerability.” See Christel Westenbroek et al., “Effect of Social Housing and Oxytocin on the Motivation to Self-Administer Methamphetamine in Female Rats,” Physiology and Behavior 203 (2019): 16.
29. Alexander, The Globalization of Addiction, 59.
30. Ibid., 58.
31. Ibid., 59–60.
32. Ibid., 48.
33. Ibid., 69
34. Ibid., 60.
35. Ibid., 62.
36. Ibid.
37. Ibid., 64.
38. Zachary Siegel, “Euphoria Doesn’t Have a Drug Problem,” Vulture, August 6, 2019.
39. Overdose rates have been especially high in Native American communities as well. Melodie Edwards, “Lack of Health Funding Led to Opioid Crisis on Reservations,” Wyoming Public Media, April 16, 2018, www.wyomingpublicmedia.org/post/lack-health-funding-led-opioid-crisis-reservations#stream/0.
40. Katherine McLean, “‘There’s Nothing Here’: Deindustrialization as Risk Environment for Overdose,” International Journal of Drug Policy 29 (March 29, 2016): 19–26.
41. Ibid., 19.
42. Ibid., 20.
43. Ibid., 24.
44. Alex S. Vitale, The End of Policing (New York: Verso, 2017), 153.
45. There is plenty of research underscoring this assertion. People who are homeless are more likely to overdose; see John R. Marshall et al., “Socioeconomic and Geographical Disparities in Prescription and Illicit Opioid-Related Overdose Deaths in Orange County, California, from 2010–2014,” Substance Abuse 40, no. 1 (2018): 80–86.
But those who are on the margins are also at a greater risk of dying. Overdose deaths rise when unemployment increases; Alex Hollingsworth, Christopher J. Ruhm, and Kosali Simon, in “Macroeconomic Conditions and Opioid Abuse,” Journal of Health Economics 56 (2017): 222–33, note that “opioid deaths and ED visits are predicted to rise when county unemployment rates temporarily increase” (223). See also Christopher S. Carpenter et al., “Economic Conditions, Illicit Drug Use, and Substance Use Disorders in the United States,” Journal of Health Economics 52 (2017): 63–73.
Ezequiel Brown and George L. Wehby, in “Economic Conditions and Drug and Opioid Overdose Deaths,” Medical Care Research and Review 76, no. 4 (August 2019): 462–77, note the links between a rise in overdose death and housing price drops: “A drop in median house prices by about $70,000 as observed during the Great Recession could potentially contribute to nearly 25% rise in opioid death rates with larger effects among males, non-Hispanic Whites, and younger adults” (12). There is also a link between property values and risky behaviors that lead to overdose deaths (14). Brown and Wehby suggest shoring up funding to prevent overdose in times of economic crisis.
In counties with more blue-collar and service jobs and other economic disadvantages, drug mortality rates are higher; see Shannon M. Monnat et al., “Using Census Data to Understand County-Level Differences in Overall Drug Mortality and Opioid-Related Mortality by Opioid Type,” American Journal of Public Health 109, no. 8 (2019): 1084–91.
Gene M. Heyman, Nico McVicar, and Hiram Brownell, in “Evidence That Social-Economic Factors Play an Important Role in Drug Overdose Deaths,” International Journal on Drug Policy 74 (December 2019): 274–84, report that “social-economic factors play a critical role” in overdose specifically and that “variation in the supply of legal opioids is highly correlated with variation in social capital and work force participation.” They argue for state-level interventions that extend schooling and address other socioeconomic factors: “When we are talking about the overdose epidemic, we are not just talking about changes in the supply of drugs, we are also talking about the decline in social-economic conditions in the United States.”
There is also a relationship between poverty and incarceration and drug use disorder. Elias Nosrati et al., in “Economic Decline, Incarceration, and Mortality from Drug Use Disorders in the USA Between 1983 and 2014: An Observational Analysis,” Lancet Public Health 4, no. 7 (July 2019): 326–33, conclude: “Reduced household income and high incarceration rates are associated with poor health. The rapid expansion of the prison and jail population in the USA over the past four decades might have contributed to the increasing number of deaths from drug use disorders” (326).
Amy S. B. Bohnert et al., in “Policing and Risk of Overdose Mortality in Urban Neighborhoods,” Drug and Alcohol Dependence 113 (2011): 62–68, assert that greater police activity, especially “broken windows” policing, “may be an important determinant of drug overdose mortality.” This can be particularly problematic in racially and economically marginalized communities.
Acknowledging the myriad challenges faced by the LGBTQ+ community in North America, Ehsasn Moazen-Zadeh et al., in “A Call for Action on Overdose Among LGBTQ People in North America,” Lancet Psychiatry 6, no. 9 (2019): 725–26, call for greater research and resources for working with this particular population. They note, too, that public health professionals must equip themselves.
See also Dasgupta, Beletsky, and Ciccarone, “Opioid Crisis”; Dave Liddell, “Poverty Is the Root of Scotland’s Fatal Drug Overdose Crisis,” The Poverty Alliance, August 1, 2019, www.povertyalliance.org/blog-poverty-is-the-root-of-scotlands-fatal-drug-overdose-crisis; and Cara L. Frankenfeld and Timothy F. Leslie, “County-Level Socioeconomic Factors and Residential Racial, Hispanic, Poverty, and Unemployment Segregation Associated with Drug Overdose Deaths in the United States, 2013–2017,” Annals of Epidemiology 35 (July 2019): 12–19.
46. Scott Higham, Sari Horwitz, and Steven Rich, “Internal Drug Company Emails Show Indifference to Opioid Epidemic,” Washington Post, July 19, 2019.
47. Sara Randazzo and Jared S. Hopkins, “OxyContin-Maker Owner Maligned Opioid Addicts, Suit Says,” Wall Street Journal, March 29, 2019, www.wsj.com/articles/purdue-pharma-owner-maligned-opioid-addicts-suit-says-11553899968.
48. Portsmouth City Council Meeting, agenda, March 28, 2011, portsmouthoh.org/sites/default/files/03-28-11.pdf.
49. Lisa Roberts, “Waging the War Against the Devil in Scioto County: A Grassroots Response to Prescription Drug Abuse in a Rural Community,” Portsmouth City Health Department, www.deadiversion.usdoj.gov/mtgs/drug_chemical/2012/roberts.pdf.
50. “Senate Passes Bill to Curb ‘Pill Mills,’” Columbus Dispatch, May 18, 2011.
51. See S. C. Brighthaupt et al., “Effect of Pill Mill Laws on Opioid Overdose Deaths in Ohio & Tennessee: A Mixed-Methods Case Study,” Preventive Medicine 126 (2019): 4, who write: “Pill mill law enactment had no effects on overall, prescription opioid, heroin, or synthetic opioid overdose deaths in Ohio or Tennessee. Interview results suggest that both states engaged in robust enforcement and implementation of the law. A multi-pronged policy approach, including but not limited to pill mill laws, may be required to effectively address opioid overdose deaths.”
52. Daniel Ciccarone, “The Triple Wave Epidemic: Supply and Demand Drivers of the US Opioid Overdose Crisis,” International Journal of Drug Policy 71 (2019): 183–88.
53. “Drug Overdose Deaths,” U.S. Centers for Disease Control and Prevention, June 27, 2019, www.cdc.gov/drugoverdose/data/statedeaths.html.
54. An ER physician and toxicology expert named Ryan Marino asserts, “Policymakers seem to have taken this urban legend to heart, and are using it as an excuse to divert resources away from evidence-based and lifesaving interventions (like naloxone)”; see Zachary A. Siegel and Maia Szalavitz, “Media Frame: Fentanyl Panic Is Worsening the Overdose Crisis,” The Appeal, July 16, 2019, theappeal.org/media-frame-fentanyl-panic-is-worsening-the-overdose-crisis. See also Elizabeth Brico, “A Dangerous Fentanyl Myth Lives On,” Columbia Journalism Review, April 11, 2019.
55. “2016 Ohio Drug Overdose Data,” Ohio Department of Health, odh.ohio.gov/wps/wcm/connect/gov/d174de32-5703-4ef2-ad0c-804f9aa5f0de/2016_OhioDrugOverdoseReport.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-d174de32-5703-4ef2-ad0c-804f9aa5f0de-miTFA2Q.
56. Dasgupta, Beletsky, and Ciccarone, in their article “Opioid Crisis,” assert, “The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector. Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation and hopelessness” (182). In other words, it wasn’t overprescribing. They add, “The emphasis on prescribing volume may be a manifestation of subconscious racial bias that frames the famously White opioid crisis as inadvertently induced by physicians; this stands in direct contrast with previous drug panics perceived to afflict minorities, whose drug use was considered a moral failing” (184).
57. Medication-assisted treatment (MAT) for opioid use disorder comes in many forms and is considered one of the most effective forms of treatment. Methadone is perhaps the most well-known medication used in MAT—it’s a synthetic opioid agonist that is typically taken at a clinic. Naltrexone, sold under the brand name Vivitrol, is an extended-release drug that can be taken as a monthly injection. Suboxone (a combination of buprenorphine and naloxone) is a partial antagonist that has a ceiling effect. A study by led by Harvard professor Dr. Sarah E. Wakeman found that “treatment with buprenorphine or methadone was associated with reductions in overdose and serious opioid-related acute care use compared with other treatments.” S. E. Wakeman, M. R. Larochelle, O. Ameli, et al. “Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder,” JAMA Network Open. 2020;3(2):e1920622. jamanetwork.com/journals/jamanetworkopen/fullarticle/2760032.
58. In 1995, France made it easier for physicians to prescribe buprenorphine—with no extra training or licensing—and more people were able to access treatment. According to Olga Khazan, in “How France Cut Heroin Overdoses by 79 Percent in 4 Years and the United States could, too,” The Atlantic, April 16, 2018, “Within four years, overdose deaths declined by 79 percent.”
59. “Naloxone Access and Good Samaritan Law in Ohio,” Network for Public Health Law, static1.squarespace.com/static/5b896c3cfcf7fd71ad6a0d47/t/5d5c465ea7a2bf0001bcf52f/1566328415214/Ohio-OD-law-fact-sheet-8_30_18-FINAL.pdf.
60. Abby Spears, “Emerging Technologies: Utilizing Data and Geomapping to Identify Health Disparities,” (Re)Covering Appalachia, Shawnee State University, Portsmouth, Ohio, November 1, 2019.
61. Samantha Artiga and Elizabeth Hinton, in “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity,” Kaiser Family Foundation, www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity, write: “Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Addressing social determinants of health is important for improving health and reducing long-standing disparities in health and health care.”
Dasgupta, Beletsky, and Ciccarone, in their article “Opioid Crisis,” write: “The social determinants lens lays bare the urgency of integrating clinical care with efforts to improve patients’ structural environment” (185).
1. Doug Swift talks to Eric about this in his documentary Up River (Wild Iris Films, 2015).
2. “U.S. Correctional Population Declined for the Ninth Consecutive Year,” U.S. Department of Justice, Office of Justice Programs, press release, April 26, 2018, www.bjs.gov/content/pub/press/cpus16pr.pdf; and Michelle Alexander, The New Jim Crow: Mass Incarceration in the Age of Colorblindness (New York: The New Press, 2010).
3. But the war on drugs has long been used as a tool to harass and control others. Alex S. Vitale, in The End of Policing (New York: Verso, 2017), points to opium’s link to laborers from China in the nineteenth century: “The prohibition of opium gave police a tool to justify constant harassment and tight social regulation of this ‘suspect’ population” (131). He also discusses how the drug was largely ignored until upper- and middle-class white women started using it. Years later, and in the same vein, he notes, marijuana was associated with black culture and led to a kind of “moral panic” among white people (132). A search of any historical newspaper database reveals the racist tropes that fueled this panic. For example, “Use of Cocaine Is Increasing at an Alarming Rate Drug Stores Downtown Are Daily Overrun by Confirmed Fiends,” St. Louis Republic, September 2, 1897; “Cocaine Is Terrible. Use of the Drug Is Growing Constantly Among Negroes,” Fort Worth Morning Register, September 3, 1899; “Cocaine Drug and Fiend. These Be Interesting Facts,” Charlotte Observer, September 29, 1906; “Specter Among Negroes—Cocaine: America’s Worst Drug Habit Has Made Great Inroads with More,” Daily Herald, July 20, 1909; and “Chinese Laundries Sell Deadly Opium …,” Columbus Daily Enquirer, November 21, 1909, all via Readex: America’s Historical Newspapers.
4. Issac J. Bailey writes, in “Why Didn’t My Drug-Affected Family Get Any Sympathy?” Politico, June 10, 2018, “Contrast all of this coverage with the coverage of crack addicts in the 1980s and 1990s. The photos from that era weren’t of innocent children being harmed; it was of U.S. marshals pointing pistols in the faces of drug addicts at crack houses, of black men in handcuffs, of crack smokers passed out on sidewalks. There were few childhood photos and shots of crying mothers.”
5. John Gramlich, “The Gap Between the Number of Blacks and Whites in Prison Is Shrinking,” Pew Research Center, April 30, 2019, www.pewresearch.org/fact-tank/2019/04/30/shrinking-gap-between-number-of-blacks-and-whites-in-prison.
6. “Ohio Profile,” Prison Policy Initiative, www.prisonpolicy.org/profiles/OH.html. Consider, too, how this is playing out within this current crisis: Panama Jackson, “This Is America: Save a White Drug Addict, Jail a Black One,” The Root, May 10, 2018, verysmartbrothas.theroot.com/this-is-america-save-a-white-drug-addict-jail-a-black-1825923681.
7. Marica Ferri, Laura Amato, and Marina Davoli, “Alcoholics Anonymous and Other 12-Step Programmes for Alcohol Dependence,” Cochrane Database of Systematic Reviews 3 (July 19, 2006): CD005032.
8. “With Sobering Science, Doctor Debunks 12-Step Recovery,” All Things Considered, National Public Radio, March 23, 2014. See also Lance Dodes and Zachary Dodes, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry (Boston: Beacon, 2014).
9. “With Sobering Science, Doctor Debunks 12-Step Recovery.”
10. Ibid.
11. Maia Szalavitz, Unbroken Brain: A Revolutionary New Way of Understanding Addiction (New York: St. Martin’s Press, 2016), 219.
12. Ibid. For more on drug courts and substance use disorder, see Marianne Møllmann and Christine Mehta, “Neither Justice nor Treatment: Drug Courts in the United States,” Physicians for Human Rights, June 2017, phr.org/wp-content/uploads/2017/06/phr_drugcourts_report_singlepages.pdf.
13. To be sure, there is a range of opinion on medication-assisted treatment among the many twelve-step organizations that exist. There are also, increasingly, recovery groups specifically for people using medication-assisted treatment. See, for example, Jillian Bauer-Reese, “There’s a New 12-Step Group: Medication-Assisted Recovery Anonymous,” Slate, April 17, 2018, slate.com/technology/2018/04/theres-a-new-12-step-group-for-people-in-recovery-who-are-prescribed-medications-like-methadone.html.
14. Annette Mendola and Richard L. Gibson, “Addiction, 12-Step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do?” AMA Journal of Ethics 18, no. 6 (June 2016): 647.
15. John-Kåre Vederhus and Øistein Kristensen, in “High Effectiveness of Self-Help Programs After Drug Addiction Therapy,” BMC Psychiatry 6, no. 1 (2006): 35, suggest that self-help groups can be useful “as a supplement to drug addiction treatment.”
16. House Bill 56, Committee Activity, Ohio Legislature, 133rd Assembly, 2015, www.legislature.ohio.gov/legislation/legislation-committee-documents?id=GA131-HB-56.
17. James I. Charlton, Nothing About Us Without Us: Disability Oppression and Empowerment (Berkeley: University of California Press, 2000).
Corey Davis, Traci Green, and Leo Beletsky, in “Action, Not Rhetoric, Needed to Reverse the Opioid Overdose Epidemic,” Journal of Law, Medicine, and Ethics 45, no. S1 (2017): 20–23, note that it took the work of activists to get any effective change during the HIV/AIDS crisis: “Structural change to address both the causes and effects of the epidemic is urgently needed. In the case of HIV/AIDS, failure to deploy non-judgmental, evidence-based interventions was directly responsible for the preventable deaths of hundreds of thousands of Americans. Improvement, when it came, was championed not by officials but by activists such as ACT UP. We are now faced with the choice of whether to learn from that mistake—or repeat it” (22).
1. Dennis Cauchon, “Fentanyl-Laced Cocaine Is Ohio’s Newest Killer—But We Can Combat This Scourge,” Cleveland Plain Dealer, January 19, 2018.
2. Billy designed this tattoo and says he was inspired by Project Semicolon. See projectsemicolon.com/about-project-semicolon/.
3. Patricia Perry, “Letter to the Editor,” Newark Advocate, November 22, 2011.
1. Colin Dwyer, “Ohio Sues 5 Major Drug Companies for ‘Fueling Drug Epidemic,’” National Public Radio, May 31, 2017.
2. Julie Hirschfeld Davis, “Trump Declares Opioid Crisis a ‘Health Emergency’ but Requests No Funds,” New York Times, October 26, 2017, www.nytimes.com/2017/10/26/us/politics/trump-opioid-crisis.html.
3. Mike DeWine, “Recovery Ohio,” DeWine/Husted for Ohio, campaign website, October 31, 2017, www.mikedewine.com.
4. See, for example, “GOP Lieutenant Governor Wants to End Ohio Medicaid Expansion,” Associated Press State Wire: Ohio, September 19, 2017; and “Policy Matters Weighs In on State Budget Sent to Governor Kasich,” Policy Matters Ohio, June 30, 2017, www.policymattersohio.org/press-room/2017/06/30/ohios-medicaid-expansion-must-be-protected.
5. Bethany Bruner, “Three Arrested with Ties to Mexican Cartel,” Newark Advocate, July 12, 2017.
6. Alex S. Vitale, The End of Policing (New York: Verso, 2017), 129.
7. Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction (Berkeley, CA: North Atlantic Books, 2008), 165, 197–210.
8. Ibid., 39.
1. Rob Wells, “Rally in Newark Draws Attention to Opioid Crisis, Recovery,” ABC 6, November 26, 2017, abc6onyourside.com/on-your-side/fighting-back/rally-in-newark-draws-attention-to-opioid-crisis.
2. “Definition of Recovery-Oriented Systems of Care,” Selected Papers of William L. White, www.williamwhitepapers.com/pr/CSAT%20ROSC%20Definition.pdf.
3. Increased “social capital” also protects communities against drug overdose. See Michael J. Zoorab and Jason L. Salemi, “Bowling Alone, Dying Together: The Role of Social Capital in Mitigating the Drug Overdose Epidemic in the United States,” Drug and Alcohol Dependence 173 (April 2017): 1–9; and Jan Sundquist et al., “Neighborhood Linking Social Capital as a Predictor of Drug Abuse: A Swedish National Cohort Study,” Addictive Behaviors 63 (2016): 37–44.
4. Bruce K. Alexander, The Globalization of Addiction: A Study in Poverty of the Spirit (New York: Oxford University Press, 2008), 340.
5. Anne Case and Angus Deaton, “Mortality and Morbidity in the 21st Century,” Brookings Papers on Economic Activity (Spring 2017): 397–476.
6. Mark Rembert et al., “Taking Measure of Ohio’s Opioid Crisis,” Ohio State University, C. William Swank Program in Rural-Urban Policy, October 2017, aede.osu.edu/sites/aede/files/publication_files/Swank%20-%20Taking%20Measure%20of%20Ohios%20Opioid%20Crisis.pdf, 10, and footnotes in chapter 2.
7. Life expectancy in this part of Licking County is perhaps the lowest in the country. “Licking County Community Health Assessment,” www.lickingcohealth.org/data/index.html.
1. This chapter is based on my article “Overdose and Punishment,” The New Republic, September 10, 2018, and relies on interviews with Lindsay LaSalle, Clifford Murphy, Kathie Kane-Willis, Leo Beletsky, and Louise Vincent, as well as the transcripts for State of Ohio v. Thomas A. Kosto, 2017, Case No. 16, CR 00069, and State of Ohio v. Thomas A. Kosto, 2018, Court of Appeals Case No. 17-CA-54. For introductions to the issue of “drug-induced homicide,” see Zachary A. Siegel and Leo Beletsky, “Charging ‘Dealers’ with Homicide: Explained,” The Appeal, November 2, 2018, theappeal.org/charging-dealers-with-homicide-explained; and “An Overdose Death Is Not Murder: Why Drug-Induced Homicide Laws Are Counterproductive and Inhumane,” Drug Policy Alliance, November 2017, www.drugpolicy.org/sites/default/files/dpa_drug_induced_homicide_report_0.pdf.
2. “Sentencing Reform through a Stronger SB 3,” Policy Matters Ohio, May 13, 2019, www.policymattersohio.org/research-policy/quality-ohio/corrections/sentencing-reform-through-a-stronger-sb-3.
3. “Drug Induced Homicide Laws,” Prescription Drug Abuse Policy System, with Health in Justice Action Lab and Legal Science, January 1, 2019, www.pdaps.org/datasets/drug-induced-homicide-1529945480-1549313265-1559075032.
4. “An Overdose Death Is Not Murder.”
5. Rosa Goldensohn, “The Shared Drugs,” New York Times, May 25, 2018, www.nytimes.com/2018/05/25/us/drug-overdose-prosecution-crime.html.
6. “Use of Guidelines and Specific Offense Characteristics,” U.S. Sentencing Commission, 2017, www.ussc.gov/sites/default/files/pdf/research-and-publications/federal-sentencing-statistics/guideline-application-frequencies/2017/Use_of_SOC_Offender_Based.pdf.
7. “Remarks by President Trump on Tax Reform,” Whitehouse.gov, February 5, 2018, www.whitehouse.gov/briefings-statements/remarks-president-trump-tax-reform-3.
8. Jamie Ducharme, “Trump Said China Doesn’t Have a Drug Problem. The Data Tells a Different Story,” Time, February 15, 2019, time.com/5530597/trump-china-drug-problem.
9. Adrian Chen, “What Trump Sees in Philippine President Rodrigo Duterte,” The New Yorker, May 2, 2017, www.newyorker.com/news/news-desk/what-trump-sees-in-philippine-president-rodrigo-duterte.
10. “Attorney General Sessions Issues Memo to U.S. Attorneys on the Use of Capital Punishment in Drug-Related Prosecutions,” U.S. Department of Justice, March 21, 2018, www.justice.gov/opa/pr/attorney-general-sessions-issues-memo-us-attorneys-use-capital-punishment-drug-related.
11. Megan Mitchell, “Middletown Considers 3 Strike Policy on Responding to Overdoses,” WLWT 5, June 23, 2017, www.wlwt.com/article/middletown-considers-3-strike-policy-on-responding-to-overdoses/10215284.
12. “Drug-Induced Homicide,” Health in Justice Action Lab, Northeastern University School of Law, 2018, www.healthinjustice.org/drug-induced-homicide.
13. Between 2016 and 2019, five people were charged in Licking County.
14. State of Ohio v. Thomas A. Kosto, 2017, Case No. 16, CR 00069.
15. Bethany Bruner, “Jury Convicts Man in Overdose Death,” Newark Advocate, June 30, 2017, www.newarkadvocate.com/story/news/crime/2017/06/30/jury-convicts-man-heroin-overdose-death/439388001.
16. Ibid.
17. “Charged with Manslaughter; A Doctor Arrested and Accused of Culpable Neglect,” New York Times, April 25, 1885, www.nytimes.com/1885/04/25/archives/charged-with-manslaughter-a-doctor-arrested-and-accused-of-culpable.html.
18. “Harrison Narcotics Tax Act, 1914,” National Alliance of Advocates for Buprenorphine Treatment, www.naabt.org/documents/Harrison_Narcotics_Tax_Act_1914.pdf; and “Three Held in Death of Boy from Overdose,” Washington Times, April 17, 1916, chroniclingamerica.loc.gov/lccn/sn84026749/1916-04-17/ed-1/seq-1.
19. Emanuel Perlmutter, “Two Indicted for Homicide in Girl’s Death by Heroin,” New York Times, February 26, 1970, www.nytimes.com/1970/02/26/archives/two-indicted-for-homicide-in-girls-death-by-heroin-2-indicted-for.html.
20. Radley Balko, “America’s Drug War: 30 Years of Rampaging Wildebeest,” Washington Post, October 28, 2016, www.washingtonpost.com/news/the-watch/wp/2016/10/28/americas-drug-war-30-years-of-rampaging-wildebeest.
21. Sue Ann Forrest, “HB 474/SB 375—Death by Distribution,” North Carolina Medical Society, July 9, 2019, www.ncmedsoc.org/hb-474-death-by-distribution. See also Michelle Lou, “Under New North Carolina Law, Drug Dealers Could Be Charged with Second-Degree Murder,” CNN, July 9, 2019, www.cnn.com/2019/07/09/us/north-carolina-hb-474-death-by-distribution-trnd/index.html; and Session Law 2019-83, House Bill 474, General Assembly of North Carolina, Session 2019, www.ncleg.gov/Sessions/2019/Bills/House/PDF/H474v6.pdf.
22. “More Imprisonment Does Not Reduce State Drug Problems,” Pew Charitable Trusts, March 8, 2018, www.pewtrusts.org/en/research-and-analysis/issue-briefs/2018/03/more-imprisonment-does-not-reduce-state-drug-problems#4-drug-imprisonment-varies-widel.
23. Peter Wagner and Wendy Sawyer, “Mass Incarceration: The Whole Pie 2018,” Prison Policy Initiative, March 14, 2018, www.prisonpolicy.org/reports/pie2018.html.
24. Stephanie Schmitz Bechteler and Kathleen Kane-Willis, “Whitewashed: The African American Opioid Epidemic,” Chicago Urban League, Research and Policy Center, November 2017.
25. Jackie Borchardt, “Ohio ‘911 Good Samaritan’ Law Granting Immunity for Overdose Calls Signed by Gov. John Kasich,” Cleveland.com, June 13, 2016, www.cleveland.com/open/2016/06/ohio_911_good_samaritan_law_gr.html; and “Drug Overdose and Ohio’s Good Samaritan Law,” OhioSTART: Sobriety, Treatment & Reducing Trauma Program, The Ohio State University, College of Social Work, October 4, 2019, u.osu.edu/ohiostart/2019/10/04/drug-overdose-and-ohios-good-samaritan-law.
26. Amanda D. Latimore and Rachel S. Bergstein, “‘Caught with a Body’ yet Protected by Law? Calling 911 for Opioid Overdose in the Context of the Good Samaritan Law,” International Journal of Drug Policy 50 (December 2017): 82–89.
27. Illinois Controlled Substances Act, 720 ILCS 570, www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=1941&ChapterID=53.
28. “Statewide Narcotics Action Plan,” New Jersey Division of Criminal Justice, issued January 1988, revised March 1993, www.state.nj.us/lps/dcj/agguide/snap93.htm.
29. “No. 54. An Act Relating to Selling or Dispensing Illegal Drugs,” Vermont General Assembly, H. 206, www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2004/acts/ACT054.htm.
30. Jim Edwards, “Making Friends into Felons,” New Jersey Law Journal, September 9, 2002, 1.
31. Joe Gyan Jr., “Denham Springs Man Serving Life Term in Fatal Heroin Overdose Seeks Relief from State High Court,” The Advocate, May 1, 2019, www.theadvocate.com/baton_rouge/news/courts/article_3380e782-6b81-11e9-abe3-f39a445d2d42.html.
32. Lindsay Bever, “She Shot Up Her Father with Heroin: Now He’s Dead and She’s in Prison,” Washington Post, January 11, 2017, www.washingtonpost.com/news/to-your-health/wp/2017/01/11/she-shot-up-her-father-with-heroin-now-hes-dead-and-shes-in-prison.
33. Stephanie Grady, “‘It’s Been Used More and More,’ but Is Wisconsin’s Len Bias Law an Effective Deterrent to Opioid Abuse?” Fox 6 Now, November 21, 2016, fox6now.com/2016/11/21/its-been-used-more-and-more-but-is-wisconsins-len-bias-law-an-effective-deterrent-to-opioid-abuse.
34. Brian Polcyn and Stephen Davis, “High-Level Drug Dealers Rarely Charged with Drug-Related Homicides as Wisconsin Death Toll Reaches 10K,” Fox 6 Now, February 9, 2017, fox6now.com/2017/02/09/high-level-drug-dealers-are-rarely-charged-with-drug-related-homicides-as-wisconsin-death-toll-reaches-10000.
35. Bethany Bruner, “Manslaughter Conviction in Overdose Death Overturned on Appeal,” Newark Advocate, May 22, 2018, www.newarkadvocate.com/story/news/crime/2018/05/22/manslaughter-conviction-overdose-death-overturned-appeal/628426002.
36. Bethany Bruner, “After Appeal, Man Resentenced for Heroin Possession in OD Case,” Newark Advocate, July 3, 2018, www.newarkadvocate.com/story/news/crime/2018/07/03/after-appeal-man-resentenced-heroin-possession-od-case/755031002.
37. Joel Brinkley, “Anti-Drug Law: Words, Deeds, Political Expediency,” New York Times, October 27, 1986, www.nytimes.com/1986/10/27/us/anti-drug-law-words-deeds-political-expediency.html.
38. Ibid.
39. Rita Rubin, “Surgeon General Urges Expanded Availability of Naloxone,” JAMA 319, no. 20 (2018): 2068, doi.org/10.1001/jama.2018.6254.
40. For starters, see Michelle Alexander, The New Jim Crow: Mass Incarceration in the Age of Colorblindness (New York: The New Press, 2010); and Michael F. Walther, “Insanity: Four Decades of U.S. Counterdrug Strategy,” Strategic Studies Institute, U.S. Army War College, December 27, 2012.
41. In an email exchange, Gutman told me he was appropriating Dan Riffle’s “Every billionaire is a policy failure.”
42. Maia Szalavitz, “These Drug Users Don’t Want Their Dealer Prosecuted if They OD,” Vice, August 20, 2018, www.vice.com/en_us/article/kzyk7n/these-drug-users-dont-want-their-dealer-prosecuted-if-they-od.
43. According to a 2012 study, 87.5 percent of people who said they sold drugs in the past year also said they used drugs in the past year. And 41.3 percent of people who said they sold drugs in the past year reported that they met criteria for a substance use disorder. See “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings,” U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), September 2013, www.samhsa.gov/data/sites/default/files/NSDUHresults2012/NSDUHresults2012.pdf.
44. Description based on “Emergency Room Report,” Pike County Sheriff’s Office, Ohio Uniform Incident Report, 14-357, August 15, 2014.
1. “Newark: Exploring Community Solutions to the Addiction Crisis,” Your Voice Ohio, April 2018, yourvoiceohio.org/wp-content/uploads/2018/05/Your-Voice-Ohio-Newark-Report.pdf.
2. These are some of the responses found in their report.
3. Kate Dengg, “Addiction Town Hall: We’re Coming Together to Solve a Problem,” Newark Advocate, June 1, 2018, www.newarkadvocate.com/story/news/local/2018/06/01/city-schools-think-tank-host-addiction-forum/659116002.
4. Andy Chow, “Issue 1, Explained: What to Know About Ohio’s Drug Sentencing Amendment,” WOSU Public Media, October 18, 2018, radio.wosu.org/post/issue-1-explained-what-know-about-ohios-drug-sentencing-amendment#stream/0.
5. “Downtown Newark Association General Membership Meeting,” meeting minutes, May 7, 2019.
6. “Downtown Newark Association General Membership Meeting,” meeting minutes, September 4, 2018.
7. Wendy Sawyer and Peter Wagner, “Mass Incarceration: The Whole Pie 2019,” Prison Policy Initiative, March 19, 2019, www.prisonpolicy.org/reports/pie2019.html.
1. “Syringe Services Programs Fact Sheet,” U.S. Centers for Disease Control and Prevention, May 23, 2019, www.cdc.gov/ssp/syringe-services-programs-factsheet.html; and Jennifer J. Carroll, Traci C. Green, and Rita K. Noonan, “Evidence-Based Strategies for Preventing Opioid Overdose: What’s Working in the United States,” U.S. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2018, www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf.
2. Carroll, Green, and Noonan, “Evidence-Based Strategies for Preventing Opioid Overdose,” 27.
3. Legalized syringe exchanges had dramatically reduced possible HIV cases in Baltimore and Philadelphia. See Monica S. Ruiz et al., “Using Interrupted Time Series Analysis to Measure the Impact of Legalized Syringe Exchange on HIV Diagnoses in Baltimore and Philadelphia,” Journal of Acquired Immune Deficiency Syndrome 82, suppl. 2 (December 1, 2019): S148–S54; and Victoria Knight, “Needle Exchanges Find New Champions Among Republicans,” USA Today, May 8, 2019, www.usatoday.com/story/news/nation/2019/05/08/needle-exchange-programs-more-accepted-republican-states/1139672001.
4. Joe Ebel, “Syringe Exchanges Are an Evidence-Based Public Health Intervention,” Newark Advocate, November 10, 2018, www.newarkadvocate.com/story/news/2018/11/10/syringe-exchanges-evidence-based-public-health-intervention/1905865002.
5. “Persons Living with Diagnosed HIV Infection Reported in Licking County,” Ohio Department of Health, June 30, 2019, odh.ohio.gov; “Ohio Hepatitis B Cases 2015–2018,” Demographic Breakdown of Ohio, odh.ohio.gov; “Ohio Hepatitis C Cases 2014–2018,” Demographic Breakdown of Ohio, odh.ohio.gov.
6. Dennis Cauchon, “For Many on 9/11, Survival Was No Accident,” USA Today, December 19, 2011.
7. “Kasich Administration Blocks Ohio’s Cash-Strapped Syringe Programs from Getting Federal Funds,” Harm Reduction Ohio, June 25, 2018, www.harmreductionohio.org/kasich-administration-blocks-ohios-cash-strapped-syringe-programs-from-getting-federal-funds; and JoAnne Viviano, “Ohio Wants to Use Federal Grant Money for Needle-Exchange Programs,” Alliance Review, July 22, 2018, www.the-review.com/news/20180722/ohio-wants-to-use-federal-grant-money-for-needle-exchange-programs.
8. According to the Harm Reduction Coalition, “Overamping means a lot of things to a lot of people. Sometimes it is physical, when our bodies don’t feel right. Other times it is psychological, like paranoia, anxiety or psychosis—or a mixture of the two. It’s complicated because sometimes one person will consider something overamping, and the other person actually considers it just part of the high, or maybe even enjoys a feeling that someone else hates.” Harm Reduction Coaltion. harmreduction.org/issues/overdose-prevention/overview/stimulant-overamping-basics/what-is-overamping.
9. Maia Szalavitz, “Dan Bigg Is a Harm Reduction Pioneer and His Overdose Doesn’t Change That,” Vice, October 24, 2018, www.vice.com/en_us/article/7x3yag/dan-bigg-overdose-harm-reduction.
10. Michael A. Irvine, Margot Kuo, Jane A. Buxton, Robert Balshaw, Michael Otterstatter, Laura Macdougall, M‐J Milloy, et al. “Modelling the Combined Impact of Interventions in Averting Deaths During a Synthetic‐Opioid Overdose Epidemic,” Addiction 114, no. 9 (2019): 1602–1613; Rebecca B. Naumann, Christine Piette Durrance, Shabbar I. Ranapurwala, Anna E. Austin, Scott Proescholdbell, Robert Childs, Stephen W. Marshall, Susan Kansagra, and Meghan E. Shanahan. “Impact of a Community-Based Naloxone Distribution Program on Opioid Overdose Death Rates,” Drug and Alcohol Dependence 204, (2019): 107536.
11. For a thorough read on harm reduction best practices, read Sheila P. Vakharia and Jeannie Little, “Starting Where the Client Is: Harm Reduction Guidelines for Clinical Social Work Practice,” Clinical Social Work Journal 45, no. 1 (2017): 65–76.
12. Maia Szalavitz, Unbroken Brain: A Revolutionary New Way of Understanding Addiction (New York: St. Martin’s Press, 2016), 241.
13. Ibid.
14. Lesly-Marie Buer, “Overdosing in Appalachia,” Boston Review, July 8, 2019.
15. “3707.57 Bloodborne Infectious Disease Prevention Programs,” Ohio Revised Code, codes.ohio.gov/orc/3707.57. See also Ohio Revised Code 3709 for an explanation of the role of a board of health in Ohio.
16. “Newark FED Up Rally,” Newark Advocate, August 30, 2018, www.newarkadvocate.com/media/cinematic/gallery/1153608002/newark-fed-up-rally.
17. Dennis Cauchon, “Needle Exchange Programs Save Money, Lives,” Newark Advocate, September 9, 2018.
1. Brian Alexander, “The Ghost Bosses,” The Atlantic, March 13, 2017, www.theatlantic.com/business/archive/2017/03/lancaster-ohio-glass-house/519351.
2. Brian Alexander, Glass House: The 1% Economy and the Shattering of the All-American Town (New York: St. Martin’s, 2017).
3. Brian Alexander, “What America Is Losing as Its Small Towns Struggle,” The Atlantic, October 18, 2017.
4. Meghan Mongillo, “‘Do You Know Who Murdered Us?’: Progress Made but More Info Sought in Pike Co. Massacre,” Local 12 News, WKRC, April 13, 2017, local12.com/news/local/do-you-know-who-murdered-us-progress-made-but-more-info-sought-in-pike-co-massacre.
5. “Prison and Jail Incarceration Rates Decreased by More Than 10% from 2007 to 2017,” U.S. Department of Justice, press release, April 25, 2019, www.bjs.gov/content/pub/press/p17ji17pr.pdf.
6. Craig McDonald, “County Officials United in Strong Opposition to Issue 1,” Newark Advocate, October 8, 2018.
7. Chengyuan Zhou et al., “The Costs and Benefits of Day Reporting Centers: A New Model of Adult Probation in Allegheny County,” Allegheny County Department of Human Services, September 2014, www.alleghenycountyanalytics.us/wp-content/uploads/2016/06/The-Costs-and-Benefits-of-Day-Reporting-Centers-A-New-Model-of-Adult-Probation-in-Allegheny-County.pdf.
8. According to Douglas J. Boyle et al., in “An Evaluation of Day Reporting Centers for Parolees: Outcomes of a Randomized Trial,” Criminology & Public Policy 12, no. 1 (2013): 119–43, “The data show that DRC participants were more likely to be arrested and convicted for a new offense in the short term compared to the Control group. DRC participants’ median time to new arrest was 99 days shorter than Control group parolees; however, this difference was not significant. No differences were found between the groups in the long term.”
9. Day reporting is, in some ways, akin to a drug court relying on “police as gatekeepers.” See Alex S. Vitale, The End of Policing (New York: Verso, 2017), 145.
10. The Licking County Board of Health is comprised of eleven members, though one seat (from the city of Pataskala) was unfilled as of this writing. All of the board members are appointed, and Ohio law (Ohio Revised Code 3709) says that only one must be a physician. Of the ten members on the board at the time of this writing, there was one physician, two nurses, one chiropractor, and one paramedic. See “Board of Health,” Licking County Health Department, www.lickingcohealth.org/admin/board.html.
11. Albert Camus, The Myth of Sisyphus and Other Essays, trans. Justin O’Brien (New York: Knopf, 1955), 121.
12. Ibid., 123.
1. See brave.coop to learn more about their Be Safe community app and the Brave Button.
2. Gordon was referring to Eli Beer, “The Fastest Ambulance? A Motorcycle,” TED Talk, April 2013, www.ted.com/talks/eli_beer_the_fastest_ambulance_a_motorcycle.
3. “Ohio Opioid Technology Challenge,” Ohio Development Services Agency, development.ohio.gov/bs_thirdfrontier/ootc.htm.
4. Often people do not have access to MAT (which cut the risk of overdose in half) while inside. Or they are given naltrexone (Vivitrol), which requires compliance. Shabbar I. Ranapurwala et al., “Opioid Overdose Mortality Among Former North Carolina Inmates: 2000–2015,” American Journal of Public Health 108, no. 9 (September 2018): 1207–13.
5. See, for example, this sticker available for $4.98 plus shipping: “Shoot Your Local Heroin Dealer,” Amazon.com, www.amazon.com/Shoot-Your-Local-Heroin-Dealer/dp/B07N46Y1R2.
6. Rhea W. Boyd, “Despair doesn’t kill, defending whiteness does,” The Lancet, Volume 395, Issue 10218 (January 2020): 105–6.
7. Katherine McLean, “‘There’s Nothing Here’: Deindustrialization as Risk Environment for Overdose,” International Journal of Drug Policy 29 (March 29, 2016): 25.
8. Ibid., 26.
9. Lynn Hunt, Inventing Human Rights: A History (New York: Norton, 2007), 20.
10. This is not an original thought, for sure, but see Jack Shuler, Calling Out Liberty: The Stono Rebellion of 1739 and the Universal Struggle for Human Rights (Jackson: University of Mississippi Press, 2009).
11. Hunt, Inventing Human Rights, 20.
12. “Newark City Committee, Dec 17, 2018,” YouTube, posted by Newark City Council, December 17, 2018, www.youtube.com/watch?v=vCMDlbEeY5I.
13. “Syringe Services Programs Fact Sheet,” U.S. Centers for Disease Control and Prevention, May 23, 2019, www.cdc.gov/ssp/syringe-services-programs-factsheet.html.
1. Peter Baker, “Trump Declares National Emergency, and Provokes a Constitutional Clash,” New York Times, February 15, 2019, www.nytimes.com/2019/02/15/us/politics/national-emergency-trump.html.
2. Kaitlin Shroeder, “Opioid Battle in Region Getting Boost from Big Data,” Dayton Daily News, February 10, 2019, www.daytondailynews.com/news/local/opioid-battle-region-getting-boost-from-big-data/2jIma9Pyc69A8lnT2l0jaO. See also Katie Wedell, “Ohio City Attempts to Shed ‘Overdose Capital of the Nation’ Title,” Dayton Daily News, June 24, 2018.
3. Abby Goodnough, “This City’s Overdose Deaths Have Plunged. Can Others Learn from It?” New York Times, November 25, 2018, www.nytimes.com/2018/11/25/health/opioid-overdose-deaths-dayton.html.
4. Erin Welch, “A Community of Recovery: Dayton, Ohio’s Compassionate, Collective Approach to the Opioid Crisis,” Center for American Progress, January 10, 2019, www.americanprogress.org/issues/criminal-justice/reports/2019/01/10/464889/a-community-of-recovery.
5. Julie O’Donnell et al., “Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected—10 States, July 2016–June 2017,” Morbidity and Mortality Weekly Report 67, no. 27 (July 13, 2018): 767–68, dx.doi.org/10.15585/mmwr.mm6727a4.
6. Chris Harris, “Spirit Airlines Pilot and Wife Found Dead by Kids Had Overdosed on Cocaine and Animal Tranquilizer,” People, May 31, 2017, people.com/crime/spirit-airlines-pilot-wife-found-dead-children-overdosed-cocaine-animal-tranquilizer.
7. “Carfentanil: A Dangerous New Factor in the U.S. Opioid Crisis,” U.S. Drug Enforcement Administration, Officer Safety Alert, www.justice.gov/usao-edky/file/898991/download.
8. O’Donnell et al., “Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected.” See also Dennis Cauchon, “Ohio’s Carfentanil Death Rate 21 Times Higher—Yes, 2000%!—Than in Other States,” Harm Reduction Ohio, August 6, 2018.
9. Corky Siemaszko, “Too Many Bodies in the Morgue so Coroner Gets Death Trailer,” NBC News, March 14, 2017.
10. Jon E. Zibbell et al., “Association of Law Enforcement Seizures of Heroin, Fentanyl, and Carfentanil with Opioid Overdose Deaths in Ohio, 2014–2017,” JAMA Network Open 2, no. 11 (November 1, 2019): e1914666.
11. Dennis Cauchon, “Special Report: Carfentanil’s Deadly Role in Ohio Drug Overdose Deaths,” Harm Reduction Ohio, www.harmreductionohio.org/special-report-carfentanils-deadly-role-in-ohio-drug-overdose-deaths.
12. Ibid.
13. Richard C. Cowan, “How the Narcs Created Crack,” National Review Magazine, December 5, 1986, 26–31.
14. Johann Hari, Chasing the Scream: The First and Last Days of the War on Drugs (New York: Bloomsbury, 2015), 230.
15. Cauchon, “Special Report.”
16. Goodnough, “This City’s Overdose Deaths Have Plunged. Can Others Learn from It?”
17. Ibid.
18. “Senate Passes Landmark Opioid Reforms, Including Portman’s STOP Act,” press release, Rob Portman, U.S. Senator for Ohio, October 3, 2018, www.portman.senate.gov/newsroom/press-releases/senate-passes-landmark-opioid-reforms-including-portmans-stop-act.
19. Wedell, “Ohio City Attempts to Shed ‘Overdose Capital of the Nation’ Title.”
20. “GBD Results Tool,” Global Health Data Exchange, ghdx.healthdata.org/gbd-results-tool.
21. “Top Employers in the Dayton Area,” Dayton.com, February 27, 2015, www.dayton.com/business/employment/top-employers-the-dayton-area/58X4L6ox8z15TNIiRpgWZI; and Samuel R. Staley, “Dayton Ohio: The Rise, Fall, and Stagnation of a Former Industrial Juggernaut,” New Geography, August 4, 2008.
1. Masha Gessen, “Nan Goldin Leads a Protest at the Guggenheim Against the Sackler Family,” The New Yorker, February 10, 2019, www.newyorker.com/news/our-columnists/nan-goldin-leads-a-protest-at-the-guggenheim-against-the-sackler-family.
2. According to Jennifer J. Carroll, Traci C. Green, and Rita K. Noonan, in “Evidence-Based Strategies for Preventing Opioid Overdose: What’s Working in the United States,” U.S. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2018, www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf, “Programs with one-for-one exchange policies, for example, allow participants only as many syringes as the number of used syringes they return, thus undercutting the program’s own effectiveness. When no limits are set on the number of syringes distributed, participants are more likely to have clean syringes on hand when they need them, and they can provide syringes to many more people than can attend the program themselves, thus multiplying the program’s effectiveness. This also increases participants’ incentive to visit the program and interact with staff and counselors” (26).
3. Joe Ebel, “Syringe Exchanges Are an Evidence-Based Public Health Intervention,” Newark Advocate, November 10, 2018, www.newarkadvocate.com/story/news/2018/11/10/syringe-exchanges-evidence-based-public-health-intervention/1905865002.
4. Gregg S. Gonsalves and Forrest W. Crawford, “Dynamics of the HIV Outbreak and Response in Scott County, Indiana, 2011–15: A Modeling Study,” Lancet HIV 5, no. 10 (October 2018): e569–e577; and Steven W. Thrasher, “Mike Pence Is Still to Blame for an HIV Outbreak in Indiana—but for New Reasons,” The Nation, October 4, 2018, www.thenation.com/article/mike-pence-is-still-to-blame-for-an-hiv-outbreak-in-indiana-but-for-new-reasons.
5. See Gonsalves and Crawford, “Dynamics of the HIV Outbreak and Response in Scott County, Indiana, 2011–15.”
6. Ellsworth M. Campbell et al., “Detailed Transmission Network Analysis of a Large Opiate-Driven Outbreak of HIV Infection in the United States,” Journal of Infectious Diseases 216, no. 9 (November 27, 2017): 1053–62.
7. Kent Mallett, “Licking County Board of Health Votes Against Needle Exchange Program,” Newark Advocate, February 20, 2019, www.newarkadvocate.com/story/news/2019/02/20/licking-county-board-health-votes-against-needle-exchange-program/2927840002.
8. The Advocate Editorial Board, “Our View: Licking County Health Board’s Needle Exchange Vote Was Cowardly,” Newark Advocate, February 22, 2019.
9. Sheridan Hendrix, “Licking County Balks at Volunteer’s Needle Exchanges,” Columbus Dispatch, November 23, 2019; and Sheridan Hendrix, “Advocates Blast Licking County Health Board’s Decision to Ban Needle-Exchange Programs,” Columbus Dispatch, March 19, 2019.
10. Will Stone, “Phoenix’s Underground Needle Exchange Offers Lifeline for Opioid Users,” KJZZ, August 31, 2017, science.kjzz.org/content/527188/phoenixs-underground-needle-exchange-offers-lifeline-opioid-users; and Stephanie Innes, “Shot in the Dark: Phoenix Area Needle Exchange Could End Due to Low Funding, Politics,” Arizona Republic, July 22, 2019, www.azcentral.com/story/news/local/arizona-health/2019/07/22/shot-dark-needle-exchange-could-close-due-low-funding/1719306001.
11. Katarina Sostaric, “Underground Needle Exchange Helps Iowans Who Inject Drugs,” Iowa Public Radio, January 25, 2018, www.iowapublicradio.org/post/underground-needle-exchange-helps-iowans-who-inject-drugs#stream/0.
12. Kent Mallett, “Critics Confront Licking County Health Board on Needle Exchange Rejection,” Newark Advocate, March 20, 2019.
13. The Advocate Editorial Board, “Our View: Licking County Health Board’s Needle Exchange Vote Was Cowardly,” Newark Advocate, February 22, 2019.
14. See Hendrix, “Advocates Blast Licking County Health Board’s Decision to Ban Needle-Exchange Programs.”
15. Bryant Somerville, “Licking County Residents Address Health Board, Defend Desire for Needle Exchange Program,” 10TV WBNS, March 19, 2019, www.10tv.com/article/licking-county-residents-address-health-board-defend-desire-needle-exchange-program-2019-apr.
16. Christine B. Hanhardt, “‘Dead Addicts Don’t Recover’: ACT UP’s Needle Exchange and the Subjects of Queer Activists History,” GLQ: A Journal of Lesbian and Gay Studies 24, no. 4 (October 2018): 428.
17. William A. Schwartz, “Drug Addicts with Dirty Needles,” The Nation, June 20, 1987, 843–46.
18. Daliah Heller and Denise Paone, “Access to Sterile Syringes for Injecting Drug Users in New York City: Politics and Perception (1984–2010),” Substance Use and Misuse 46 (2011): 140–49.
19. “Up in Arms Over Needle Exchange,” video, Gay Men’s Health Crisis, 1988, Gay Men’s Health Crisis Records, Manuscripts and Archives Division, New York Public Library.
20. “Possessing Drug Abuse Instruments,” Ohio Revised Code 2925.12, codes.ohio.gov/orc/2925.12.
Syringe programs are covered by “Bloodborne Infectious Disease Prevention Programs,” Ohio Revised Code 3707.57, codes.ohio.gov/orc/3707.57.
21. Dennis Hevesi, “Dave Purchase Dies at 73; Led Early Needle Exchange,” New York Times, January 27, 2013.
22. Benjamin Shepard, Community Projects as Social Activism: From Direct Action to Direct Services (Los Angeles: Sage, 2015), 139.
23. Bruce Lambert, “Drug Group to Offer Free Needles to Combat AIDS in New York City,” New York Times, January 8, 1988.
24. Bruce Lambert, “10 Seized in Demonstrations as They Offer New Needles,” New York Times, March 7, 1990; and “ACT UP Capsule History: 1990,” ACT UP Historical Archive, actupny.org/documents/cron-90.html.
25. Shepard, Community Projects as Social Activism, 139–44; and “Needle Exchange Trial,” video, Royal S. Marks AIDS Activist Video Collection, 1983–2000, Manuscripts and Archives Division, New York Public Library.
26. Evelyn Nieves, “Judge Acquits Four of Distributing Needles in an Effort to Curb AIDS,” New York Times, November 8, 1991.
1. For the results of some of this library research, see Bruce K. Alexander, The Globalization of Addiction: A Study in Poverty of the Spirit (New York: Oxford University Press, 2008), 207–39.
2. According to Steven H. Woolf and Heidi Schoomaker, in “Life Expectancy and Mortality Rates in the United States, 1959–2017,” JAMA 322, no. 20 (November 26, 2019): 1996–2016, doi.org/10.1001/jama.2019.16932, “The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010–2017 was associated with an estimated 33,307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.”
3. Some salient points from “Suicide Deaths Increased by 45% Among All Ohioans and by 56% Among Youth Ages 10–24 from 2007–2018,” Ohio Department of Health, November 13, 2019, odh.ohio.gov/wps/portal/gov/odh/media-center/odh-news-releases/ohio-suicide-demographics-trends-report: “From 2007 to 2018 the number of suicide deaths increased nearly 45% in Ohio. Suicide rates are highest among white, non-Hispanic males. From 2007 to 2018 the number of suicides among youth ages 10–24 increased by 56%, and the suicide rate increased by 64%. In 2018, 271 of Ohio’s suicide deaths were in this age group. From 2014 to 2018 the suicide rate among black non-Hispanic males increased nearly 54%.”
4. “Newark Teen Sentenced for Accidentally Killing Friend,” 10TV, WBNS, December 16, 2009, www.10tv.com/article/newark-teen-sentenced-accidentally-shooting-killing-friend.
5. George Orwell, Down and Out in Paris and London (New York: Harcourt, 1933), 180–81.
6. Ibid., 182–84.
7. Ibid., 184–85.
8. Tim McKee, “The Geography of Sorrow: Francis Weller on Navigating Our Losses,” The Sun, October 2015, thesunmagazine.org/issues/478/the-geography-of-sorrow.
1. Barbara Lazear Ascher, “On Compassion,” in The Habit of Loving (New York: Random House, 1986).
2. Kent Mallett, “Homelessness Appears to Be a Growing Problem in Licking County,” Newark Advocate, February 17, 2019.
3. Ibid.
4. “‘It’s a Long Hard Ride’: The Faces of Newark’s Homeless,” Newark Advocate, February 17, 2019.
5. “Newark City Council Mar 4 2019,” YouTube, posted by Newark City Council, March 4, 2019, www.youtube.com/watch?v=kqvLnC2MagA&t=1081s.
6. Ibid., at 29:42–30:07.
7. Michaela Sumner, “Newark Defends Police, Parks Actions in Homeless Camp Removal,” Newark Advocate, March 5, 2019, www.newarkadvocate.com/story/news/local/2019/03/05/newark-official-defends-police-parks-actions-homeless-camp-removal/3065712002. More recently in central Ohio, camps were demolished in Columbus. See Rita Price, “Homeless Struggle After Makeshift Camps Demolished,” Columbus Dispatch, December 17, 2019.
8. Field Case Report, Newark Police Department, Case #2019-00005334, February 27, 2019.
9. Alex S. Vitale, The End of Policing (New York: Verso, 2017), 91.
10. Ibid., 92.
11. Ibid.; and Bidish Sarma and Jessica Brand, “The Criminalization of Homelessness: Explained,” The Appeal, June 29, 2018.
12. “Housing Not Handcuffs, 2019: Ending the Criminalization of Homelessness in U.S. Cities,” National Law Center on Homelessness and Poverty, December 2019.
13. “Newark City Council Mar 18 2019,” YouTube, posted by Newark City Council, March 18, 2019, www.youtube.com/watch?v=MwJvf1fTIdo.
14. Sheridan Hendrix, “Newark Council Confronted About City’s Treatment of Homeless,” Columbus Dispatch, March 18, 2019, www.dispatch.com/news/20190318/newark-council-confronted-about-citys-treatment-of-homeless; and Kent Mallett, “Residents Express Outrage at Removal of Homeless Camps to Newark City Council,” Newark Advocate, March 19, 2019.
15. “Newark City Council Apr 15 2019,” YouTube, posted by Newark City Council, April 15, 2019, www.youtube.com/watch?v=SMLYnI6nbHU.
16. Kent Mallett, “Mayor Confronted on Homeless Issue After Council Meeting,” Newark Advocate, April 17, 2019, www.newarkadvocate.com/story/news/2019/04/17/newark-mayor-confronted-homeless-issue-after-council-meeting/3482707002.
17. Michaela Sumner, “Community-Based Group Aims to Reduce Chronic Homelessness in Licking County,” Newark Advocate, May 23, 2019.
18. Naomi Klein, “Reclaiming the Commons,” in A Movement of Movements: Is Another World Really Possible? ed. Tom Mertes (New York: Verso, 2004), 227.
19. Ibid., 228.
20. According to Gabor Maté, in his TED talk “The Power of Addiction and the Addiction of Power,” TEDxRio, October 9, 2012, www.youtube.com/watch?time_continue=1&v=66cYcSak6nE&feature=emb_title, “Let’s not look to the people in power to change things. Because the people in power, I’m afraid to say, are very often some of the emptiest people in the world and they’re not going to change things for us. We have to find that light within ourselves, that light within communities.”
1. “Licking County Health Department: The Stigma of Addiction,” video, Flicker-lit Productions, 2019, posted on Vimeo, vimeo.com/337444434.
2. “Agenda for HRO’s ‘Family Matters’ Conference on Saturday, April 6,” Harm Reduction Ohio, March 29, 2019.
3. “The Granville Riot: Granville’s Reaction to the 1836 Abolitionist Convention Held at the Bancroft Barn on North Street,” The Historical Times: Newsletter of the Granville, Ohio, Historical Society 12, no. 3 (Summer 1998), static.squarespace.com/static/5054b15de4b02b42cb2ebd87/5054b1c0e4b02aa16c339410/5054b1c0e4b02aa16c339413/1339881980031.
4. Kent Mallett, “Residents Rally Against Move of Gazebo from Courthouse Square,” Newark Advocate, October 3, 2017.
5. Kent Mallett, “Commissioners Won’t Light Courthouse in LGBTQ Rainbow Colors for Pride Event,” Newark Advocate, April 20, 2018, www.newarkadvocate.com/story/news/2018/04/20/commissioners-wont-light-courthouse-lgbtq-rainbow-colors-pride-event/532882002.
6. Sara Tobias, “People’s Pride Lights Courthouse,” Newark Advocate, June 9, 2018, www.newarkadvocate.com/story/news/local/2018/06/09/peoples-pride-lights-courthouse/687268002.
7. Jack Shuler, The Thirteenth Turn: A History of the Noose (New York: Public Affairs, 2014), 183–95.
8. See Johann Hari, Chasing the Scream: The First and Last Days of the War on Drugs (New York: Bloomsbury, 2015).
9. For a quick discussion of this, see David Emery and Kim Lacapria, “Did the U.S. Government Purposely Poison 10,000 Americans During Prohibition?” Snopes.com, May 12, 2017, www.snopes.com/fact-check/government-poison-10000-americans.
10. State of Ohio v. Billy R. McCall, Case No. 18 CR 490, Second Stage Revocation Hearing, Transcript of Proceedings Before the Honorable Thomas Marcelain, July 18, 2019.
11. Jails and prisons increase a person’s risk of death, especially for those people with substance use disorders. See Elias Nosrati et al., “Economic Decline, Incarceration, and Mortality from Drug Use Disorders in the USA Between 1983 and 2014: An Observational Analysis,” Lancet Public Health 4, no. 7 (July 2019): e326–e333.
12. State of Ohio v. Billy R. McCall, 2017, Case No. CR 00709.
13. Elizabeth L. C. Merrall et al., “Meta‐Analysis of Drug‐Related Deaths Soon After Release from Prison,” Addiction 105, no. 9 (2010): 1545–54.
14. “HRO Syringe Program Advocacy Director Billy McCall Sentenced to Prison for Addiction to Heroin,” Harm Reduction Ohio, July 18, 2019, www.harmreductionohio.org/hro-syringe-program-advocacy-director-billy-mccall-sentenced-to-prison-for-addiction-to-heroin.
1. “Drug Overdose Deaths,” U.S. Centers for Disease Control and Prevention, June 27, 2019, www.cdc.gov/drugoverdose/data/statedeaths.html.
2. Travis Lupick, “Is Vancouver’s Downtown Eastside Still the ‘Poorest Postal Code’ in Canada?” Georgia Straight, April 8, 2019, www.straight.com/news/1225081/vancouvers-downtown-eastside-still-poorest-postal-code-canada.
3. Nurses and Nurse Practitioners of BC, “B.C. Honours Excellence in Nursing,” press release, GlobeNewswire, December 17, 2018, www.globenewswire.com/news-release/2018/12/17/1668231/0/en/B-C-Honours-Excellence-in-Nursing.html.
4. Travis Lupick, Fighting for Space: How a Group of Drug Users Transformed One City’s Struggle with Addiction (Vancouver: Arsenal, 2017). Note: This book should be the starting point for anyone wanting to understand this movement. It is a force.
5. Bud Osborn, “1000 Crosses in Oppenheimer Park,” video, posted at Vimeo by Liz Evans, vimeo.com/94463923.
6. “Insite User Statistics,” Vancouver Coastal Health, July 2019, www.vch.ca/public-health/harm-reduction/supervised-consumption-sites/insite-user-statistics.
7. Ibid. The following statistics are listed:
• 189,837 visits by 5,436 individuals
• An average of 337 injection room visits per day
• 1,466 overdose interventions
• 3,725 clinical treatment interventions (such as wound care, pregnancy tests)
• Substances reported used were opioids (62% of instances), stimulant (19% of instances), and mixed (19% of instances)
8. Elana Gordon, “In Vancouver, People Who Use Drugs Are Supervising Injections and Reversing Overdoses,” The World, Public Radio International, September 24, 2018, www.pri.org/stories/2018-09-24/vancouver-people-who-use-drugs-are-supervising-injections-and-reversing-overdoses.
9. “Overdose Prevention Sites,” Portland Hotel Society, www.phs.ca/project/overdose-prevention-sites.
10. “Providence Crosstown Clinic,” Providence Health Care, www.providencehealthcare.org/hospitals-residences/providence-crosstown-clinic.
11. Spike, “How Legal Prescription Heroin Saved Me: One Participant of a Groundbreaking Vancouver Health Experiment Tells His Story,” The Tyee, February 8, 2016, thetyee.ca/Opinion/2016/02/08/Legal-Prescription-Heroin; and “How Crosstown Clinic Helped a Vancouver City Council Candidate Get His Life Back,” Daily Scan, September 17, 2018, thedailyscan.providencehealthcare.org/2018/09/crosstown-and-spike.
12. Eugenia Oviedo-Joekes et al., “Diacetylmorphine versus Methadone for the Treatment of Opioid Addiction,” New England Journal of Medicine 361, no. 8 (August 2009): 777–86.
13. The program at Crosstown even has an independent peer-run group connected to the HAT program. See Susan Boyd, Dave Murray, and Donald MacPherson, “Telling our Stories: Heroin-Assisted Treatment and SNAP Activism in the Downtown Eastside of Vancouver,” Harm Reduction Journal 14, no. 1 (May 2017): 27–14.
14. See Franziska Güttinger et al., “Evaluating Long-Term Effects of Heroin-Assisted Treatment: The Results of a 6-Year Follow-Up,” European Addiction Research 9, no. 2 (May 2003): 73–79. For an overview of early HAT programs, see Benedikt Fischer et al., “Heroin-Assisted Treatment (HAT) a Decade Later: A Brief Update on Science and Politics,” Journal of Urban Health 84, no. 4 (July 2007): 552–62.
15. BC Substance Use Conference, May 23–25, 2019, www.bccsu.ca/event/bc-substance-use-conference-2019/.
16. Geoff Bardwell, Evan Wood, and Rupinder Brar, “Fentanyl Assisted Treatment: A Possible Role in the Opioid Overdose Epidemic?” Substance Abuse Treatment, Prevention, and Policy 14, no. 1 (2019): 1–3; Taylor Fleming, Alison Barker, et al., “Stimulant Safe Supply: A Potential Opportunity to Respond to the Overdose Epidemic,” Harm Reduction Journal 17, 6 (2020).
17. “Safe Supply Concept Document,” Canadian Association of People Who Use Drugs, February 2019.
18. See, for example, John L. McKnight and John P. Kretzmann, “Mapping Community Capacity,” revised ed., Institute for Policy Research, Northwestern University, 1996, web.archive.org/web/20161011224806/http://www.abcdinstitute.org/docs/MappingCapacity.pdf.
19. “Episode 3: Unsanctioned,” Crackdown, crackdownpod.com/podcast/episode-3-unsanctioned.
20. Crackdown, crackdownpod.com.
21. Ten years ago, an article in The Globe and Mail asserted that 14 percent of the people in the Downtown Eastside were indigenous. See Patrick Brethour, “Exclusive Demographic Picture,” Globe and Mail, February 13, 2009.
22. “Episode 7: Stand Down,” Crackdown, podcast, July 31, 2019, crackdownpod.com/podcast/episode-7-stand-down; and Alexandra B. Collins et al., “Policing Space in the Overdose Crisis: A Rapid Ethnographic Study of the Impact of Law Enforcement Practices on the Effectiveness of Overdose Prevention Sites,” International Journal of Drug Policy 73 (November 2019): 199–207.
23. E. J. Dickson, “Philadelphia May Become the First City to Open Safe Injection Sites,” Rolling Stone, September 5, 2019, www.rollingstone.com/culture/culture-news/philadelphia-safe-injection-sites-880346; and Bobby Allyn, “Judge Rules Planned Supervised Injection Site Does Not Violate Federal Drug Laws,” National Public Radio, October 2, 2019, www.npr.org/2019/10/02/766500743/judge-rules-plan-for-safehouse-drug-injection-site-in-philadelphia-can-go-forwar.
24. “Louise’s Story,” Drug Policy Alliance, www.drugpolicy.org/drugsellers/louise; and Louise Vincent, “The Rage of Overdose Grief Makes It All Too Easy to Misdirect Blame,” Filter, December 5, 2018, filtermag.org/the-rage-of-overdose-grief-makes-it-all-too-easy-to-misdirect-blame.
25. Angela Y. Davis, Freedom Is a Constant Struggle: Ferguson, Palestine, and the Foundations of a Movement (Chicago: Haymarket Books, 2015).
26. “Episode 18: Drug User Unions—The Rebirth of Harm Reduction,” Narcotica, podcast, podcasts.apple.com/us/podcast/narcotica-podcast/id1390336378?i=1000437419170.
27. Travis Lupick, “How Drug Users Are Fighting Back Against America’s War on Drugs,” Yes! Magazine, December 10, 2019.
28. Zachary Siegel, “The Struggle of Death, Hope and Harm Reduction in the Midwest,” Filter, October 7, 2019, filtermag.org/death-harm-reduction-midwest.
29. Colin Miller, “On a Mission to Show Up for Drug Users in West Virginia,” Filter, October 22, 2019, filtermag.org/drug-users-west-virginia.
1. “17-2804 - In Re: National Prescription Opiate Litigation,” GovInfo, www.govinfo.gov/app/details/USCOURTS-ohnd-1_17-md-02804/USCOURTS-ohnd-1_17-md-02804-0/summary.
2. Laura Strickler, “Purdue Pharma Offers $10–12 Billion to Settle Opioid Claims,” NBC News, August 27, 2019, www.nbcnews.com/news/us-news/purdue-pharma-offers-10-12-billion-settle-opioid-claims-n1046526.
3. As of early 2020. “America’s Richest Families,” Forbes, www.forbes.com/families/list/#tab:overall; Tom Maloney, Jef Feeley, and Bloomberg, “Sacklers to Remain Billionaire Family If Purdue Settles Opioid Lawsuits,” Fortune, August 28, 2019, fortune.com/2019/08/28/sackler-family-billionaires-opioid-crisis-lawsuits; and Mike Spector, “OxyContin Maker Purdue Pharma Files for Bankruptcy Protection,” Reuters, September 15, 2019, www.reuters.com/article/us-purdue-pharma-bankruptcy-idUSKBN1W1058.
4. Jan Hoffman, “$260 Million Opioid Settlement Reached at Last Minute with Big Drug Companies,” New York Times, October 21, 2019, www.nytimes.com/2019/10/21/health/opioid-settlement.html.
5. Andy Chow, “Kasich Fears Potential Opioid Settlement Could Be Frittered Away,” Statehouse News Bureau, August 22, 2019.
6. One positive intervention would be for more money to get in the hands of community-based harm-reduction programs. See Maia Szalavitz, “The Bankruptcy Money from the Makers of Oxycontin Might Actually Save Lives,” Vice, October 24, 2019, www.vice.com/en_us/article/kz4y7x/purdue-pharma-oxycontin-bankruptcy-could-fund-harm-reduction-and-save-lives.
7. Some suggest that naloxone should be readily available over the counter. See Corey S. Davis and Derek Carr, “Over the Counter Naloxone Needed to Save Lives in the United States,” Preventive Medicine 130 (November 2019): 105932.
8. Johann Hari, in Chasing the Scream: The First and Last Days of the War on Drugs (New York: Bloomsbury, 2015), says it well when writing about a few of the issues this book addresses: “If you are alone, you are vulnerable to addiction, and if you are alone, you are vulnerable to the drug war. But if you take the first step and find others who agree with you—if you make connection—you lose your vulnerability, and you start to win” (297).
9. Ricardo Alonso-Zaldivar, “Feds to let states tap opioid funds for meth, cocaine surge,” Associated Press News, January 21, 2020, apnews.com/d71e1848689d214595387169cd946f39.
10. “Jeremy Blake with Sherrod Brown,” YouTube, posted by Adam Rhodes, September 16, 2019, www.youtube.com/watch?v=7sKKzhUGXYo&feature=youtu.be.
11. Shanti Basu, “Success of Newark Recovery Home for Women Leads to New Option for Men,” Newark Advocate, December 8, 2019, www.newarkadvocate.com/story/news/local/2019/12/08/success-newark-recovery-home-women-leads-new-option-men/4302691002.
12. Sam Sobul, “Ohio Syringe Services Program Profiles,” The Center for Community Solutions, May 2019, www.communitysolutions.com/wp-content/uploads/2019/05/IssueBrief_Ohio-Syringe-Services-Program-Profiles_SSobul_updated-05202019.pdf.
13. Kent Mallett, “Former Longaberger Building to Open for Business Again as Luxury Hotel,” Newark Advocate, October 21, 2019, www.newarkadvocate.com/story/news/2019/10/21/former-longaberger-basket-building-open-business-again/4057557002.
14. Kent Mallett, “United Way’s Hope Award Winner: From Homeless to Helping Others,” Newark Advocate, May 3, 2018, www.newarkadvocate.com/story/news/2018/05/03/united-ways-hope-award-winner-homeless-helping-others/576494002.
15. Clare Roth, “Ohio Opioid Technology Challenges Awards $1 Million to Four Projects,” WOSU Public Media, August 27, 2019, radio.wosu.org/post/ohio-opioid-technology-challenges-awards-1-million-four-projects#stream/0.
16. This will require a significant amount of momentum and money—some estimate at least $100 billion. See Nabarun Dasgupta, Leo Beletsky, and Daniel Ciccarone, “Opioid Crisis: No Easy Fix to Its Social and Economic Determinants,” American Journal of Public Health 108, no. 2 (2018): 184; and Daniel Ciccarone, “The Triple Wave Epidemic: Supply and Demand Drivers of the US Opioid Overdose Crisis,” International Journal of Drug Policy 71 (2019): 186.
1. “She’s Saving Lives by Giving Clean Needles to Opioid Addicts,” CNN, November 5, 2019, www.facebook.com/watch/?v=559631781455570.
2. Lin Ma, Lam Tran, and David White, “A Summary of the State Unintentional Drug Overdose Reporting Surveillance Dataset in Ohio, 2016–2018,” under review. This research is based on analysis of the National Center for Injury Prevention and Control, State Unintentional Drug Overdose Reporting Surveillance (SUDORS) dataset for Ohio, 2016–2018, retrieved July 20, 2019, Ohio Department of Health. Work on this dataset can be found here: personal.denison.edu/~whiteda/research.html.