The Opioid Issue: Part 6

Part 6: Hope, Not Handcuffs

Handcuffs

In a growing number of towns, police aren’t arresting people facing addiction. Instead, they’re providing a doorway to treatment.

Judge Linda Davis hasn’t only seen the toll opioids take from the bench. She’s also seen it at home—with one of her daughters. “I thought our family would be the last family on earth this would happen to,” she says. “I was a judge and a former prosecutor who’d run the drug unit. We talked about these issues constantly.”

Then one of her daughters—a fine student and athlete—got hurt at age 17 and needed knee surgery. Pills were prescribed. That led to heroin. And later, a four a.m. confession: “Mom, I’m a heroin addict. I need help.”

That was 12 years ago: Davis’ daughter has been clean since then. “I’m just one of many parents with a story like that,” Davis says. “It amazes me that every time I share it, someone says, ‘I have a son or daughter or grandson or nephew or mother or grandmother with a problem like that.’ It’s that widespread.” Davis hasn’t stopped at telling her story. She volunteers her lunch hours to serve on drug court on top of her normal docket as a judge in Clinton Township, Mich. She co-founded a group, Families Against Narcotics (FAN), which has spread across the state. And that group is taking a leading role in promoting a new approach to fighting opioid addiction.

Angels Among Us

In May 2015, Gloucester, Mass. Police Chief Leonard Campanello posted a Facebook announcement: Anyone could come to the police department, report an opioid addiction, and police would get them into treatment. No arrests, no punishment. Just help. In the first year, 376 people showed up. Almost 95 percent got direct referrals for treatment. Today, that’s grown into a national program: the Police-Assisted Addiction and Recovery Initiative (PAARI), with nearly 400 participating police departments in approximately 30 states. Some 12,000 people have been ushered into treatment so far.

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The largest of those partners is Macomb County, Mich., comprised mostly of 860,000 Detroit suburbanites—FAN’s home base—where an important new element was added. FAN’s idea, successfully pitched to police and community leaders: Rather than burden police in such a populous area with getting people into treatment, specially-trained community volunteers—known as “angles”—would help with the load.

Under the Macomb County program—called “Hope, Not Handcuffs,” an angel is called to the police station to give one-on-one attention to the person reporting an addiction. The volunteer sits with him or her, helps fill out forms and makes the calls to get into a treatment center right away. The angel is there after treatment too—helping, if needed, to find housing or support services, among other things.

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It’s an approach which has captured a lot of hearts and minds. Some 250 people have stepped up to the angel role. Three emergency-service ambulance companies agreed to provide free transportation to treatment centers. Hope Not Handcuffs already is operating in eight Michigan counties, and spreading. “The program started a little over a year ago, and already we’ve placed almost 1,300 people in treatment,” Davis says. “We’re working with up to 90 police departments on implementing this in the state of Michigan. “We get calls from all over the U.S. wanting to initiate the program. But as an all-volunteer group, we don’t have the resources to coordinate with them. We can’t grow that fast.”

After decades as a judge and prosecutor, Davis is struck by the change in law enforcement’s approach. “Police officers are leading the charge for reforms,” she says. “We’ve had a big shift from the ‘lock ’em up’ mentality they were taught in the academies. “Now you’ll hear officers say it all the time: ‘We can’t arrest our way out of this. This is a disease, and locking up people with a disease won’t work.’ For them to say that is really changing the stigma of addiction and opening up new possibilities.”

Living Testimonies

Signs of that changing mentality in law enforcement are popping up all over. There are more than 3,100 drug courts in the country, the U.S. Department of Justice reports—specialized docket programs focusing mostly on treatment and rehabilitation. Roughly half of them deal with juveniles; the other half, with adults.

In Macomb County, a lot of people are grateful. And some are giving back. Micki Dodson’s mom was an addict. Micki, now 30, eventually followed in her footsteps, spending the better part of a decade on pills, heroin, and crack cocaine. Only after her mother died of an overdose last year did she turn the corner. Dodson has been clean since May 2017, and she’s scheduled to graduate from the drug court program in October. “I’m a huge fan of Hope Not Handcuffs,” she says. “Drug court has been my saving grace. I can’t thank them enough: They worked wonders for me. I couldn’t stay clean on my own.”

Now Dodson plans to undergo angel training, so she can do for others what someone did for her. “I have to give back,” she says. “It helps me. I want to let them know there’s hope. If I help one person today, I’ve done my job for that day.”

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Anthony Mattarella is giving back too. Much like Davis’s daughter, he was injured in his youth and went from prescription opioids to heroin and other drugs. That lasted eight years, with numerous fruitless stints in jail or rehab. Three years ago, when his case was bounded over to Davis’ drug court, things changed. “Before I got into the program, I wanted to die,” Mattarella says. “When I got in, I was willing to do anything they asked of me. I knew I was either going to kill myself or I was going to get sober.”

Now he’s a peer-recovery coach for 41B Drug Court in Clinton Township, Mich.—the same court where Davis serves. He’s helping lost people find their way, using his experience to connect with them and guide them. “It’s so rewarding,” he says. “I see them go through the [recovery] process; I see the smiles on their faces when they start to understand.”

Looking back, Mattarella marvels at the change in his life.

“It’s absolutely unbelievable to me,” he says. “I never thought I’d be here. I never thought I’d be someone who helps people.”

FOR MORE INFORMATION: To learn more about Hope, Not Handcuffs, go to familiesagainstnarcotics.org/hopenothandcuffs. For more information on the Police-Assisted Addiction and Recovery Initiative, visit paariusa.org.

The Encounter in the Desert

He stood, sweating, gazing over the vastness
of what looked like nothingness; hot, glaring,
monochromatic landscape, broken only by an
occasional dune. His eyes batted against the
stinging bits of sand encircling his head as He
tried to catch His breath. He was, after all, Jesus
in a mortal body.

He was hungry. He had not eaten for the past
forty days. He caught sight of an approaching
figure surrounded by piercing light. The desert
floor began to vibrate. The figure was enormous
in size, and seemed to exude tremendous power.

As if reading His mind, the figure said, “Tell
these stones to become bread.” In response,
Jesus took a confident breath and said, “It is written:
‘Man shall not live on bread alone, but on every
word that comes from the mouth of God.'”
Although Jesus stood his ground, the figure reached
toward Him and whisked Him away.

Now, Jesus and the figure were at the Holy City,
standing on a steeple. The figure said, “If you
are the Son of God, throw yourself down, for it is
written, ‘He will command his angels concerning
you, and they will lift you up in their hands, so that
you will not strike your foot against a stone.'”

Jesus answered, “It is also written: ‘Do not put
the Lord your God to the test.'” The figure was
persistent in his provocation, reaching toward Jesus
again, spiriting Him away to a very high mountain,
where he showed Him all the kingdoms of the world
in all their splendor and beauty and majesty.

“All this I will give you,” said the figure,
“If you will bow down and worship me.”
“Away from me,” Jesus said, “For it is written:
‘Worship the Lord your God, and serve Him only.'”
Jesus could not be tempted or drawn away,
nor did He lose His faith in God, as a result
of his encounter with the devil in the desert.

©2016 Steven Barto

Equipping the Next Generation

The Holy Bible

We are in danger of not passing on biblical principles. What might this mean for the future of the Christian church? Current research indicates we are realistically in danger of not passing the Christian doctrine to the next generation. Both an overexposure to worldly philosophy and an over-dependence on church programs has caused us to fail in our task to hand off a vibrant, kingdom-focused faith.

What Do We Want From and For Our Children?

First, we need a clear definition of what we’re looking for in our children. Do we want nice kids who don’t get in trouble, or passionate followers of Christ? Second, we must adopt a multi-generational perspective, providing opportunities for those older and more mature in the faith to impart a spiritual legacy to the next generation—essentially to be mentors. Third, following the example in Deuteronomy 6, parents must fully grasp and live their faith in order to possess and pass it on to their children. This includes making the most of teachable moments in everyday life. Fourth, fathers must take the lead, recognizing that they are the spiritual thermostat of the home—the head of the household, even as Christ is the head of the church—and are obligated to raise their children in the training and instruction of the Lord.

It’s All in How We Raise Them

Proverbs 22:6 says, “Start children off on the way they should go, and even when they are old they will not turn from it” (NIV). Both the home and the church must educate in sound doctrine, equip in apologetics, and explain moral principles. Raising confident teens with a desire to serve God does not happen by accident. Nor can our children learn it by osmosis! Instead, it requires parents to recognize teachable moments, and to use those moments to pass on their faith. This is truly a matter of apologetics.

Train Up a Child

As parents, we want our children to grow up in a world where belief in God is said to be reasonable and desirable. Unfortunately, there are many who shout loudly from the rooftops—especially militant atheists like Richard Dawkins, Christopher Hitchens, and Sam Harris—who think belief in God is on the same level as belief in Santa Claus, fairies, leprechauns, and the like. Faith in God, however, is a reasonable faith. Hebrews 11:1 says, “Now faith is the substance of things hoped for, the evidence of things not seen” (NKJV). We want our kids to see that Christianity is true to the way things are—that it corresponds to reality. We also want them to see Jesus as the Christ, the Messiah, Who can satisfy all their needs in a way that nothing else can.

Tough But Important Questions

As our children grow older, the dialog about God becomes more complex. Suddenly, they’re coming home from science class asking how Darwinian survival of the fittest fits into the story of creation. Their teacher told them nature, not God, painted the stripes on a zebra. We ask them to consider that although evolution might account for the zebra’s stripes (and the variety of stripes among zebras), it can’t account for the evolution of one species into another, or the origin and existence of zebras, or other living organisms. In other words, where did life come from? Darwin did not postulate a theory as to the origin of life or the universe. Of course, the title of his seminal work is about the origin of species, not life. Are we being hoodwinked into believing Darwin meant to explain how the whole of existence came into being?

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When Darwinism is paired with materialism, as it often is, a more complicated picture emerges concerning the intelligibility of what J.P. Moreland calls “the Grand Story” of materialistic evolution. This issue was astutely explained by C.S. Lewis in Miracles. Lewis wrote, “Thus, a strict materialism refutes itself for the reason given long ago by Professor Haldane: ‘If my mental processes are determined wholly by the motion of atoms in my brain, I have no reason to suppose that my beliefs are true… and hence I have no reason for supposing my brain to be composed of atoms.'” Lewis notes a deep conflict between the Grand Story of materialism and the reliability of our cognitive faculties.

The Point

We must begin where our children are and nudge them toward a deeper understanding as they learn about God, themselves, and the world in which they live. It is important to poke and prod our kids to see the world in its proper light: Everything is sacred. It’s all from God, for God. A great tactic for engaging children on questions about God is to point out the transcendence of things like the scent of vanilla reminding us of home, or tasting boardwalk fries at the county fair and being transported to the beach. Remarkably, such ruminations can lead to contemplating the first cause of the universe (the cosmological argument). Further to this, we can open a discussion with our children about how the beneficial order in the world points to a Designer (the teleological argument). And how does the reality of moral obligations and values point to a moral Lawgiver (the moral argument).

Answering Their Questions

When my son Christopher was in 4th grade, he lost one of his classmates to a tragic and freakish accident. Several of them were playing flashlight tag in the dark. Christopher’s friend was running away, looking for a place to hide, when he crashed through a huge piece of plate glass. Sadly, the friend bled out as a result of his injuries and did not survive. As parents, my wife and I were faced with explaining why bad things happen, especially to children. Why would God kill a young boy? As my son grappled with the evil that befell that young lad, I was struck by the realization that my response to his struggle would lay the foundation for how he would process the concept of suffering.

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Peter Kreeft argues in his book Making Sense of Suffering, God’s answer to the problem of evil is Christ on the cross. When our kids experience times of pain and suffering, we want to recognize these moments as opportunities. They allow us to explore God’s loving care and help us to learn to trust his goodness. We first need to listen to our children’s pain and allow them to express any feelings of disappointment before we try to correct their ideas about God. After our kids feel heard and their emotions and doubts validated, we can remind them—and ourselves—that God alone offers hope.

As Frederick Buechner explains, “It is a world where the battle goes ultimately to the good, who live happily ever after, and where in the long run everybody, good and evil alike, becomes known by his true name.” Perseverance is a little easier when we’re reminded of the ending. That’s the promise of the cross—one day all tears will be wiped away by our Savior. The experience of angst is a classroom to teach kids how to turn to Christ and point others to Him as the only hope in the face of evil.

Cultivate the Imagination of Our Children

We must encourage our children to love stories. This can be accomplished by reading to them from an early age. Tim Keller, in his book King’s Cross, quotes theologian Robert W. Jensen, who argued that our culture is in crisis because the modern world has lost its story. How often do you hear about families camping together, sharing stories around the fire, or recounting family history? How many children do you know that choose to read instead of play endless hours of video games or watch TV shows and movies? Of course, the Gospel is the ultimate story that shows victory coming out of defeat, strength coming out of weakness, life coming out of death, rescue from abandonment. And because it’s a true story—take that Sam Harris—it gives us hope. When our children fall in love with story, their hearts are prepared to recognize the best and truest story of all, which is the Gospel.

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C.S. Lewis said this: “In reading great literature I become a thousand men and yet remain myself. Like the night sky in the Greek poem, I see with myriad eyes, but it is still I who see.” Through stories, our kids expand their horizons, imagining what it’s like to walk on the moon, or visit a Mayan ruin, or climb Mt. Everest. The same is true about the many stories of faith and triumph, failure and regret, obedience and rebellion told in Scripture.

We are called upon to give personal testimony to the difference God has made in our lives. This includes telling our children. Typically, parents tend to keep their struggles a secret from their kids. Certainly, a great deal of what parents deal with on a daily basis is not necessarily suited for sharing with their kids. However, it is important that we look for teaching moments we can share with our children—situations where God brought us out of bondage and into freedom. We wrongly assume that if we simply instruct our children in Christian doctrine, shelter them from immoral behavior, and involve them in church and religious organizations then we’ve done all we can.

We must be consistent in our behavior, wise about reality, and genuinely personal about our faith. Today, most Christians rely on institutions and formal instruction to pass on the faith. It is painfully obvious that the influence of parents in teaching the faith is waning. Cultural forces—especially relativism and pluralism—are overwhelming the good intentions of mothers and fathers and challenging the efforts of our church leaders to build faith among believers. Sadly, we’re loosing ground. It is critical that we don’t panic or become disillusioned. Rather, we need to take a long-range view. We need to live our lives sharing God with our children and others.

Concluding Remarks

Taking an active role in sharing and passing on our faith is about a lot more than just “doing church” together as a family. While it is clearly important to do that—worship, pray, serve, learn, and fellowship together—what we do outside of formal worship services and Sunday school class time is where the real opportunities happen. I squandered the chance to lead by example. Embroiled in active addiction for nearly forty years, I pulled every scam, told every lie, forgot every birthday, missed important events, lost jobs, failed at budgeting, broke hearts, disappointed friends and family, and lived a truly hypocritical life. This is clearly not an appropriate legacy for a father to leave behind.

Passing on our faith to the next generation isn’t just about making sure our children can name all the books in the Bible. Instead, it involves living a life that exudes the love and character of Jesus in such a way that those watching will imitate us. Every Christian has a baton, a spiritual inheritance in Christ, which is worth passing on. Our baton is the sum of all the lessons, insights, wisdom, counsel, character, and spiritual anointing we have gained. Our baton is the spiritual legacy God wants us to impart to others. Indeed, to the next generation.

Our children are watching.

 

The Opioid Issue: Part 5

Part Five: Troubling Vital Signs

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The opioid epidemic is straining America’s health care and treatment resources, while opening the door for unscrupulous fraudsters to make money off those struggling to overcome addiction. How much more can emergency rooms handle? The most recent numbers from the U.S. Centers for Disease Control and Prevention (CDC), spanning 45 states, show nearly 143,000 ER visits for opioid overdoses over a 15-month period. That period ended in the third quarter of 2017 and represented a 30-percent jump from the same time span a year earlier.

“The staff isn’t sure what to do with [opioid overdose patients],” says Karl Benzio, M.D., a Christian psychiatrist and member of Focus on the Family’s Physicians Resource Council (PRC). “You don’t feel comfortable just discharging the person. The staff doesn’t know how dangerous the person is when they leave the doors, whether they will overdose—or worse—when they leave, how to find a responsible party to transfer the care and responsibility to.” Fellow PRC member W. David, Hager, M.D., agrees. “We’re seeing a lot of frustration among our providers with ‘frequent fliers,” says Hager, a practicing physician with Baptist Health Medical Group in Lexington, Kentucky. Both physicians point to different problems connected to the opioid crisis.

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Benzio notes that many overdose cases are complicated because ER staffs aren’t generally equipped to deal with mental or behavioral health. Many of those patients  should ideally be in a residential rehabilitation program, but are unable to secure health care insurance coverage. This leaves the medical personnel on the front lines of care facing a dilemma for which there are no simple answers. Between the rapid rise in overdose cases and the moral gray area of providing narcotics to so-called “frequent fliers,” America’s emergency rooms are in a precarious position when it comes to the opioid issue. The crisis threatens to break the backs of overworked ER staffs, whose efforts to help those in pain with long-term prescriptions may only be fueling the crisis.

FAKE TREATMENT CENTERS

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The overwhelming strain the opioid epidemic has placed on legitimate health care providers has also opened the doors for unscrupulous con artists looking for easy money. These fraudsters—and it’s not clear just how many there are across the country—run fake treatment centers preying on those seeking a way out of their opioid struggles.

“Several factors came together—so many people in need of addiction treatment and managed care to reduce their length of stay in the hospital—that there became a huge need for more addiction rehabs,” Benzio explains. “Certain states that had a high level of drug use made it very easy to open a rehab; not many restrictions, licensing issues or hoops to go through. Also, insurance plans needed a place to put someone who was in danger of overdosing but needed one-on-one monitoring, so entities put together minimally-trained people with a schedule and sold it to the insurance as a rehab.” With the potential to make big money and only vague criteria for what a “quality” treatment facility includes, many unqualified providers jumped into the rehab industry.

Cash from Treatment Centers

“A lot of people going through addiction thought, ‘Wow, I could put together a better program than that,’ so they developed their own after getting clean for 20 minutes,” says Benzio. Though he believes some who entered the rehab industry in this way truly wanted to help, others are outright shams and just billing insurance large sums. Some bill for services they don’t even provide. Some will encourage their patients to use drugs or supply them so they can continue to bill insurance. Many cannot get doctors or licensed therapists [on staff], which would make them accountable to higher state and national licensing standards.

UNSCRUPULOUS REHAB CENTER OPERATORS

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Somehow, even with all our laws pertaining to drug possession and use, we still find ourselves in a largely unregulated addiction treatment field. And even worse, the biggest driving force seems to be well-meaning legislation—like the Affordable Care and Parity Acts—which made treatment more accessible for more people, but unfortunately also opened the door for predators and frauds to get in on the action. They are unconscionably attempting to make a profit off our nation’s current drug epidemic with unethical and shocking practices like patient brokering, identity theft, kickbacks, and insurance fraud.

A behavioral healthcare survey on ethical concerns in the drug rehab industry identified patient brokering tactics in the form of money and gifts that some treatment centers are using to entice patients. Need sober living but can’t afford it? Some programs address this by offering free room and board and other amenities, then bill insurance excessively for unnecessary drug testing and other services to make up the cost. Sadly, many unregulated sober living homes have become unsafe and overcrowded “flophouses” where crimes like theft, human trafficking, prostitution, and illegal drug use are commonplace.

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We’re also seeing patients-turned-recruiters, people just out of treatment with very little time in recovery who can suddenly start making big money selling people they know to rehab centers, checking themselves into competitor programs to lure clients away, and collecting “finder’s fees” of $500 to $1,000 per patient or more. And if that doesn’t work, people are getting paid to relapse so that treatment centers can collect more insurance money. Shockingly, some of these practices are not per se illegal. And in situations where they are, states do not have the resources to regulate.

A Palm Beach Post investigation of the county’s $1 billion drug treatment industry found that testing the urine of recovering addicts is so lucrative that treatment centers are paying sober living homes for patients. Urine drug screen costs may be $6 once a week, but centers test every 48 hours and bill insurance companies $1,200 each time. You may have heard about treatment center owner Kenneth Chatman. A federal investigation targeted sober living homes and rehab centers founded by Chatman and others. Chatman appeared before a U.S. magistrate in West Palm Beach, Florida. The recovery businesses founded by Chatman provided illegal kickbacks, coerced residents into prostitution, threatened violence against patients, and submitted urine and saliva for screening even when no medical need existed.

It’s an exploitation of some of our nation’s most vulnerable individuals and it needs to stop!

FINDING REAL HELP

Amid a sea of get-rich-quick frauds, how can those struggling to overcome opioid addiction find genuine help? How can they—and their families—be sure they’re not scammed by fraudsters? Benzio says quality facilities have several standout features. He advises looking for those that are Christian-owned, apply the Bible to daily living, and emphasize the importance of growing in a relationship with God. Some of the other key elements include:

  • One of the owners is an accomplished clinician, such as a psychiatrist, counselor, or therapist. Clinicians with ownership stakes usually have professional reputations to maintain, an understanding of what great care looks like, and a desire to make clinical excellence a primary focus.
  • A psychiatrist sees the patient early in the admission process for detox purposes and to help diagnose underlying issues that contribute to the patient’s opioid use.
  • The treatment and residential facilities are located on the same campus, allowing for a higher level of accreditation and insurance approval.
  • Individual therapy is provided by masters-level and/or licensed therapists. Each patient receives several individual sessions per week.

A FAMILY AFFAIR

Between the overloaded hospitals, risky prescribing practices and minefield of rehab programs, the opioid epidemic is stretching and straining America’s health care resources like nothing we’ve ever seen. Tackling those (and many other) massive opioid-related issues will require innovative solutions.

Cece and Bobby Brown of Charleston, WV had a son who died four years ago at age 27. His parents describe him as being “just like the kid next door,” stating he was a trouble-free child who loved sports, music, skateboarding, and God. His mother said, “I sent him to college to get a degree, and he came home with an addiction.” Ryan struggled with opioids for seven years, surviving three overdoses along the way. But in April 2014, he had another—at the local mall. The Browns believe their son ran into an acquaintance there who gave him the heroin that snuffed out his life.

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The couple spent thousands on detox and rehabilitation programs for Ryan. What he really needed, they say, was a long-term facility where he could get clean for good. Instead, a typical cycle for Ryan would consist of seven days of detox and regular participation in outpatient programs, therapy groups and Narcotics Anonymous. That combination would keep him clean for about six weeks.

But he needed more.

Ryan was on waiting lists for two long-term treatment centers when he died. Having aged out of his parents’ insurance plan at 26, he had just received Medicaid benefits three days before his death. Most heartbreaking, his parents learned after his passing that a treatment facility that could have accepted Ryan was only three miles away. Now his parents can’t help but wonder, What if the wait times had been shorter, the coverage had come a bit earlier, and we had known about the facility nearby?

“That would’ve given opportunity. I can’t say that would have changed things, but opportunity is everything,” Cece says. Over the last four years, the Browns have made it their mission to make sure others with similar struggles in West Virginia have the opportunities Ryan didn’t.

INNOVATE FOR THE STATE

After a two-year effort led by Bobby and Cece, last year West Virginia lawmakers passed legislation creating the Ryan Brown Addiction Prevention and Recovery Fund. The Fund aims to expand the state’s capacity to help those struggling with opioids but lacking private insurance, Medicaid or Medicare coverage by blending public grants and private dollars. People can contribute charitable gifts.

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So far, the model has yielded promising results: The West Virginia Department of Health and Human Services has awarded $20.8 million through the Fund to nine long-term treatment facilities statewide. That’s already translated to 300 more West Virginians getting treatment than would’ve been the case otherwise. The Browns explain it’s just reality that many struggling with opioids have low-wage jobs that don’t offer insurance. Some, they say, have felonies that prevent them from securing jobs with better wages and benefits. But that doesn’t mean they should be left behind. Bobby said, “If they don’t want help, there’s nothing we can do. But if they do want help, we need to get them help.”

The Browns are also grateful West Virginia has addressed another problem: In September 2015, the state launched a resource hotline to help those combating opioid addiction.  “We didn’t have a number to call to talk to anyone; didn’t know where to get help,” Bobby recalls. “Now that number has come out.” Those needing help can simply call 1-800-HELP-4WV—and thousands have.

Bobby and Cece say they feel honored to play a role in easing the burden the opioid epidemic has placed on the health care system, and to help families struggling with the weight of it all find solid answers. They’ve been part of several White House events aimed at finding solutions, and say they’ll continue to engage the Trump administration in the hopes of keeping the heat on. As a reminder of the epidemic’s devastating toll, Cece displayed a picture of Ryan at a round table discussion with First Lady Melania Trump earlier this year.

This needs to be about people, not politics.

The Opioid Issue: Part 4

Part Four: Taking It to the Streets

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The opioid epidemic doesn’t stay behind closed doors. It’s spilling into public life, spurring crime and homelessness.

The opioid crisis has hit hard in Macomb County, Michigan. Composed of 27 Detroit suburbs, the county has the state’s second-highest opioid-related overdose death rate, more than double the national average. District Court Judge Linda Davis has been on the bench 17 years. She sees the consequences pretty much every day. “When I look at the docket I handle, I’d say 70 percent is addiction-related,” she says, not counting low-level traffic offenses like driving on a suspended license. “We’ve definitely seen a rise in thefts with this opioid surge.”

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Although opioid addiction often starts out legally, recent years have seen a shift toward illegal opioids. It’s an all-to-familiar story: People get hooked on prescription painkillers, often moving on to heroin, which can be cheaper on the street. Since 2011, as prescription opioid overdose deaths leveled off, heroin overdoses started rising. Starting in 2014, illicit fentanyl deaths began spiking upward. Whatever the substance, the cost mounts up fast. So many users resort to theft. They’ll steal from family, friends, acquaintances or strangers. They’ll shoplift, commit fraud, rob pharmacies, break into homes or cars. Even commit armed robbery. And whether or not they’re committing those crimes themselves, their desperate dependency can feed some even worse ones.

Lethal Combination

In 2015, the nation’s homicide rate rose sharply (11 percent) after decades of decline. The uptrend continued in 2016, climbing another 8 percent. Some observers looked for racial reasons for it. There could be one, says Richard Rosenfeld, an emeritus professor of criminology and criminal justice at the University of Missouri-St. Louis. But he thinks there’s more to the story. When Rosenfeld looked into the data, he quickly saw homicides had jumped among several ethnicities—and it was very pronounced among whites.

“The increase is quite abrupt, quite recent and quite large, at levels we hadn’t seen since the early 1990s outside of 9/11,” Rosenfeld says. “The ‘Ferguson Effect’ doesn’t explain that. So what might explain it? The opioid epidemic, for one thing—which crosses racial lines, but is most concentrated among whites. Drug-related homicides rose more than 21 percent in 2015, a rate far higher than other common categories of homicide, which rose between 3 and 5 percent. Rosenfeld said it stands to reason that there’d be a connection between the spikes in opioid use and lethal violence.

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“It’s not opioid use per se that sparks violence, but the markets,” Rosenfeld says. “When disputes arise between sellers or buyers, they can’t be settled by police or courts or the Better Business Bureau. As the number of buyers expands, so does the number of disputes that turn deadly will also go up.”

Just how big a role do opioids play in driving the rise in homicides? That calls for more research, Rosenfeld says. But he sees ample evidence to sound the warning and to call for addressing the root causes. “Policymakers and law enforcement are framing this as a public-health crisis more than as a criminal-justice crisis, and I’m very much in favor of that,” he says. “The bottom line is: If we reduce demand, we reduce crime.”

“We Don’t Want Those People Here!”

Reducing demand for opioids would likely reduce other social pathologies too. Like homelessness. “For those of us who’ve been providing health care to people who are homeless, this is not a new problem,” says Barbara DiPietro, senior policy director for the National Health Care for the Homeless Council. “We’ve been seeing opioid addiction and overdoses for decades.

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“When people are in a spiral and aren’t getting the help they need, oftentimes they lose their jobs and their ability to pay rent. Before you know it, you cycle through family and friends, and you’re in a shelter or on the street.” Of course, not all people who are homeless have addiction issues, but those that do have a harder time getting into treatment once the stability of housing is gone. Living on the street could easily drive anyone to substance abuse. Maybe you started with alcohol, but once you were on the street, you found other things. It’s very hard to get well when you’re homeless.

Federally-qualified health centers provide care to 1.2 million people a year, and the Council provides technical assistance to help improve quality and access. DiPietro says homeless service providers often see clients who never expected to be in this situation. “We see a lot of clients who come from construction work or other hard-physical-labor jobs, who got hurt and got prescriptions for legitimate reasons,” she says. “We see a lot of people who’ve experienced trauma in their lives—child abuse, domestic violence, sexual assault. So they self-medicate to deal with the pain.” And on the street, their problems are much more visible than those of people who engage in their addictive behavior behind closed doors.

“They’re living their private lives in a public space,” DiPietro says. “They’re subject to public scrutiny, arrest and incarceration at a much higher rate. And once you have an incarceration history, it’s hard to get housing assistance or a job again.”

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While more medical facilities and first responders are being equipped with opioid-overdose medications like naloxone (Narcan), that’s just an emergency measure, not a solution. DiPietro says what people struggling with addiction and homelessness need most is stable housing where they can get effective treatment. Health care providers the Council works with can help, but not enough to meet the scale of the problem.

Right now, communities don’t have the capacity desperately needed to get people into treatment. Another big obstacle is the attitude known as NIMBY—Not in My Back Yard. “Everyone believes treatment is important, but no one wants the services near them,” DiPietro says. “When that’s proposed, they rise up in community meetings and say, “We don’t want those people here.”

We’ve simply got to get beyond that attitude.

A Parting Thought

I spent forty years in active addiction. It started simple enough: A case of beer and an ounce of Colombian Gold. Eighteen months later I was serving 3 to 10 in state prison. Drug and alcohol abuse continued throughout parole and into my thirties, forties and early fifties. My drug use ran the gamut, from weed to cocaine to crack to opiates. When I couldn’t get enough oxycodone through doctors, I began stealing it from friends and family. My addiction cost me plenty, yes, but it also cost my children, my two ex wives, my brothers, my sister, and my parents. I lost jobs, cars, apartments, friends and family. I blew every penny I made, bounced checks, embezzeled, fenced stolen goods. I was enslaved to addiction. Not only did my family disown me for nearly two years, my youngest son didn’t talk to me for five years.

It’s not only the family of addicts that can become fed up and turn their backs on their loved ones struggling with addiction; society has become rather fed up and impatient. One of our local television stations airs a nightly feature called “Talkback 16,” where viewers call to voice their grievances, pet peeves, and, yes, an occasional compliment. Several days after a news story aired about plans to build a drug and alcohol treatment center in the Pocono Mountains (Pennsylvania), a viewer called to complain about the plan, adding, “Not in my neighborhood. [Addicts and alcoholics] can’t be trusted. Besides, they did it to themselves.”

Truly, this attitude must change.

 

The Opioid Issue: Part 3

Part Three: A System on the Brink

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Already under tremendous strain from a lack of qualified homes and social support, the American foster care system is staring down its toughest opponent yet: the opioid epidemic. Typically, when a mother or father in active addiction has young dependent children, agencies such as Children and Youth or Child and Family Services will remove the children from their parents. Of course, family court judges nearly always focus on possibly reuniting the children and their parents after they become clean and sober.

Consider the mother of a child who was born addicted to opiates. The court removed the infant from the mother’s care and placed him in foster care. After the mother was able to stay clean for one year and put her life back together, the child was returned to her. Sadly, the mother ultimately relapsed, and the child’s health and welfare were put in jeopardy. He would need to reenter the foster care system, this time with the goal of being adopted permanently. Foster Care CollageAccording to the U.S. Department of Health and Human Services (HHS), nearly half a million children nationwide were living in foster care arrangements in 2016—and that number has been rising for the last four years. One could say the very heart of the nation’s foster system is aching for any sort of relief.

A Century-Old Practice

Since creating a Children’s Bureau in 1912, the U.S. government has played a critical role when parents can no longer care for their minor children due to illness, death, criminal activity and/or substance abuse. That care—provided mainly by individual foster families or relatives, but also through group homes and institutions—has at times extended to other nations, such as the more than 8,000 European refugee children who were fostered in American homes during World War II.

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Though it has successfully kept millions of children fed, clothed, educated, sheltered and safe over the last 106 years, the American foster system hasn’t been foolproof. In 1972, when President Richard Nixon declared a “National Action for Foster Children Week” to recruit more foster families, the system has been highlighted mostly for its deficits: Too few willing foster parents, too many kids, too little funding and support, too hard on the heart for everyone involved.

Margie Nielsen deals with those shortcomings daily. As the director of Foster Care & Adoption Ministries at Louisiana Baptist Children’s Home (LBCH)—a nonprofit ministry founded in 1899, more than a decade before official government foster care was created—Nielsen’s organization is an official partner of the Louisiana Department of Children & Family Services. Certified foster parents run residential “cottages” that each accommodate up to six children between the ages of 5 and 17. LBCH exists to educate, inform, encourage, support, and strengthen current and prospective foster parents.

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While there are many families who clearly are not called to foster, everyone can and should be involved in supporting the families who are. In James 1:27, God’s Word teaches, “Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world” (NIV). It is our duty as the Body of Christ to help foster families to understand the call God has placed on their lives and to help equip them to answer that call. A joy, yes—but the last few years have greatly expanded the need for people to answer that call.

With opioid addiction soaring to crisis level, it certainly calls for more information to be disseminated. And while drug addiction of any kind affects everyone, the nation’s opioid crisis has upped the ante. The necessity of developing preventive strategies is felt more than before.

Little Victims

While the connection between drug abuse and children needing foster care is nothing new—think heroin in the 1970s, cocaine in the 1980s, and meth in the 1990s—what has changed the game for today’s foster care system has been the sheer percentage of Americans struggling with opioid addiction across all demographics. The cold hard truth: That number staggers at more than two million, according to the American Society of Addiction Medicine, a 60-year-old professional society for treatment providers based in Maryland.

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According to the National Institute of Health, 21 to 29 percent of patients suffering from chronic pain misuse their prescription opioids, and that often puts them on the path to harder drugs; about 80 percent of people who use heroin first abused prescription opioids, Tragically, around 116 people in the United States die from an opioid overdose every day—that’s one death every seven minutestranslating into tens of thousands of dead Americans annually. In fact, the U.S. Centers for Disease Control and Prevention reports more than 200,000 people died from prescription opioid overdoses between 1999 and 2016.

It stands to reason that a significant portion of those people who died, as well as the millions living with addiction, were or are parents of minor children. Indeed, HHS reports 30,000 more children were living in foster homes nationwide in 2015 than in 2012, and substance abuse (including, but not limited to, opioids) was cited as a reason in about one-third of those placements. Drug addiction does not discriminate; sadly, it can hit any family at any time. And often, when it does, children of those struggling with addiction enter the already-pressed foster system.

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Simply put, there are not enough foster homes in the United States to accommodate the burgeoning number of kids needing short- and long-term care. In California, for example, the Los Angeles Times reports the number of available beds in qualified foster homes fell from 22,000 in 2000 to just 9,000 in 2016. Massachusetts had more than 6,100 foster children in 2016, but less than 4,800 foster homes, according to The Boston Globe. Such shortages have led to reports of foster children sleeping in government offices and even hotels around the nation while their social workers scramble to find willing families.

But it’s not just the dearth of available foster parents that concerns child welfare advocates. Though government reports show about one-quarter of all formal foster care placements are with relatives (sometimes called kinship care), the vast majority of foster families are strangers to foster children. According to the National Center for Missing & Exploited Children, 88 percent of the 25,000 children who reported ran away from home in 2017 were in foster care at the time. Many of those runaways become the victims of sex traffickers.

We need to pray that as each day passes these foster children (who have had their tiny world shattered by drug abuse) survive—indeed, thrive—and that they live with hearts full of love and hope. Sadly, the future is yet unclear regarding America’s opiate epidemic. Moreover, we don’t know the full scope of opioid crisis’ on the foster system still has yet to be revealed. These little victims never had the choice to be exposed to the drugs. They can’t Just Say No.

Thousands upon thousands of little Americans are waiting to be seen, helped and healed.

The Opioid Issue: Part 2

Part Two: Collateral Damage

As the nation grapples with opioid’s hold over millions, its smallest victims cry out to be heard, held, and healed. No Child Left Behind is a familiar battle cry. But to foster parents helping to care for children of parents addicted to drugs, those words have nothing to do with a political agenda or advertising campaign. One foster mom reported quietly watching another baby detox from opiates, its high-pitched wails unique with the sound of drug-induced anguish, and whispering, “A whole generation is being lost from the opioid epidemic. A whole generation.”

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That generation—with hundreds of thousands of America’s youngest feeling its physical, mental, and emotional impact, sometimes from the moment of conception—is staring down what doctors call Neonatal Abstinence Syndrome (NAS). The condition is not something that can be cured with a pill. There are so many children growing up without their parents that the long-term ramifications are still unforeseen. The United States has certainly faced its share of social and public health problems over the years, but when it comes to the opioid crisis, child advocates around the country warn, it’s a strange and scary new world.

Agony in the Womb

According to a study released by the University of Minnesota this spring, one baby struggling with NAS is born in America every 15 minutes. Furthermore, almost 90 percent of pregnancies among women struggling with opioid addiction are unintentional. When a woman takes opioids while pregnant—even exactly as a doctor might instruct, according to the March of Dimes—she runs the substantial risk of harming her unborn child.

One Baby Every Half Hour

Prescription painkillers like codeine, fentanyl, hydrocodone, morphine, and oxycodone (as well as the street drug heroin) are all classified as opioids and all negatively affect children in the womb. Common risks of opioid use during pregnancy, the March of Dimes says, include miscarriage, preterm labor, premature birth, birth defects, low birth weight (defined as weighing less than five pounds, eight ounces), and NAS. NAS is its own beast. The completely preventable condition can grip babies with tremors, fever, chills, weight loss, seizures, and even death. Dr. W. David Hager, member of Focus on the Family’s Physicians Resource Council (PRC), believes 55-94% of newborns delivered to women who used opioids in pregnancy suffer from NAS.

Clearly, it is nearly impossible for an unborn child to skate past the consequences of his or her mother’s opioid use, no matter how slight. Yet damage isn’t usually intentional. Instead, Hager says, addiction to opioids reaches far beyond the initial physical pleasure to something much deeper.

It All Adds Up

That’s a familiar story for J. Scott Moody and Wendy Warcholik, a married pair of economists. As the directors of Family Prosperity Institute (FPI), a New Hampshire-based think tank focused on measuring the health of the American family, Moody and Warcholik frequently hear about opioid-related crises—and have watched their own loved ones succumb to substance abuse along the way. Warcholik, for example, grew up in a family fragmented by her parents’ collective five divorces. Of all her siblings, she was the only one to have fully escaped the negative consequences. The others have experienced unemployment, substance abuse, government dependency, low educational attainment, unwed childbirth, and divorce.

FPI has created a family prosperity index—a formula-driven rankings list that measures the strength and prosperity of families and the nation by combining the most important economic and social data into a single number and then ranking those states based on which create the best environment for families to thrive. The index fills in the gaps around other measures like the gross domestic product, assembling all the pieces of the prosperity puzzle into a complete picture of the economy. No other measure takes into consideration both the economic and social choices of people in a state to create a holistic measure of human behavior in the States.

The latest FPI index ranked Utah first and New Mexico last. FPI’s formula calculates things like average welfare utilization, children in married households, religious attendance and infant mortality rate. That last category is most disconcerting because as opioid use has risen, so has infant mortality rate. (The U.S. Centers for Disease Control and Prevention defines that as the death of an infant before his or her first birthday), while the infant mortality rate is the number of infant deaths for every 1,000 live births.

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Between 2010 and 2015 twenty-one states saw an increase in their infant mortality rate. So many states, in fact, that while the national average dropped 16 percent between 2000 and 2015, the last five years only saw a decrease of 1.6 percent. Clearly, if trends continue, the country could see an increase in the infant mortality rate in the near future. Keep in mind that a rising infant mortality rate is typically only found in Third World countries. Besides the physical, emotional and mental cost to America’s children, opioid addiction doesn’t come fiscally cheap, either. For example, in 2015 Ohio paid more than $133 million to care for approximately 2,000 NAS babies born that year.

The True Cost

Interestingly, FPI’s research shows that devout beliefs and behaviors (consistent church attendance, daily prayer, Bible reading, etc.) reduce illicit drug use. The converse holds true as well. Moody says, “It is clear that people in despair who don’t turn to God for help will try to numb their pain some other way, whether it be with drugs or sex. Unfortunately, at least for the last decade, we’ve been seeing more and more people turning to drugs and sex than God. We have to reverse this trend.”

Ultimately, America truly has no idea what the long-term consequences of opioid addiction on our most innocent citizens will be. “We read horrifying stories in New England about parents shooting up their own children just to keep them quiet, or left in a freezing car with their parents passed out in the front seat,” Warcholik says. How far are we, as a society, willing to go in elevating adult desires over the health and well being of our children?

That is a question far beyond the scope of any research team—but one the Church must rise up to help answer.