How place-making can help fight opioid addiction

Six people in Council Bluffs were taken, unresponsive, to the hospital this month, apparent victims of painkillers so powerful that first-responders have been warned about touching them, but otherwise legally and easily obtained over the internet.

The culprit is a synthetic opioid called fentanyl, a substance that already has decimated communities throughout the country that are battling opioid addiction. Forensic chemist Christine Gabig with the Douglas County Forensic Services Division told The Nonpareil that many synthetic variants of fentanyl have made their way onto local streets. Because the chemical compounds differ, the substances are not “true” fentanyl, commonly used in surgical procedures, and not illegal. Such synthetic varieties can easily be purchased online without a prescription.

In some instances, these potentially deadly synthetics are mixed with other illicit drugs to produce more intense or prolonged episodes of euphoria. Users purchasing the mix often are unaware.

The first three of Council Bluffs’ recent victims were found in a gas station parking lot, their lives saved by strangers who called police. Another man was found in a nearby home. Two days later, hospital personnel treated and were able to revive two more men.

Council Bluffs Police Sgt. Robert Christiansen said it was a good thing these victims were around other people or they may not have survived.

His words might be even more insightful than he realized.

Michael Zoorob, a graduate student at Harvard recently co-authored a study exploring the effect of connectedness and overdose.

Bowling alone, dying together” is a nod to previous work done by Harvard sociologist Robert Putnam, who coined the phrase “social capital” and authored a book titled “Bowling Alone.”

Social capital is the core of place-making because it involves the extent and depth of social connections and trust. In other words, it represents the strength and resilience of a community.

While several measures exist to determine levels of social capital, no matter the measure used, experts agree that as inequality rises, social capital declines. People begin to view neighbors as less trustworthy, they become less active in the community. The cultural ties that all humans crave decline, and the individual becomes isolated and the entire community suffers.

The Harvard study looked at county-level social capital and overdose data from 1999 to 2014, finding that counties with the least social capital had the highest overdose rates. The findings held true even when other factors such as level of opioid prescribing, income level and education were included.

Pennsylvania sociology study of people seeking addiction treatment found similar results. Addiction and overdoses were linked to culture — lack of employment opportunities, unaffordable housing, overall dissatisfaction with the region, and feelings of being isolated or not surrounded by people who care. Study authors concluded there’s a real need for interventions that address the poverty and social isolation of opiate users.

The good news in Eastern Iowa is that some already are attempting to address this shortfall. A support group, Community Resources United to Stop Heroin in Iowa (CRUSH), provides education and resources to families and those in recovery, sponsors outreach events and works with elected officials on ways to combat the opioid crisis. Fresh Start Ministries, which I’ve highlighted previously, provides outreach and support to those who are jailed and to those returning to the community. At least one area church, Mount Zion, is working to rehab homes for former inmates.

The difficulty is that all these initiatives provide support after the fact — after a person already has become addicted and, most often, after that addiction has negatively affected the person and the community.

According to the Harvard researchers, place-making and social capital can serve as buffers against further spread of addiction and overdose. Jobs and relationships within the community are key. Social support is vital, especially for those spiraling downward.

When people feel a sense of belonging to a community, when they feel connected to who and what is around them, they feel a greater responsibility to care for themselves. It’s the difference between believing that you are simply out in the world on your own and believing that you are a vital part of something larger.

Making sure that hospitals and emergency responders have access to lifesaving Nalaxone or Narcan is one piece of the puzzle that can help save lives. But there’s more our communities can do to stave off addiction and prevent overdoses.

This column by Lynda Waddington originally published in The Gazette on August 27, 2017.