“There is a patient in the Emergency Department/clinic who is seeking pain medication.” I wonder how many times a day that phrase, or something similar, is spoken, just in Kentucky. I would guess that the answer is “thousands” if not “tens of thousands”. Most of us have heard of the opioid crisis. We’ve actually been pretty lucky around here, in that we haven’t really seen the dramatic increase in drug overdoses that has occurred in other parts of the state. Parts of eastern Kentucky and the metropolitan areas around Louisville, Lexington and northern Kentucky near Cincinnati have seen huge increases in drug-related deaths. 1,404 people died from drug overdoses in Kentucky in 2016, which is an increase of about 40% since 2012. The 2017 data just came out, showing a further 11% increase in overdose fatalities. There are counties in eastern Kentucky where the death rate from drug overdoses is 6 times the national average.
There are lots of reasons for the growing crisis around opioids. There are lots of things people are trying to do to address it. That’s not my topic for today. Today, I want to start by looking at just one person. This person has been in and out of jail six times over the past two years on charges of theft and drug possession. This person doesn’t have a job. This person has gone to rehab twice. The first time, they left after three days. The second time, they made it through the program and was using drugs again within a week of getting out. Child services placed their kids in foster care. This person has stolen from family and friends, not to mention strangers.
My question is this: “What do you think about this person?” Many of you probably think (at least to yourself) that this person is a loser. Maybe you think they made their choices and are getting what they deserve., because you reap as you sow. Maybe you think that, if they had been a better person, they wouldn’t have gotten mixed up in that mess. Maybe you think they are weak. Maybe you think they are sick. Truth is, they may be all of those things, or maybe just one.
What if I told you that, three years ago, this person was a school teacher? What if I told you that, three years ago, this person was badly injured when their car was t-boned in an intersection by a drunk driver? What if I told you that this person had to have three surgeries to repair a broken pelvis and three shattered vertebrae? What if I told you that this person didn’t even drink alcohol prior to the accident and the very first narcotic they ever took was prescribed for them by their doctor to help with the severe pain they were in after surgery? What if this person took their prescribed medications for a month and then found they couldn’t stop taking them? What if I told you that this person never took an illegal drug until their prescriptions ran out and they couldn’t get anyone else to refill them, even after trying every physician, urgent care and ED in a hundred-mile radius? What do you think now? What, exactly, did this person do wrong?
My point is this: real causes for things are very often not what they would seem to be. There are a few other points that go along with this, actually. One is about not judging people. One is about how you can’t know someone until you’ve walked a mile in their shoes. How about, “don’t judge a book by its cover.”
I’m a little ashamed to say that I didn’t really come to understand these things until I was middle-aged. I spent most of my life seeing things very black-and-white and that causes for things were generally pretty straightforward and easy to see. Then I learned that things are often not really very simple at all. Life isn’t all about choices. Sometimes life is all about a lack of choices. Sometimes it’s about having to go with the “least bad” choice.
So, why am I telling you all this? Believe it or not, it’s about community health. The key word there is “community”. You are part of a community. The person with the substance abuse disorder is part of a community. The old person who lives on the corner is part of a community. The doctor, the prom queen and the homeless guy who sleeps in the stairwell with his dog are part of a community. Maybe they are all part of the same community. Maybe they are part of yours.
That means that what happens to the addict and the old guy and the homeless guy with his dog should matter to you, just as much as the doctor or the prom queen. Think of it like a street. There are 9 houses on the street and you live in the one in the middle. When all nine houses are inhabited by people who take care of their homes and treat their neighbors with respect, it’s a pretty good situation. What happens if one of the houses becomes abandoned and the weeds grow and the paint peels? It’s not your house. Your house is still comfortable and well-maintained. So are the other seven. Why then, are all those houses in your nice little neighborhood now worth a little less? Nothing has changed with your house. The reason it is worth less is because one of the houses in the neighborhood has been abandoned to decay. There are still eight great houses on the street, but the derelict one is impacting the whole neighborhood.
This happens all the time. We see it and we know it’s true. We also often see people take steps to correct the situation. People mow the grass. Try to get someone to fix it up for sale. Plant a few flowers. People know that the abandoned house isn’t just an abandoned house. It’s something that is affecting everyone else in the neighborhood. Why is it easy to see that, but it’s not so easy to see that the addict, or the old guy who is isolated matter to us all? If my neighbor is sick, it impacts me. It impacts our community. It’s not just the cost of treating the sickness, but also the lost contributions that my neighbor might make. Maybe he can’t do his job anymore. Maybe he can’t sing in his church choir anymore. No man is an island.
We’ve all seen vibrant and prosperous towns, and we’ve all seen depressed and decaying towns. We all know which is better. We all know which we would rather live in. We all know which we would rather raise families in. Our corner of rural Kentucky is a really great place to live, for some of us. For others, maybe it’s not as great. However things are working for each of us, one thing is certain—it can be better. We can make it better. We can make it better by working together to make it so. We can learn a little more about what makes people, families and communities healthier. We can take a step toward living healthier. Then we take another. We can realize that when we decide, as a community, to reach out and do whatever is necessary to lift up those who need our help, we’re not just helping that person or that family—we’re helping ourselves, our kids and generations not yet born.
There are only two factors that ultimately determine if something can be done—resources and the will to do it. We have the resources we need to start building a new, healthier, more prosperous future. What we need now is for you to want to change our future and to understand and believe it can be done. Our community health coalition is ready to help. Other community organizations are ready to help. Are you?