Faith in Recovery Coalition Offers Hope for Opioid Use Disorder in Fayette County, Ohio

by Kathryn Rutz

In 2017, Fayette County, Ohio, made national news: they were ranked the #2 county in the state for opioid overdose and the #7 county in the nation. As a small county of roughly 28,000 people, being featured in such a way was unsettling to its residents. An initiative began by the Community Action Commission of Fayette County, the Faith in Recovery coalition had been meeting since 2014 with the goals of opening detox, inpatient treatment for men, and establishing recovery housing. However, at this point, the community decided to ramp up efforts to find a new, innovative way to help their friends, family, and neighbors struggling with opioid use disorder (OUD).

Christina Blair recalls, "I was talking to people that were trying to be in recovery or in recovery, and really there's a lot of AA groups in our community and two treatment providers, but not a whole lot of anything else." Blair began her work at the Faith in Recovery coalition in 2016, after previously working with the county's homelessness program. After conducting a community needs assessment, Blair identified several barriers to treatment and recovery, including stigma, a lack of knowledge about substance use disorder, and lack of an array of treatment facilities specifically for those struggling with OUD.

In 2018, Faith in Recovery received the first of its Rural Health Opioid Program grants from the Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy, which allowed it to begin expanding its services. First and foremost, Blair and the Faith in Recovery coalition set about finding immediate ways to combat overdose. Initially, they hired peer support specialists — those who have been through substance use disorder and treatment themselves — to reach out to people currently struggling. They created a program called Pathways to Recovery and distributed the number to their "hope line" throughout the community as the place to call if someone was in crisis.

Another initiative that the Pathways to Recovery program pushed was the use of medications for opioid use disorder. Although medication-assisted treatment (MAT) is gaining popularity as a way to treat those struggling with opioid use disorder, many of the organizations partnering with the Faith in Recovery coalition had reservations. However, one of the program's peer support specialists had successfully utilized MAT and was no longer using it, showing coalition and community members there really are multiple pathways to recovery.

"When we started, [they were] hesitant about the idea of MAT. Talking about harm reduction was not very widely accepted…not a ton of buy-in," Blair explained. "I really credit the stigma reduction that's happened in our community to [the peer support specialist's] boots on the ground."

The unavailability of treatment centers, particularly inpatient treatment and detox facilities, was a problem that the coalition knew it needed to tackle.

"When we started this [program]," Blair explained, "there were only two treatment providers, and they had outpatient treatment. There was only one inpatient treatment in Fayette County, which was a women's residential center. And there was no MAT aside from Vivitrol." Faith in Recovery member agency Fayette Recovery has since established recovery housing in the community and developed additional transportation support to access detox and inpatient treatment outside of the county.

The Faith in Recovery coalition also knew that it needed to address the root causes of opioid dependency in the community. It identified the county's large number of opioid prescriptions per capita as a place to start. Peer support specialist Tina Scharenberrg now provides education outreach to hospital staff and other healthcare providers, teaching them how to identify medication-seeking patients and encouraging the use of other pain relief methods over opioids. Meanwhile, peer support specialists meet with patients, particularly those who providers feel are struggling with opioid use or seeking prescriptions. The project also runs a web-based education program for professionals that provides participants with continuing education units (CEUs).

We market our program to be, 'Hey, we're going to talk to you about ways to reduce harm and possibly save your life.'

Blair indicated that phrasing is key. Rather than insisting immediately on detox, treatment, and sobriety, peer support specialists meet the patient where they're at. "We market our program to be, 'Hey, we're going to talk to you about ways to reduce harm and possibly save your life. We're going to train you on how to use Narcan. And by the way, here's Joe [a peer support specialist]. Joe's been through what you've gone through. And he just is here to talk to you and help you out.'"

This approach creates inroads with those struggling with addiction, allowing for conversation and connection. When that patient becomes ready for treatment, they're much more likely to reach out and follow through on suggestions given by Tina Scharenberrg , Joe Cantrell, and other peer support specialists.

The peer support specialists are instrumental to the Faith in Recovery coalition's work, going above and beyond to be accessible to the community. Aside from hospital outreach, they work with the schools, probation offices, and jails and even attend emergency overdose situations at the hospital. Pathways peer support specialists lead the county's overdose response team alongside Brian Carlson (probation and peace officer), Tony Kegg and Hannah Dingman (EMTs), and Mark Allen (LiCDC).

There are a variety of ways in which the Faith in Recovery coalition helps people get back on their feet, as Blair explained: "We'll connect them to things that they need, like housing. If they demonstrate readiness, we'll go ahead and enroll them into the [treatment] program. And then the peer recovery supporter, depending upon the needs or ability, will either find the treatment facility or work with the client to find the appropriate treatment facility."

And we try to keep touch with the person while they're in treatment and we pay attention to those transitions across settings, because that's usually when people relapse…

The peer support specialist makes sure that each client gets help targeted to their own needs. "We do a history and figure out what they've done in the past and why that didn't work necessarily. And try to think about: Is there a different type of program that might be better suited for what you're wanting?" Blair continued, "And we try to keep touch with the person while they're in treatment and we pay attention to those transitions across settings, because that's usually when people relapse…that gap between outpatient treatment starting and inpatient treatment ending or as they leave the jail."

The Faith in Recovery coalition, under the leadership of the Paint Valley Alcohol, Drug Addiction and Mental Health (ADAMH) Board, also added a wellness component to address social determinants of health for outpatients. They offer a variety of activities and programs — including bowling, art, and gym time — to provide social opportunities to those in recovery who are seeking a fun, sober environment.

Personal connection is a crucial step in creating a support network for people recovering from substance dependencies. "The wellness program is also for people that might be a little bit further along in the recovery. They need something outside of treatment to do, to kind of get away from the people, places, and things that could lead them into a relapse," Cantrell explains. "[Through the program] they get to meet more people in recovery that are on the same journey."

However, in 2020, many of the in-person support programs and options abruptly halted with the lockdown due to the COVID-19 pandemic. Suddenly, Faith in Recovery had to figure out how to stay in contact with patients and keep them in recovery. It was a difficult time, as Blair recalls: "[The state was] decreasing the length of time that people can stay in inpatient treatment. It was just very, very difficult to get and keep people in treatment…our peers were working to get waivers to keep people in treatment. Once they're exiting, we were trying to connect them to all of the services and supports when possible — sober housing or their own housing through our homeless programs — and do care coordination."

One example of how the Faith in Recovery coalition kept in touch with its community is the gala they threw on New Year's Eve, a hybrid event broadcast live on social media in addition to a socially distanced in-person component.

A lot of people are maybe scared or just don't know what to do when it comes to asking for help. If we're already there and talking about it, that helps.

"We had the whole recovery community come together," Cantrell recalled of the event. "We were able to meet new people, help new people. We had peers on site that were able to talk to people in a crisis situation or that needed help right at the moment. So it was huge. A lot of people are maybe scared or just don't know what to do when it comes to asking for help. If we're already there and talking about it, that helps. And then we're all talking about our recovery, and where we were and where we're at now. It makes it really easy for the person to come forward and ask for help. And then we try to help them in any way we can."

Even as places slowly open back up, the inclusion of more technology in outreach, such as online events and Narcan training, as well as the Fayette County Sheriff's Tip App, will make the Faith in Recovery coalition's resources available to a wider selection of Fayette County's population.

The Faith in Recovery coalition is starting to see the impact of its work. Fatal overdose rates in the county are falling, and community engagement is even higher than before.

[We] keep sure that we're loud and proud, just so that people understand that you can win this fight and people can recover…[The peer support specialists] are living testament that it can work.

Blair hopes that seeing the success of others can inspire people to get the help they need: "[We] keep sure that we're loud and proud, just so that people understand that you can win this fight and people can recover…[The peer support specialists] are living testament that it can work."