‘We’re on the front lines every day’: How county officials in Appalachia are fighting opioid abuse

Most people have never heard of Clinton County, Jeffrey Snyder readily admits, but they’ve undoubtedly heard of the two places that it sits between: State College, Pa., home to Penn State University, and Williamsport, Pa. the home to the Little League World Series.

The rural county of about 40,000 souls in north-central Pennsylvania bears a distinction all its own: Like the rest of the Keystone State, it’s been hard hit, first, by the opioid epidemic, and, now, by such synthetic opioids as fentanyl that are ending lives and destroying families.

“[It] hit our community hard,” Snyder said Tuesday during a panel discussion in Washington D.C. that was co-sponsored by the National Association of Counties, a national advocacy organization, and the Appalachian Regional Commission, a federal/state partnership that represents 13 Appalachian states, including Pennsylvania. “We got on the ball real quick to deal with it.”

Clinton County ranked 59th of 67 counties for its opioid overdose death rate in 2017, according to U.S. Drug Enforcement Administration statistics, down from 37th in 2016, the most recent years for which data were available.

County officials from across the country met in Washington Tuesday for what organizers described as a “capstone” event for a year-long effort aimed at looking at how county governments across the Appalachian region have responded to the epidemic, as well as the path forward.

The national counties association distilled that work into a 40-page report, released last year, that catalogued the grim toll that opioid abuse has exacted on Appalachia, as well as the strategies that local officials have employed to turn the tide.

Among the most sobering bottom line findings: Appalachian counties had an overdose death rate of 24 people per

100,000 residents, compared to the national rate of 14 deaths per 100,000 residents in 2017. The opioid prescription rate across the 13 state region was staggeringly high at 84 prescriptions per 100 residents, compared to the still-high nationwide rate of 58 prescriptions per 100 residents, the report concluded.

Appalachian leaders also operated with fewer financial resources than their counterparts nationwide when it came to fighting the epidemic. In 2012, per-capita revenue was 35 percent lower ($1,184 vs. 1,831, respectively) in Appalachian counties than in non-Appalachian counties, the report concluded.

Collectively, the 13-state region spent $7.2 billion on health and human services programs and more than $5 billion on “justice” and public safety in 2019, the report indicates. The latter includes everything from county sheriffs to courts, while the former includes abuse and addiction services and child welfare programs.

The abuse epidemic is tragedy “that impacts on both the human level” and on the economic level, said Tim Thomas, the Appalachian Regional Commission’s federal coordinator. The struggle against addiction and overdoses results in lost economic productivity and fewer workers in the workforce, he said.

“Unfortunately, the epidemic first manifested in Appalachia,” he said. “Fortunately, we can lead the way in finding solutions.”

During a panel discussion with Mercer County, W.Va. Commissioner Greg Puckett, Snyder ran down some of the strategies that Clinton County officials have employed to fight the epidemic. He ticked off a list that included a web-based training program for the family members of those contending with addiction and specialized treatment courts within the county judicial system.

Both Snyder and Puckett agreed that access to good jobs was central to stemming some of the hopelessness that often leads people to addiction. But they added, efforts to encourage economic development and to attract new employers had to be done in tandem with fighting addiction.

Snyder credited efforts by Pennsylvania Gov. Tom Wolf  to curb prescriptions and to fight abuse. Last month, the Democratic administration announced that it was extending a statewide opioids disaster declaration for the eighth time, a move that gives the state added leeway to fight the public health crisis.

The effort, which first began in January 2018, appears to have paid dividends. Pennsylvania’s rate of opioid prescriptions is now below the federal average. And from 2017 to 2018 – the most recent data available – overdose deaths declined by 18 percent, the administration said.

On Tuesday, Snyder said flexibility — buttressed by state support — remains the key to fighting abuse. That, and “never giving up,” he said.