The Voices for Voices TV Show and Podcast Episode 58 with Guest, David McCartney
Voices for Voices, Justin Alan Hayes:
Welcome to the Voices for Voices TV show and podcast sponsored by Redwood Living. Thank you for joining us today. I am Justin Alan Hayes, founder and executive director of Voices for Voices, host, and humanitarian. You can learn more about Voices for Voices on our Instagram, Facebook, and YouTube channel at Voices for Voices, or also on our website at voicesforvoices.org. Voices for Voices is a 501(c)(3) nonprofit charity organization, otherwise referred to as an NGO, a non-government organization, and we survive solely on donations. If you were able to, please consider heading over to voicesforvoices.org to help us continue our mission, and the goal, and dream of mine to help three billion people over the course of my lifetime and beyond. Or you can also send a donation to the mailing address of Voices for Voices, and that's at 2388 Beckett Circle, Stow, Ohio 44224, or you can find us on the Cash App @voicesforvoices.
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Today's guest, David McCartney, a public health coordinator at Summit County Public Health, is going to join us via Zoom, and we are going to talk about, and learn about the status of addiction in Summit County. He's going to talk about what addiction is, how it is a disease. Individuals may have preconceived notions when they hear the word addiction and say, "Oh, well that's not a disease, that's a choice," and other things. We really want to hone in on what the facts are, and especially here in Summit County. David's going to do that, and he is going to also provide some data and some figures around that, to give us a little perspective on what's happening within the county. If you'll help me join David McCartney for joining us on the episode today. Thank you so much for being with us.
David McCartney:
No problem. Thank you for having me. To get started, you've already mentioned it, addiction is not a moral failing like people sometimes do assume, it is clinically a disease. It's categorized as a disease, and it impacts everybody a little bit differently across the way, and it doesn't always look the same within the broader organization, well, within the larger community overall. When we look at addiction, we need to remember that it's not... There are changes that happen within the brain for some individuals with substances. When we look at substance use, there's a spectrum of that, so people can use substances, for example, like alcohol socially and be perfectly fine. But then there are others who are, when they have a drink, they need to have another one, and another one, another one, and it continues on that spectrum. There are people who can use different types of substances recreationally, occasionally, and not have any major addictive issues.
But then unfortunately, there are those who do have that trigger within their brain that creates that sensation of euphoria, that need, that want, that urge, desire. Unfortunately, in Summit County, we have that happening. But that happens everywhere else as well. We really don't have a good number per se of what addiction or who has an addiction within Summit County. We can look at the rates of those who are overdosing, which I'll get into later a little bit here. We can look at the number of overdose deaths, but again, those aren't always accurate representations of what is currently going on. For example, with the overdose, reported overdoses that are non-fatal, we rely on hospital data for that, and so that's only if the individual is taken to a hospital, or seen by an emergency paramedic. It's not necessarily including those who are overdosing within their communities, within the people who they are using drugs with, and who are revived, and safe with Narcan, naloxone generally, but Narcan is a new brand.
It's not full picture, but it does give us a little bit of insight as to what is happening. Unfortunately, those numbers have continued to increase over the past years. We've stayed steady within Summit County, relatively. We haven't had any major increases in overdose death, which is a good thing. But unfortunately, that number is still over 200, and with current projections, it might be about that again this year, so that's where we are. Public Health is trying to make sure that generally the health of the community is well. But specifically for those who are dealing with a substance use disorder, that we are focusing on them, because they are often a population who faces discrimination within healthcare systems, who don't always have access to what they need. There is a often prejudice, unfortunately, within healthcare systems for people who have signs or symptoms of using drugs on their arms.
If they have injection sized wounds, they often don't seek treatment for that, because of the stigma that they fear they might encounter. We have individuals who are on MAT, who are afraid to go into emergency room, and tell the providers there that they are on MAT, which is Medicaid Assisted Therapy, which is usually something that, if people who are in treatment or recovery, are often used to help them wean off substances, or are on it for long-term, that then implies to the physician or to the healthcare team that this person is a person who's using drugs, who could be "drug seeking behavior."
There are issues that are ingrained within medical society for people who are using drug substances, or may have a substance use disorder. Our goal is to help fill those gaps, to help empower people to continue to be safe while they are using, while they are on their journey to recovery, whatever that might look like for them, to keep them safe and alive. Because if you are not alive, you cannot go into recovery, and so that's our perspective of it, is to help ensure that that population of individuals are able to have a good quality of life.
Voices for Voices, Justin Alan Hayes:
Absolutely. I think another area we take the conversation to is, individuals who are experiencing addictions, those are individuals, but it's not just the individual that addiction is impacting. Can you maybe touch on how that is happening and how, as you mentioned, the health department is seeking the health of everybody in the community?
David McCartney:
Sure. Addiction, while it does impact the individual on a more individual level, unfortunately, addiction is also seen throughout the community. Overall, we see that with just, unfortunately, for example, employers. A person who has a substance use or is actively using substances is at work and they have an overdose, then that is now something that the employer has to report, manage, deal with as well as with that individual. But a new initiative that we're working on here at the health department is a recovery-friendly workplace. I believe Maggie will talk about that on a later podcast. That's just one step that we're doing. It does impact the neighbors, it impacts their families, and so we try to help reduce that stigma of not only just using substances, but also having naloxone on you, carrying it, having over the counter prescription now, though you don't even need to have a prescription.
Unfortunately, with that, there's also issues. If you go to a pharmacy, they might require you to pay for it, to use your insurance to get it, and that could cause a lot of issues for individuals. But if people want free Narcan, all they have to do is go to Summit County Public Health website, fill out a form, and we will mail you a naloxone kit. You can get them throughout the community as well at different locations. One of our new initiatives that we're working on is having a naloxone vending machine located within certain communities of usually higher need. With that, I mean, we look at the data, as I mentioned earlier, for overdose death and for overdoses that are reported. That gives us an idea of where a majority of the substance use is occurring.
There are tens of codes that are usually the ones that are more impacted, and we focus on that area. We also have done targeting mail orders. Last year, for example, when we noticed that there was an increase in the African American overdose death rate, and overdose rate in general, we focused on zip codes of where those reported overdoses were happening, and then also looked at higher-density populations of black individuals, and then sent flyers out, mailed them postcards to a majority of the houses in that neighborhood, inviting them to get naloxone, and why it's important, what's happening within your community. Hoping it could break down some of those also barriers, because drug use isn't always something that people are comfortable talking with. Even if they do have a substance use disorder, it's usually a more personal thing for them. Sometimes, families don't even know that the individual has substance use disorder, so just encouraging.
The more people that we have that have naloxone on them, and can respond to an overdose, the better. It provides more opportunities to save a person's life, and keep that person going until they reach recovery. It also impacts other systems that they interact with, so criminal justice system, mental health system, physical health systems, as I mentioned before. But it is not just a singular, it's not I just have a substance use disorder, it's I have a substance use disorder and it impacts me in a majority of my life, so it's not just that one touch point. While we focus on the individual, we also have to look at the bigger picture. That's why, we have community relationships with the ADM, which is the Alcohol, Drug, and Mental Health Board of Summit County. We are developing relationships with other community partners such as Canopy, and the Bay Area Center, which focus on the LGBTQ community, and the black LGBT community in particular.
That allows us an opportunity to hit two populations that are often overlooked, and discriminated against, and face discrimination against within the healthcare systems overall. But we need to also look at social determinants of health, and so those are the things that aren't just your physical health. That's your income level, your physical environment, what's your education level? Do you have food at home? Do you have a grocery store nearby? Are you living in a food desert? Do you have access to transportation? All those other things that go on within life that if you don't have access to could then also impact your health later on, right? At Summit County, our chief epidemiologist, Rich, has done a great job working with the United Way, and 211 to create an asset map, which can also be found on our website. If you just type in scph.org/maps, it'll take you to the asset map.
While there are instructions on there, it can be a little tricky. If anybody does go and look at it, feel free to reach out to me, or to Rich, or the EPI help desk in general, and we'd be more than happy to help you walk through it. But on that map, for example, you can look at the overdose rates, and basic drugs in Summit County. If you do look at that, as the colors get darker, that means that there's a higher population, or a higher incidence of that happening. We also have the ability to look at social determinants of health, and overlay that on top. If we look at the social vulnerability index, which is a big formula that the CDC uses to determine what... Oh my goodness, I can't think of the word. Not zip codes, but it goes that census track. There we go, census track.
They focus on that and determine, if something bad were to happen in that, how bad would it be? When we look at that, and we overlay the social vulnerability index over top of where the overdoses are happening in Summit County, we see that a majority of them also overly each other that the colors, the red is now where the green used to be. That also reinforces the fact that we need to do more within those communities, and that these are the areas that we need to look. I'll stop talking for a minute and let you write.
Voices for Voices, Justin Alan Hayes:
No, no, it's good. I think an important area just to let levels set with people is, data is driving the decisions, it's driving the programs, it's driving where the assets, where the programs are set up. I think that's just good to know in general that the data is driving. It's not what one person thinks and says, "Oh, I think this, because I live in this neighborhood and I see this, or I read this in the paper, or I saw this online or on an app."
David McCartney:
But also with that, data doesn't always tell us the full picture. Like I said earlier, the overdose numbers, those are only reported, so we are still missing... We could be completely wrong with this information. There could be a lot of overdoses happening elsewhere that we are not familiar with, because people don't report them. People are afraid of being arrested for calling the police, or calling for emergency help. But Ohio does have a Good Samaritan Law, and it was recently revamped this year, so a different part of that also decriminalized fentanyl test strips. With that, we are now able to purchase those, and distribute them without them being considered drug paraphernalia, which is great, because now it allows individuals to test their substances that they're using for fentanyl. When we look at the overdose numbers, or overdose death, 85 plus percent of overdose deaths in Summit County included fentanyl.
That wasn't just them using pure fentanyl. A lot of that was also polysubstance use, so it's fentanyl and methamphetamine, fentanyl and cocaine, fentanyl and what they're assuming is heroin, and so it's not just that. Unfortunately, what we're also seeing with an increase is, with the polysubstance use, that not all individuals are expecting to have fentanyl in their substances, right? For example, cocaine and methamphetamine are stimulants, and fentanyl is a drug. With that combination, if you are used to doing cocaine and you think what you have is cocaine, but it's actually just the bag of fentanyl that will be most likely fatal for you, if you have no tolerance for it. Unfortunately, we're seeing more of that happening with the polysubstance use that people... It's likely that those aren't always what people are expecting, or that they just don't have a tolerance for it. Also, using current drug trends, I'm sure everybody has heard of this drink dope that's happening, and so that's diovan, which is a animal additive that should not be in the drug use supply at all.
But people again aren't used to experiencing it. Not only does it cause horrible wounds within individuals, often not even at the site of injection, but it also is causing them... It does not respond to Narcan, because it isn't an OPA. We're working on getting those test strips as well, and distribute throughout the community, so that way our population can at least know if their substances have a different substance in them that they aren't expecting, so that they can change their behavior, so that they can use less, go slower, have somebody around to provide them Narcan if they were to overdose, to have somebody check in with them, and go from there. Again, it's not just an individual level thing, it's making sure that the community as a whole is also aware of what's going on.
While the population of individuals who use substances are often connected to each other or at least have some communication, that they are often the ones who are more aware of what's happening on the ground than we are, by the time we have this. We need to make sure that that population is aware of what we're also saying, and have that communication back and forth, so we do that during our exchange programs. We have conversations as to what individuals are seeing, what they're using, what they're doing, and then what impact, what behavior changes they're doing whenever they are detecting these substances.
Voices for Voices, Justin Alan Hayes:
Great. Can you touch on maybe a little bit of how you got interested in the work that you're doing? Some of our audience are students in college, they're going through those different phases, or change in majors, and to be able to help others, we need more people like you to join the ranks to be able to continue that. Can you touch on those a little bit?
David McCartney:
Yeah, absolutely. I went to a small Catholic university in Erie, Pennsylvania, and I was on the bio premed track. But then I read a book by Dr. Paul Farmer who founded Partners in Health, who did really great work, unfortunately passed away last year. But he did really great work in Rwanda, in Haiti, working with individuals who don't have access to healthcare, through taking TB medications that hospitals don't use, and distributing it to people who need them, and working with individuals who have HIV, or at risk of HIV, and providing them with those medications, help them have a better quality of life. I realized then that I could do more work in a public health aspect, and help a lot of people without necessarily becoming a doctor, and so a couple of loops here and there. But I have always had a passion for people who are on the fringe, people who are often discriminated against as a person.
I find that one of my passions is LGBTQ health, but that also includes a lot of other aspects, so recognizing that people who need the help are often the ones who don't get it, and how can I help make that better for them? That's how I got onto it. My first job, post-graduation from my Masters in Public Health, was a harm reduction specialist, and an HIV prevention specialist, and so I got to do both of the things that I really enjoy together, and here I am now.
Voices for Voices, Justin Alan Hayes:
Great. That's awesome. Anything we didn't cover that you want to make sure we get to, before we close out?
David McCartney:
Sure. We did talk about addiction, we talked about overdoses, but one thing that I really didn't touch a whole lot on was access to treatment. If you are a person who is using substances, or you are a family member of a person who using substances, highly recommend, cannot stress enough, that you have naloxone on you or nearby. It's available through us, available at other locations, it'll be available in community, please have it. But also, if you are looking to get into treatment, the ADM has both great system of care, a great network of care to help you get into treatment quickly, and just opt-in soon. I highly would want them to call the hotline to get connected to those resources if they don't have that connection already. Just hopefully, that with some of the conversation we've had, that stigma might be able to be reduced, that more people with carry Narcan, and that we can help prevent more overdoses from happening in the Summit County.
Voices for Voices, Justin Alan Hayes:
Great. Thank you so much for joining us today, David. Really appreciate your insight, your information, and being so transparent.
David McCartney:
No problem. Thanks for having me.
Voices for Voices, Justin Alan Hayes:
Absolutely. And then we want to also thank you, our viewers, our listeners, or individuals checking out our transcript. I want to thank our special guest, Public Health coordinator at Summit County Public Health, David McCartney, for joining us and providing insight. We'll have links, and information in our show notes that you can check out. Until next time, I'm Justin Alan Hayes, founder executive director at Voices for Voices. This has been an episode of the Voices for Voices TV show and podcast. Until next time, have a great day, and be a voice for you or somebody in need.
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