Portsmouth City Council is considering extending a measure directed primarily at the growing number of drug and alcohol rehabilitation facilities in Portsmouth. The ban does not exclusively apply to drug and alcohol treatment facilities. New healthcare, medical counseling, and mental health facilities are also not permitted.
Last November 25, the council adopted a facility banning “new healthcare, medical, rehabilitation, counseling or mental health facilities within the City of Portsmouth, Ohio” for one year. The plan was for the city to update its zoning rules to make sure facilities were properly regulated and maintained.
The city could prohibit new facilities permanently.
“Whereas, City staff will require additional time to review and make recommendations on zoning, prohibition and/or limitations of new healthcare, medical, rehabilitation, counseling or mental health facilities so that any necessary regulations conform to goals of the City of Portsmouth and help ensure the public peace, health, safety, and welfare of its citizens.”
(Cyn Mackley. “Should Portsmouth Ban New Rehab Facilities?” Scioto County Daily News. November 2021.)
The Scioto County Daily News reports that according to a memo from City Manager Sam Sutherland, the zoning plan is not finished. Judging from the language of the ordinance extending the ban, Portsmouth may not allow new medical facilities even after the ban expires, “The purpose of this moratorium is so that City staff may determine whether to limit or entirely prohibit healthcare, medical, rehabilitation, counseling or mental health facilities in the City of Portsmouth and to prepare any necessary, related zoning or other regulations.”
Council has expressed concerns about the growing number of drug and alcohol rehabilitation facilities in the community. Some say “the large number of treatment centers is not good for the city’s image.” Others claim that the area’s well-documented drug problems justify the number of facilities.
“Harm Reduction Ohio” ranks the death rates for all 88 Ohio counties. Scioto County ranked No. 1 (the deadliest) in 2021, 2020, 2019 and 2018. It was No. 9, the ninth worst in 2017 and No. 12 in 2016.
In 2020, “Harm Reduction Ohio” reported the next five counties with the highest levels of overdose death – Meigs, Vinton, Pike, Gallia and Ross – are also located in south and southeastern Ohio. The seventh ranked county — Trumbull County (Warren) — is in northeast Ohio.
(“Ohio Overdose Deaths, Ranked By County, 2020”
(“Overdose Death in Ohio: Where does your county rank?” https://www.harmreductionohio.org/overdose-death-in-ohio-where-does-your-county-rank/. Jan 24, 2022.)
Desperate Times And Desperate Measures
Council is currently reviewing a detailed “recovery housing” ordinance which is currently 19 pages long with 17 sections covering all aspects of residential treatment facilities including:
Services offered and levels of support.
Recovery residence standards.
Termination of residency.
Residents’ rights.
Training and technical assistance.
Access to medication.
Access to finding and referrals.
Zoning
Data collection.
Denial, suspension, or revocation of certification.
Complaints.
Appeals.
Crimes and penalties.
Confidentiality
Severability.
WSAZ reported in July 2021 that Portsmouth City Councilman Edwin Martell says that no city has the desire to become the “capital” of recovery. However, when it comes to substance abuse, recovery cannot be ignored. Martell says he is seeing a recurring theme within the city, especially when it comes to recovery housing facilities.
“We’re seeing houses that are not capable of housing the amount of people that are in it. In some cases, there is no hot water, or no water at all and that’s pretty scary,” said Martell.
WSAZ reported although there are plenty of good recovery facilities in Portsmouth, Martell worries that the work they do is being overshadowed by the ones with less than ideal living conditions. He thinks the process to start running a facility is far too easy.
According to Martell, a person just needs to purchase a house, find a certified clinical director with access to Medicaid, and then begin billing for each resident living in the facility.
“The amount of money that is thrown at this with no regulation is very unnerving,” said Martell.
The State of Ohio has voluntary certification programs, but Martell would like to see the City of Portsmouth require recovery facilities to enroll in them. This would ensure that the conditions are up to code and the facility can operate.
“Make sure that it has adequate space. Make sure that it has running water and hot water. Make sure that it has washers and dryers. Some of the basic necessities that people need in order to live!” said Martell.
(Joseph Payton. “Councilman wants more regulations for recovery housing in Portsmouth.” WSAZ Channel 3 https://www.wsaz.com/2021/07/05/councilman-wants-more-regulations-recovery-housing-portsmouth/. July 05, 2021.)
Ohio And “Recovery Housing”
According to the Ohio Revised Code Section 340.01 (A)(3) "Recovery Housing" means housing for individuals recovering from drug addiction that provides an alcohol and drug-free living environment, peer support, assistance with obtaining drug addiction services and other drug addiction recovery assistance.
Ohio Recovery Housing (ORH) is an alliance for individuals and organizations operating quality recovery housing in Ohio. ORH is a state affiliate of the National Alliance for Recovery Residences (NARR), which creates and maintains standards of excellence for recovery housing and the Ohio Mental Health and Addiction Services.
ORH creates and maintains standards of excellence for recovery housing in Ohio that meet expectations of NARR, and it provides opportunities for peer reviews that regularly document an ongoing commitment to ORH quality standards.
“Recovery Housing In Ohio: Analysis of Resident Survey Data (March 2016-November 2020) prepared by Mighty Crow Media, LLC. and Ohio Recovery Housing is available at the following site: https://www.ohiorecoveryhousing.org/_files/ugd/195f09_700c5f8846bf48f8a69d05b645648693.pdf.
All housing sites affiliated with ORH have been inspected and found to provide a standard of living that meets ORH & NARR requirements. The housing inspection includes health, life skills programming, safety and management reviews that ensure each site lives up to the standards set forth by ORH.
In addition the ORH Associate Peer Review is a set of standards that supersedes any and all previous standards required to be an ORH associate.
The quality review process begins when the application is received by ORH. No claims of operating in good standing with the quality standards can be made until the site visit is completed and approved by the ORH Advisory Board.
Upon approval, associates are encouraged to display documentation that they are in good standing with the ORH quality standards, “Associate of ORH,” or some similar statement in all literature for the property.
(Note that ORH provides peer quality reviews for Levels I, II, and III. Level IVs are licensed by the State of Ohio as residential treatment providers.)
The National Alliance for Recovery Residences (NARR) “Standard 3.0” (November 2018) can be found at the following site: https://narronline.org/wpcontent/uploads/2018/11/NARR_Standard_V.3.0_release_11-2018.pdf.
Image
In January 2020, The New York Times published an article about Portsmouth by Sabrina Tavernise – national correspondent covering demographics and lead writer for The Times on the Census – titled “This Town Is Known For Opioids: Can It Escape That Image?”
Tavernise described the wonderful efforts of a small group of younger residents – business owners, college professors, Iraq war veterans and museum curators – led by Jeremy Burnside, personal-injury lawyer turned civic leader, that have brought new energy to solving Portsmouth’s problems “with a goal of changing both the image and reality of life in town, figuring that you cannot really do one without the other.”
Jeremy Burnside has a dream that someday, someone will write a story about his town that has nothing to do with drugs. It is true his town has a problem, Mr. Burnside says. But it also has “an art museum, a circus school, a dog park, a new restaurant, a skating rink and a university – and somehow those things never get mentioned.”
Ed Hughes, recently retired as head of the Counseling Center, Portsmouth’s main rehabilitation facility, said this about Burnside's and other's efforts to change the image of Portsmouth …
“They are working harder at this than anybody I’ve ever seen. I think we may be adjusting to the fact that if things are going to get better, we have to do it. The cavalry is not coming …
“Opinions, for the most part, are still set against people in recovery.”
(Sabrina Tavernise. “This Town Is Known For Opioids: Can It Escape That Image?” The New York Times. January 11, 2020.)
Looking around a busy cafe, Lofts Coffee Company, Hughes said, “Half the people in this coffee shop would say, ‘Why are we spending so much time on these people?’”
At the same time, something is happening, he said, pointing out that places like the coffee shop did not exist 10 years ago
Any lasting change will require real efforts to stitch people in recovery back into the community, Hughes said. That means attitudes have to change.
(Sabrina Tavernise. “This Town Is Known For Opioids: Can It Escape That Image?” The New York Times. January 11, 2020.)
The Bottom Line
All efforts to end the opioid crisis in Scioto County must be applauded. It's hard, thankless work that largely devoted individuals take upon themselves because they love their home. No one wants this unspeakable devastation to continue. And, I think it is very important to celebrate and honor the achievements of so many during times that, quite frankly, depress the progressive spirit. God bless these local leaders, first responders, business people, and private citizens.
However …
At the same time, considering “image” is far less important than dealing with the “reality” of the situation. We here in Scioto regret with all our hearts and minds being known year after year as the “deadliest county in Ohio” – the center of the opioid epidemic. As we lift up all the hard-earned progress and and ponder better strategies to end drug abuse, we simply cannot afford to cut or limit vital services for rehabilitation, healthcare, medical counseling, and mental health.
The statistics paint a horrid materiality, and that very circumstance should be our primary concern. We continue to pursue a positive attitude while working more closely together to end opioid abuse. I believe to ignore or downplay or disparage our assault on the drug epidemic will only make conditions worse.
I agree with Ed Hughes. We must work those people in recovery back into the community. As we do so, we save lives and build stronger relationships between those who stigmatize dependency and those who support rehabilitation. I think we need to do an even better job of inclusion and put more resources into making better transitions. I wonder what changing opinions about recovery would do to lift us out of our many problems. I even wonder what embracing our heritage might do to further progressive change.
The truth is our strength to endure comes from our birthright of being “Children of Appalachia.” The connection we have is central to our bonds as human beings – a deep kinship to the place we call home. Still, part of that bond is that we are isolated both geographically and culturally. From that isolation comes a strong, independent attitude. We all know that some see us as backwards, and despite their view, we still take pride in individualism and perseverance.
From an early age in Appalachia, we learn that if we're not “raised right,” it’s a reflection on our parents – an embarrassment. And shaming our parents is something we would never do … or, at least, should never do.
But, somewhere along the line this pride and appreciation of the basics – the food on our table, the shelters in which we live, the clothes we wear – has been too strongly influenced by greed, materialism, and the pursuit of pleasure. So many people now attempt to escape pain and struggle – things we once valued overcoming on our own – through substances. Abuse of alcohol, opioids, even cigarettes wreck our health and alter our reality. Generations suffer from the addictions and feed a vicious cycle of depression and despair.
My point is – we must return to our resolve of the past, not give up, but instead develop greater understandings to effectively change and fight the substance war we find ourselves in. God knows the rehabs, mental health facilities, recovery houses, and so many others are fighting day and night to do just that. We have to invest even more in these facilities and also in research-based intervention.
We, like those before us, know we must not give up in the midst of great danger, and to fight our way out, we must build our resolve by supporting efforts to end poor health and substandard mental and physical conditions in which we live. Anyone worrying about a negative image must face the root of the problem, not whitewash the epidemic with a thin and temporary veneer or walk away in indifference.
Historical Note:
Since 1999, opioid overdose deaths have increased more than four-fold in the United States—and the Appalachian Region has been disproportionately impacted.9 In 2017, four states within the Appalachian Region (West Virginia, Ohio, Pennsylvania, and Kentucky) had the highest rates of drug overdose deaths in the country.13 In addition, most Appalachian states experienced increases in drug overdose deaths between 2016 and 2017.
Several factors contributing to higher rates of opioid misuse and overdose deaths converge in Appalachia.Higher rates of injury-prone employment, aggressive marketing of prescription pain medications to physicians, and an insufficient supply of behavioral and public health services targeting opioid misuse contribute to higher rates of opioid misuse and mortality in the Region.
These factors, coupled with limited access to treatment and high rates of poverty, create a multifaceted public health threat. Equally multifaceted intervention strategies are needed to address opioid misuse and overdose deaths in Appalachia.
National Institute on Drug Abuse. (2019). Overdose death rates. Retrieved from: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.
Scholl, L., Seth, P., Kariisa, M., Wilson, N., & Baldwin, G. (2019). Drug and opioid-involved overdose deaths – United States, 2013–2017. Morbidity and Mortality Weekly Report, 67(51-52), 1419-1427.
Moody, L. N., Satterwhite, E., & Bickel, W. K. (2017). Substance use in rural Central Appalachia: Current status and treatment considerations. Journal of Rural Mental Health, 41(2), 123
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