Local nonprofits rally to tackle the opioid epidemic

Written by Lydia Coutre
Published by Crains Cleveland

Seeing more and more of its clients struggling with addiction, The Centers for Families and Children has stepped into the treatment space for the first time.

The Cleveland-based nonprofit, which traditionally focuses on integrated behavioral health care, early learning and workforce services, began offering alcohol and other drug services just seven months ago in an effort to help combat the opioid crisis.

"Clients in all of our services lines are needing (these) services," said Laura Chalker, chief program officer for the Centers. "We're identifying it — whether that's the reason they first presented themselves to the Centers or discovered that through our different intake processes and assessments."

As the opioid epidemic continues to ravage Northeast Ohio, local nonprofits have found themselves on the frontlines. Those who for years have operated in the addiction treatment field say they're trying to bring more awareness to the crisis and find the resources to bring on more staff to fight it. Other organizations not working in the traditional clinical space are looking at how they too can help curb the epidemic.

"Truly, it takes a village," said Dr. Doug Smith , chief clinical officer at the Summit County ADM board.

Nonprofits join the fight

Last year, unintentional drug overdoses caused the deaths of 4,050 Ohio residents, a 32.8% increase over the prior year, driven largely by fentanyl and related drugs like carfentanil, as well as cocaine, according to the Ohio Department of Health.

"I think that there were nonprofits who didn't think addiction was really part of their services that understand now that addiction services are definitely a part of the conversation," said Nancy Mendez, associate vice president of community impact for the United Way of Greater Cleveland, which acts as a convener of sorts for local nonprofits.

For example, she said, a foodbank that a decade ago just focused on providing food, could now include in their intake process questions about other services that individual might need, and "unfortunately, addiction services might be one of those needs."

Lifebanc, a nonprofit organ and tissue recovery organization serving Northeast Ohio, has seen a growing percentage of its organ donations coming from an overdose case. Last year, 24% of its donations were from overdose donors, up from 16% the year before. So far this year, one-third of its donations have been from an overdose.

The nonprofit is exploring the possibility of offering prevention programming in an effort to "save lives any way we can," said Lifebanc spokesman Nick VanDemark.

Nelson Burns, president and CEO of Coleman Professional Services, a nonprofit offering programs for individuals diagnosed with mental and physical disabilities, said he welcomes all efforts of nonprofits to help educate people about the dangers of opiates.

"When you have an epidemic like this, it's natural, I think, for all organizations to say, 'Hey, not one group has the answer,' and become a little bit more modest in your approach," Burns said.

Partnerships are key

The Centers for Families and Children began working to bring on addiction services about a year ago, upon realizing just how much its services were affected by the opioid epidemic.

In its early learning programming, the nonprofit knew that children of those struggling with addiction could need support because of added challenges, such as an unstable home life or the trauma of experiencing a parent with addiction. And in the Centers' workforce programming, they saw clients who were addicted and unemployed, as well as employers looking for staff that could pass a drug screening.

So the Centers gradually added new staff to support the growth, Chalker said. In total thus far, it has added seven staff to help offer non-intensive outpatient and aftercare services, group support, drug screenings and talk therapy. Next, the organization wants to expand services to offer intensive outpatient therapy and eventually, partial hospitalization.

That's not to say that everyone should try to provide those services, Chalker said. Rather, it's critical to know what services are available, partner with other organizations and refer people as necessary.

"You can't address these things without looking at housing or other barriers that our clients face every day," Chalker said.

Many nonprofits providing addiction treatment have been in the field for decades, but the opioid epidemic is different, leaders say, both in its intensity and deadliness.

In 2003, just 5% of the people who came into the detox unit at the Salvation Army of Greater Cleveland had a primary diagnosis of an opioid or heroin addiction. By last year, that was nearly 80%, said Beau Hill, executive director at The Salvation Army Harbor Light Complex.

"It's meant that we've had to retool how we think about addiction, and it's also had to retool kind of how we operate," Hill said.

For instance, over the past 40 or 50 years, blue collar alcoholics who would get clean and find a job were a huge part of the work, he said. Now, many of those who struggle with addiction are younger and haven't developed some of the skills to secure a blue collar job, which are harder to come by these days anyway.

The nuances and broad effects of addiction make partnership with different agencies "absolutely critical," Hill said, "because the problem is so prevalent that there's no one single agency that can be the entire answer."

As nonprofits improve in the work of trying to tackle poverty and its symptoms, they're better understanding the links of various issues — education and opportunities, substance abuse, mental health, housing, lack of employment, and more.

"We can't work in silos anymore," United Way's Mendez said. "We're going to need to leverage and collaborate our resources, and the opioid crisis is one great example of that."

Resources needed

Nonprofits say that the state Medicaid expansion came at the right time, as the opioid epidemic was really starting to ramp up.

"Without Medicaid expansion, we would see more people dying," said Sally Longstreth Fluck, director of clinical operations at chemical dependency treatment nonprofit Oriana House, where the expansion helped alleviate the toll of providing treatment free of charge to clients who couldn't pay.

Medicaid too helps support the Centers' added services, although the nonprofit self-funded the initial costs to start the program and hire staff.

The Summit County ADM board, which increased its beds from 18 to 28 within the past year, reallocated dollars that once funded care now covered in the expansion, and used those dollars for prevention and other programming to help combat the crisis.

What, of the ADM board, sees as a bigger strain right now on the agencies he works with is the need for trained staff.

"It's not like there was a surplus of addiction specialists who are sitting around doing nothing before the opioid epidemic came along," he said.

High turnover of staff overwhelmed by the tragedy of the work makes keeping counselors difficult, said Longstreth Fluck of Oriana House, which has worked to increase its treatment staff by about 30% in the last five years.

Many also noted the need for more sober or residential support systems, as well as longer-term care for patients to follow up and maintain their sobriety.

And overall, nonprofit leaders would like to see more awareness of the problem and a better understanding of the disease of addiction. Government and social services can have all the programming they want, but work still needs to be done in families, homes, churches, soccer practices, PTA meetings and everywhere else that people gather to talk about the problem, reduce the stigma and make sure fewer people start abusing opiates, Hill said.

The role of nonprofits, as Chalker sees it, is both providing services and raising that message.

"It's a very significant issue that's (been) added on for many folks that are already dealing with so many complex challenges," she said. "This is a community-wide problem, and I think everyone needs to step up and help, whether it's for-profit, nonprofit, government sectors."