What Is It Like To Report On The Opioid Crisis In Rural America?

Notes from a small-town reporter in Vermont.

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About a year ago, I started reporting about the opioid crisis.

I write for a very small newspaper in rural Vermont. The county where I live, and where my newspaper is based, led Vermont in opioid-related deaths last year. Statewide, there were 110 deaths. In Windham County, there were 24. That’s 21% of the overall deaths in the state.

The reason I started reporting about opioids about a year ago is because that’s when the people in my town started paying attention to it.

In June 2018, a 25-year-old native of our small community died due to an opioid overdose. He became addicted as a teenager after being prescribed opioids for a sports injury. He had been in and out of recovery, and much of our community knew that, and many of them looked the other way. His mother has since said that part of the pain for her family, during his addiction and following his death, was stigma.

About a month after his death, the Rotary Club held an early-morning meeting about opioid addiction. A man from another town came to talk about a girl in her twenties who had died and how that death had rocked her community into action. There was an energy in the room that told me that was happening here, too. I attend a lot of public meetings — hundreds over the few years I’ve been reporting here. I can count on one hand how many times I’ve had to stand and take notes in a notebook because there were so many people that there wasn’t room for me to sit with my computer. That Rotary meeting was one of those meetings.

A week later a group that would become known as the “Opioid Task Force” met for the first time. It was a mix of people — Rotary Club members, community members, town officials, law enforcement.

They went around the room and said why they were there. The woman who called the meeting, who runs a substance use prevention program for kids, said she called the meeting because people kept calling her for help with their addictions, and she didn’t know what to do. She didn’t have the resources to get them into recovery.

Several people said they came to the meeting because of the 25-year-old who had died. “He was a friend and a neighbor,” a retired state representative said, uncharacteristically fighting back tears. “I think it is important that we create a framework so that we don’t have any more of the tragedies that emerge from this.”

The town’s assistant librarian said she was there because she knew young people were using in the library’s bathroom, and she didn’t know how to help. The library, she said, had recently installed a sharps box in the bathroom, because needles were ending up in the garbage. The library’s bathroom is located in the children’s room.

That was the first of what would become regular meetings of a group that has at its core stayed the same — a dozen or so dedicated volunteers who show up, over and over.

We live situated between two mountains. There are scant recovery services available here. The Opioid Task Force has a goal of bringing recovery services closer to home. Their overarching goal is to help those in recovery and their families. Beyond providing recovery services, their self-prescribed tasks include education, reducing stigma, and providing support.

I’ve covered most of their meetings.

So. What is it like to report on the opioid crisis in rural America?

It’s hearing one of my small town’s two doctors — one who prescribed opioids when they were being overprescribed and now administers medically-assisted treatment to those in recovery — say, “God knows there have been errors in all of this. We are doing the best we can.” It’s hearing him say that after publicly debating a mother who said her son was told he couldn’t enter the doctor’s treatment program because he wasn’t ready for treatment. A mother who said she worried every day her son was going to overdose.

It’s sitting in a room packed with healthcare professionals — first responders, doctors, nurses — there to hear from an addiction expert. “No one signs up for addiction,” he tells them. His overarching message is to treat people, first and foremost, as humans. Words like dopamine, and involuntary, and stigma are thrown up on a white board. “Curbing addiction is everybody’s business and responsibility and we can all look to find what we can do to move it along,” he’d tell the room. “We might start with looking to avoid judgement and a movement to avoid labels.”

It’s listening to a mother whose son died from an opioid overdose talk for five minutes, uninterrupted, in front of the very community she felt shut out by months earlier. It’s hearing her voice shake as she, in a stream of consciousness, talks about what it is to be a parent who is trying to help a child with addiction — the sheer helplessness of it woven into her voice for the rest of time. It’s hearing her say:

“I can’t stop it. That’s what is so disturbing. You just want to feel sane at some point. There has to be an answer. I get to spend my whole life struggling, and something is going to come along and take my kid away from me? No. But yeah, it did. I just want to feel sane at some point, that there’s going to be a fix to this. It needs to be easier to get help. And when these people are reaching out, someone is grabbing on, saying, ‘I gotcha.’ And be able to fix something that is broken.”

It’s watching a room full of people moved to tears.

It’s watching helpers show up. People with knowledge, and grant money. It’s watching a woman who reminds you so very much of your grandmother when she was young, though you never knew her then, step up and say, “I’m in recovery, and I’m ready to help, so I’m going to get trained for five days on how to be a recovery coach. But I want to do it here. We can’t keep sending people to other towns for help.”

It’s getting phone calls from people who aren’t really calling about a newspaper article, but they’ve heard you’re the one who knows about this stuff. It’s hearing their tales of friends overdosing. It’s hearing their fears. It’s getting pushback from people. Nothing’s happening fast enough. Why doesn’t anyone do anything NOW? There are people dying. It’s encouraging those people to come to the meetings. To speak up. It’s watching them be heard when they do.

It’s sitting in a room full of community members who are getting trained on Narcan, because just last week two people overdosed in bathrooms in town. It’s getting trained on it yourself, even though you’re there reporting, because you’re a community member, too. It’s carrying it around in your bag, ready and waiting but hoping for the best.

It’s knowing that there are still so many meetings to attend. That there are still community members who don’t understand that addiction isn’t a choice, and that people need help. It’s jumping at any opportunity you can to write an informational article — about state-level advancements in treatment, about the science of addiction. It’s sharing stories of people. Of survival and death alike. It’s knowing the road is long. It’s knowing you have to keep at it.

Lauren Harkawik is an essayist, fiction writer, and small-town reporter in rural Vermont.

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Essayist, fiction writer + local reporter in VT. She/her.

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