City of Bloomington, Indiana Facebook Live Town Halls, 20 May 2019

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From YouTube: Facebook Live with Sam Quinones

Description

May 20, 2019
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Author and journalist Sam Quinones shared the observations he made in the course of writing Dreamland: The True Tale of America’s Opiate Epidemic, winner of the 2016 National Book Critics Circle Award for Nonfiction. During the roundtable, City officials and members of the local recovery community shared Bloomington’s own experience with opioids and efforts toward solutions.

Guests included:

Sam Quinones, author of Dreamland: The True Tale of America’s Opiate Epidemic
Linda Grove-Paul, Centerstone, Vice President of Adult Services
Tammy Hooten, Centerstone
Beverly Calender-Anderson, Director, City of Bloomington Community and Family Resources Department
With moderator Yael Ksander, City of Bloomington, Communications Director.
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Sam Quinones’ visit to Bloomington was sponsored by Centerstone, the City of Bloomington, and the IU Responding to the Addictions Crisis Grand Challenge initiative.

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Welcome and thanks for joining us., I'm the yael ksander, communications.

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Director for the city of bloomington, and I'm so glad you tuned in for today's.

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Conversation., since the 1990s communities across the country have been grappling.

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With the effects of heroin and opioid addiction and bloomington, of course, is.

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No exception between 1999 and 2017, according to some.

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Figures almost 218,000 people died in the u.s. from overdoses related.

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To prescription of opioids according to the us centers on disease control and.

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Prevention today, we are very fortunate to have with us the author and.

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Journalist, sam quinones, with us to share the observations he made in writing.

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Dreamland: the true tale of america’s opiate epidemic.

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And that book along the 2016 national book critics circle award.

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For nonfiction- and I should mention that mr. kent I just mentioned that mr...I'm sorry...mr.

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Quinones visit to bloomington has been made possible through centerstone.

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The city of bloomington and the iu responding to the addictions crisis.

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Grand challenge initiative, talk about a mouthful.. Mr. quinones will be speaking this.

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Evening at the buskirk-chumley theater at 6:30 he has a full day and we're so.

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It's my way to thank you all for having me appreciate it, and I should also.

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Mention that we are fortunate to be joined by folks, who've had boots on the.

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Ground here in bloomington, with regards to this crisis for many years with us to.

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My right is linda grove-paul,, vice president of adult services for centerstone.

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The health care organization, specializing in mental health care and.

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Addiction, treatment and community education here in bloomington also from.

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Centerstone to my left recovery, specialist, tammy hooten, who is a person.

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With lived experience, she says she is a grateful recovering addict, who has.

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Currently, two and half years of sobriety awesome. Her journey has not been easy.

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But helping to start the centerstone city of bloomington parks and rec.

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Employment partnership allowed her in early recovery to have meaningful.

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Employment and a sense of purpose and accomplishment, it's great to know that.

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You've gone from being one of the first members of the crew to developing the.

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Program in a leadership position at centerstone and last but not least from.

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The city of bloomington beverly calendar-anderson, the director of our community.

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And family resources department she's worked closely with our public safety.

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Departments on the front lines of the opiate issue here in bloomington and.

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Provided services to those affected, welcome all of you excited about this.

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Conversation we're gonna have to speak really quickly to get in all of the.

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Topics that we wanted to discuss, I'm really looking forward to bringing.

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Together the first-hand experience you all have dealing with this issue.

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With your trip, anonymous reporting on, as you put it in some on one page, the way.

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To separate commercial enterprises managed to exert quote a catastrophic.

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Synergy, I thought that was a pretty great description that produced a.

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Juggernaut, that is the crisis. Your book came out in 2015, but it's strangely.

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Relevant now, some of us are only waking up to this issue. I mean we're just.

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Hearing on the news last week that four more states have filed lawsuits against.

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Purdue pharma the makers of oxycontin, and I would love for you to just catch.

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Us up here for those who haven't read this book.

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Give us a thumbnail sketch about purdue about the change in philosophy, about.

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Pain sure there's a lot there wrong. Basically, this epidemic begins because.

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In very different ways than past drug problems, if the supply is provided not.

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By drug traffickers or drug peddlers or mafias is provided really by doctors.

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Over prescribing, in my opinion, over prescribing narcotic painkillers for all.

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Manner of pain in long periods of time, for long periods of time and ever.

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Escalating doses, a lot of that creates a black market, but they were pushed. I.

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Think control a little pressure by pharmaceutical companies and being.

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Specialists who believe that those could solve pain in america kind.

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Of a quixotic idea that this was like a new day and together this economic force.

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Change prescribing that it's across america and and was were adopted in.

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Medical schools and so on, so you get all these people and deciding that we can.

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Prescribe these pills for a long periods of time ever escalating doses without.

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Anything without really any risk if the person was a pain, paying patient and for.

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Something that's true for other people. It's not true. It does depend on the.

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Person, that's what the background for the person of the environment if the.

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Person lives, variety of things like that, and, and also the the dose and the extent.

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To which the person is exposed to these to these drugs.

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Some people don't have a problem with them and very short dose there's a lot.

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Of people don't have a voluntary short doses and small doses.

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The longer you extend that the higher the dose, the more you see, people having.

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Having problems and the pharmaceutical companies were particularly involved in.

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That marketing these drugs, they have, fortunately don't addictive, and that was.

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A big claim that purdue had that these pills can be used now with risk free. You.

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Don't have to worry about this, it's risk free, don't worry about the background of.

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The patient, don't worry about patient, has alcoholism and her family, or, if that.

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Patient is also smoking marijuana or what variety of things or whatever.

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Events might have been or a child would say, none of that is.

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Worth really paying attention to, and so that got us to a point where we have an.

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Unprecedent amount of these pills being used for a pain in an unprecedented.

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Amount of prescribed medicine leaking out into what I consider the black.

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Markets and most market most areas of the of the country, and so even people.

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Who get addicted not through him until subscribe to them are getting addicted?.

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To medicine that was prescribed to somebody so a high school party to find.

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Often that the pills replaced beer and poppers like the the go to drug.

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Experimental drug very dangerous to be doing that you mentioned also that.

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Really important role that the economy is shifting economy played, especially in.

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The so-called rust belt well, there's certain areas sure that.

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That have been left behind. This is what this thing did, I think is show us the.

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Effects of globalization in a very stark way, it showed us areas of the country.

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That have been left behind something that we should have realized decades.

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Earlier in a lot of communities, we're kind of crying out for help for some.

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Time this in some ways, kind of highlighted that to some degree I would.

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Say but it's not just an economically disadvantaged or devastated areas, all.

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Those taking place this the interesting thing.

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Is that it? It goes to some of the best off communities suburbs not far from.

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Here around indianapolis that are really the beneficiaries of previous. What 30 40.

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Years of economic expansion, those folks too, so it's not the economic answer to.

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All this is not, I think, the crucial one. The crucial one is is our own isolation.

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And only what does the common denominator of all these communities is.

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They're kind of a social, economic, political, cultural, professional.

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Isolation and them sony in so many ways, and I think that that's what brings us.

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Brought us to the point where my book and some other things happened after.

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That yeah also in the book important to just bring everyone up to speed. You also.

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Described this, the second large commercial enterprise responsible here I.

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Think is that all this was done as if it were in a little bat like this. We could.

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Do this and there would be no there's, no other world trend that would affect this.

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And in fact, we had already seen the truth. The historic change in our heroine.

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Markets what nobody noticed it from the va, because.

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Cartels and drug trafficking groups shifted that and they took over the.

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Heroin market in our country from the apparently used to come from the far.

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East from berlin, turkey and time and so on, because that stuff got here very.

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Expensive and very weak and they could bring it in cheaper and more potent and.

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In time that and so they've just essentially crowded out all that far.

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Eastern area, all that was essentially a fact on the ground by the time.

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Pharmaceutical companies began promoting.

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Paying bills, along with pain specialists, and we as americans honestly began.

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Demanding it as well as pains pain as health consumers, we demanded, you know.

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Fix me when the doctor said well, you know your pain. Is you know it's really.

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Doesn't want to do with exercise and eating better and getting outside and.

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Being with other people into a variety of wellness solutions, you know a lot of.

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Americans give me the inning, and that was really a big part of all of this.

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Kind of combines, and then it's overlaid on a culture of self gratification, but.

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Then also on this little known fact that our heroine was now.

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I'm coming cheaper and more potent than ever and that becomes the replacement.

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For four pills and pills get too expensive in the black market.

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You switch the heroin that would not have happened in the 1970s, because the.

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Heroin was coming from the far east got here very expensive, relatively expensive.

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I would say, and weak bitumen stepped on cut numerous times, so it was not the.

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Same kind of replacement, that's what I found fascinating and wanted to reflect.

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In the book that this they are not much of a believer in man, theory of history.

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It's more that there are a variety of factors who went into these stories. They.

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That we all need to take, in fact, and if we don't there were those a lot of.

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Policies that there probably will fail, be waste of money and we people jaded.

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Like nothing works, not work. Well, things will work if we come at it from a kind.

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Of a community vantage point that there are lots of ideas behind this, they went.

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Into this and lots of things went into, this is not just a few bad batch, so it's.

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Important to understand the wool pharmaceutical companies, but it's that's.

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Not all yeah the culture was receptive and yeah.

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I think we more I got into this book the more I realized we needed to be the.

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Change we want so I stopped drinking sugary drinks. I don't really like sodas.

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And sweet tea, fair amount of that I begin exercising.

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It's all about a lot of this gets back to each of us taking personal.

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Accountability for our own response and then saying: we've have the ability to to.

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Make the change we want to say that's important, I'm so excited to bring.

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Everyone in into our conversation and our audience folks watching this is.

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Facebook live conversation with sam quinones...the, author of dreamland:, the true tale of.

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America's opiate epidemic and we'll be taking your questions here in a.

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Moment but first I'm really anxious to bring in members of our community who.

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Have direct experience with the opiate epidemic locally would love to know from.

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Beverly from linda from tammy, when he first became aware that things were.

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Changing here from your perspective as a clinician, etc, well, as a clinician again.

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That's the best book I've ever read it pulled together. So many things as a.

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Person with boots on the ground that you'd seen happening in my 22 years in.

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The field into one comprehensive narrative, so I really appreciated that.

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And then they made it accessible to everyone, because people you know would.

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Stretch their heads and say: what's happened, how did this happen and you do.

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Such a wonderful job of talking about the factors in a pan is that the vital.

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Sign you know that that idea that you know in our country were under under.

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Managing pain and looking for that quick fix all those be pieces, but there was a.

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New idea, it wasn't I'm still kind of a one that doesn't have universal.

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Acceptance right and harbor crediting body, you know sense. You were treating.

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People with pain, you know you need to send more people off to the hospital or.

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The doctor's, but what I was say from my experience, is you know 22 years ago, when.

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I first started in the field probably 90, to 95 percent of the clients that we had.

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Were men and they were alcohol? This was really what we were treating her for and.

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The women that there was some cocaine- you know the kind of dabbled in heroin.

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But for the most part of this alcoholism and then women who really started to.

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Come in it was women on those, so primarily in tammy, and I were talking.

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About this a little bit earlier- and she was saying kind of her experience- is the.

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Same but primarily, people came in and when used, the post, enlarged, percocet.

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Rama and they were trained, they found one on. They disagreed about the.

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Medication helped, but it also very much emotionally helped them in coping and.

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Then, over the years I've began to change men. You know started to use pills more.

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And tammy can talk about that a little bit more, but then you know.

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The real change was about 2013-14 when you know basically elemental legislation.

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Went through and then access medication.

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That pill mill is a word that confused me for a long time, so I think it bears.

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Along with opioid opiate, I feel like there's a term definition. We need to do.

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Here pill mill is not the factory pill, mill is prescribing, but it's can you.

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Describe what that term means? So you know in bloomington we certainly had two.

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Doctors, new scripts and one they referred to as the candyman, so expanding.

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Began and any opiate any benzo any kind of medication that they wanted or needed.

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You could get in fact when this person ended up giving up his license. They had.

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Over this led to the kind of the commercialization of pain management, so.

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That people were doctors were getting very used to to just being.

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Prescription pills.

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And then you just go back there and tell me what it's not. There was nothing, no.

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Pay, no systems, no more lies. There's no attention to you whether you try lately.

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Let's see if we try this again something else, it was just yesterday.

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That's why I walked out with, and that's what everybody else unfortunately, and.

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Then we read in your book that not only was this happening for individual.

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Patients but predatory folks were going in, and patients shopping and finding.

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Folks, like you to go in and paying for you doctor this yeah and then taking as.

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A result: half your prescriptions yeah and a lot of these areas. I think.

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Probably hammond indiana certain kentucky west virginia ohio and then a.

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Lot of pain, clinics open up in florida in the mid-2000s, so there's a to.

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Caravans and go guys hi organics, I'm taking six or ten addicts down the.

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Florida getting them all with prescriptions, taking half their pills, but I wanna say one thing about that. That is true: that that that phenomenon.

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Led to an enormous part of the increased supply, but we would not be in this.

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Problem today, if that's all, it was, I think it was really the widespread.

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Adoption by doctors all across the country, well, meaning not quacks, not you.

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Know scandalous, folks, who, who prescribed this just as a routine. Almost everything.

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The camp that came up that was part of it. They were not necessarily pill. Mills.

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They were just doctors who bought into this. If so many did, and that is what.

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Accounts for the enormous like every year. Not these guys were bad and and.

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They were easy to find and easy to point out. You could find them in every region.

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So two or three dogs were just scandals, but that's not where don't have a so.

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Supply control, well, they bought into the notion that there were. There was no.

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Concussion I mean that wasn't going to be an addiction afterwards, and I wasn't.

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Saying you know we first came into this from the city standpoint about three.

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Years ago, three and a half years ago we started the state, disability and justice.

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Initiative and we were seeing seeing the ramifications of what happened because.

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We were seeing more and more people were experiencing homelessness, downtown and.

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Then they were mental health issues, their addiction issues there, and so, when.

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We went through to try and address some of those issues, but but help me.

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Contextualize, what was happening too, and so somebody.

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Non-Commissioned coming into it really did help put some of this into.

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Perspective and understanding that this was not, and it wasn't one promise or.

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Anything he's saying you know that it's a community issue as it was it's the.

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Solution to it, it's not okay. Now we're going to get everybody that is affected.

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And that's not, and so we have in our community lots of different people.

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Working on this issue, whether it's from the city or the county in the health.

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Department, the you know the harm reduction. Folks I mean so we're all you.

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Know, working together on it or trying to work together to address the issue. Yeah.

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We've talked a lot about the pharmaceuticals know as far as the.

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Heroin is concerned, I'm curious about when you all here in bloomington start.

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Seeing that show up, I know I came to town in 1998 and I was surprised when.

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They got here from virginia to to hear about people I knew using heroin. I know.

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I had not heard about that for decades. You know with something kind of.

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Legendary yeah, I would say my experience and then I went to me to talk a little.

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Bit about her experience, but my experience as a clinician was that there.

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Were pockets of heroin and kind of the late 90s, the early thousands? But you.

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Didn't see massive amounts, primarily, it was pills and cocaine. Just.

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On the back side of the crack epidemic, you still had some people that were.

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We're using crack on in math really started to come on the same and bethel.

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Was actually much worse than our heroin problem in this location until probably.

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The last five years or so yeah, I know that I was going to doctors about.

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Medicine and years of doing that, you know, and then, when doctors now that was.

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Where did you get it yeah so, but then you were saying that the markets they.

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We can't sell there because there's too many too much competition, so it's.

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Unfortunate they come here to make money off this town. I found a lot of small.

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Towns faced up where you find urban centers being the place where the dope.

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Ends up but then very quickly, they realized they can double their money.

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Triple their money, whatever by going someplace, someplace else and then or.

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Which also find is that usage from those towns realize that, if they just go to.

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The big city, whatever it happens, to be the reach of the metro area. That's.

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Closes they come by they'll, come back home, spur clear habit in and with no.

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Money spent, you know, so it's that back and forth. I think that you find that.

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Really ravaged a lot of smaller because of the what's coming.

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But one of the reasons it's coming in is because in every place in the country.

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You have this phenomenon of people excessive. I was indiscriminate, almost.

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Prescribing and paying bills that you're creating so maybe not exist before the.

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Reason they can sell for triple or whatever price livington. The other small.

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Towns, because there's a lot of market there now the supply helped create the.

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Demand and the demands it's like, we can't find the middle. You know we're.

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Like over here to here, and one of the reasons I think for that there's several.

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Reasons and it's not good- it's not okay to say well, you just got to go it alone.

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Now, you're on your own, that's not okay! One of the reasons, though, for that is.

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Because pain, one of the goods we've got going in all this is because insurance.

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Companies stopped reimbursing for treatment that didn't involve pain, pills.

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And so a pain, personal chronic pain would have opioids and then punisher and.

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An exercise in physical therapy and cognitive behavioral therapy, a variety.

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Of things and that all together all reimbursed and all together so the.

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Doctor would be able to kind of like adjust these treatments little by little.

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The pills take over and there's no more insurance reimbursement and so a lot of.

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Folks, with chronic pain became diagnosed in.

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Them and I'm treated with just pills, and they are up in very high levels and we.

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Have spent a lot of time decreasing the supply which, on it's a good thing very.

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Thing it's a central thing, but we have not worked on replacing treatment. Yeah.

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Giving other replacement treatment replacements going there or excruciating.

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Pain like men in pain, and it's like like we as a culturally, really not been able.

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To find a happy medium is one one patient. You know it's a chronic patient.

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It's all there, nothing with us, it's always bills or nothing. I don't know and.

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I think we need to get to this point and part of that, a big part of that frankly,.

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Is the world and insurance companies play in the solution they need to.

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Understand that it's not just that they write in prescription for physical.

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Therapy they also have to write for cognitive, behavioral thinking. All these.

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Different things all at the same time,.

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I want to talk about some of those solutions here in the second half of our.

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Conversation we've hit the halfway mark, and this is facebook live here with.

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Author, sam quinones,, author of dreamland:, the true tale of america's opiate epidemic.

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He's here at the town speaking tonight, at 6:30 at the buskirk-chumley and his.

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Visit is sponsored by the city and centerstone and iu., we're so glad to.

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Have you here and so a really great you know it's fantastic.

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Also, we have linda grove-paul from centerstone tammy hooton from centerstone and also beverly calendar-anderson from the city.

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Of bloomington. I'm yael ksander.. Please join us with your questions. If you have any.

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About the opiate problem in bloomington or farther afield, and we love to.

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Entertaining those I would love to talk about treatment and solution, and things.

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That have worked, how we've grappled this on them national basis and what's worked.

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Here, obviously, what your research has shown us is that we are here battling.

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Global forces and it's a complex issue that requires a multi-pronged solution.

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um So you told us about many things that have started to you, know: sort of eat.

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Away at a problem a little bit, some of changing the pain prescribing guidelines.

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Has changed, although, as we've mentioned, it.

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Another equal change in prescribing reimbursement, reimbursement for pain.

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Treatment right, yeah, so you've also got the enforcement side.

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And we've got the treatment side, maybe we can discuss what's worked and and.

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What's worked here, what's working well, so I mean, I think, one of the the biggest.

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Issues is what we're talking about before is a just misunderstanding about.

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What addiction in our history have exposure to certain kinds of substances.

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And I think, for a long time, addiction really was not. It was considered immoral.

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Family, you know this idea that you just we need to pull ourselves up by our.

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Bootstraps we need that mister gratification. Give me the pill we need. You know a quick fix and, as we said, it is a very complicated issue and you know two people respond.

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The same in treatment really has changed in that regard because it used to be.

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Fairly prescriptive rigid in the large part that came along with just kind of.

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The criminal justice partnerships when, for the most part, most people weren't.

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Coming to us until they were in a system and that's just kind of the way things.

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Have worked over the years, is you know you have a parent call and say? Oh my.

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Gosh, my kids, you know really struggling but.

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You know, information may be may be, compliance will be better and that's the.

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Reality for a lot of for a lot of people, you know the system being involved and I.

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Think now, finally, you know not the government policies at all levels are.

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Recognizing you know we want to be able to get people, we want to be able to do.

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Prevention, we need to be able to do friends diversion and you know obviously.

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Support programs that we know work like drug or medication, assisted treatment. We.

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Have to look at housing first, employment! First, all of these programs and.

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Protocols that we know that are out there but truly meet clients where they.

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Are and their level of readiness, because you know somebody who's, maybe shooting.

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Up by the heroin everyday isn't ready for an abstinence based treatment, but.

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Would be interested in something safe, it won't have a safe place to sleep. I mean.

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That might just be where we start with that individual yeah. That's what I'm.

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Gonna say I know that I'm trying to get silver plenty of times and I would go to.

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Like 30-day treatment centers and you go there and you don't have anything you.

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Leave and you go right back to the same way: you're not changing today, so I tried.

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That several times, I think I wasn't covering certain times. You know.

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Because I didn't know what to do last time I went to jail. I remember getting.

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Out and thinking I know you know what do I do here.

D

So that's whenever I ring to a friend that you were peer-run was, and I applied.

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For a job there, because once I did that, then I started getting support. You know.

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And I certainly don't you reach out and talk to people, because if I would have.

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Done that that I went back home and I would stay at my room- baby frustrated.

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But I had people get on board and help me because you got to change every.

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Aspect of your life and you have to change people places things, so I feel.

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Like once I got home with that job, he gave me, you know some compliments can.

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You talk about that job, the peer-run program. It's a partnership between.

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Between center stone and the city of bloomington, and I work for the parks, the.

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First year it was just a part of our community likes his parks, but since then.

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And just to describe it a little bit, it was a program to say people who are.

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Homeless, we might be able and the city of bloomington a hard time.

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Selling these positions so but.

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Housing she worked at this one day, not talking about. I didn't have happy, so she.

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Was job now it's not there to stop treatment center like there about the.

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Isolation, the lat impractical addict, so so there was a.

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Connection and so you're always alcohol. Yes, yes, which is so powerful. It's all.

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Very common sense: when you think about it, you get out of jail. You have one kind.

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Of life, you need a little support and in finding another kind of life you know it.

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Just took us all that really expensive.

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Like we need, we need employees. This is terribly hard work. You know where I.

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Think this this brings up, though, is one place that I've found is very, very, very.

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Important that needs to change deeply, and without it I cannot see how we can.

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Get away from this, and that is a wavy ground of jail. I've spent some time and.

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Really, the type of kentucky's done a lot of change in la to jail in certain areas.

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And in kentucky some spending time in kenton, county jail, which is right across.

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From cincinnati and they have a whole new pot where basically, they repeat what.

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They would find at your center, but it's for I don't know how you do it here. It's.

B

It's 24 hours, you know you don't leave you're, always working on your recovery.

B

Waking up making your bed very neatly and then you're going to class. If you.

B

Want also, and then when they figure it out, of course, probably knew but didn't.

B

Have the political ability to accomplish them till recently? Is all this really.

B

You leave jail to chandlers for years to spit okay you're on my channel. I don't.

B

Think you're gonna, you know until I see you again, which was.

D

Yeah well now they're figuring out well yeah, but what you also need to do is.

B

Transform jail-jail needs to be done in a radically different way, because it's.

B

Been part of the problem of crime and part of the problem with addiction from.

B

Sins forever and then you do that change jail enough. You know.

B

Route when funding them in a way, but they have to provide just exactly what.

B

You're talking about anna, which is all these community services, and then it.

B

Still is not perfect, but it's if you kind of hear you're getting that, because.

C

We actually do have a partnership with the jail here where we have a 12-bed pod.

C

For men, which is 24/7 exactly, you talked about 90 days, while there.

C

Which is small, but they found it in this one child is it's actually overalls? I.

B

Can cheaper to run the jail that way because the inmates are buying in there.

B

Cleaning there's not many fights, there's less contraband weapons are not as common is, which is not to say, there's no problems.

B

There's still problems and they're they're serious, but it's it's like this.

B

New way of dealing jail that when you think about it with addiction and crime,.

B

Both are exacerbated and fomenting by the language I'm done jail up to now. If.

B

You break that so now, which is what my next book is about: aggressive responses.

B

And one's gonna be about how jail might change and just kind of.

D

If you're in beverly, you all have been exploring a whole other option that I.

F

Think you should really bring up. That seems very unemployment. It's a modeling.

A

You've described in the book, can you talk best in the suman, assisted.

E

Diversion center, so yes in other communities and hoping to even keep.

E

People out of the jail system that don't need to go there, we can, if we can direct.

E

Them to services and treatment prior to arrest. You know, then maybe we can get.

E

Them to be community members of in a different way, and so we also looked.

E

At a crisis diversion center we're looking at space and looking at you know.

E

How that would be said linda, you may know more about the internal work yeah.

C

Well, you know, so we went to fayetteville north carolina to look at how they're.

C

Doing the law enforcement assisted diversion program and I think one of the.

C

Things that we found that was particularly striking is a lot of the.

C

People that needed to be diverted were people who could touch the jail again.

C

I mean how my wiki were talking about dna. It was you know, kind of the first.

C

Time, whether it's the jail or the emergency department- and you know we're.

C

So fortunate in wilmington to have a very progressive police department that.

C

Does a lot of community policing works very closely with us and other providers.

C

To ensure people that don't belong in jail, don't end up in jail to get.

C

Services services to make those connections, but you know, there's not.

C

Necessarily a place to divert people to and who who lead was working with there.

C

Were a lot of people who were in and out of the system to say like okay, let's.

C

Come up with a different plan for you, so I think what we found is that, in order.

C

To do the law enforcement assisted diversion? Well, we actually have a place.

C

To divert them to, but it's not you know the evening or.

C

And so we've been looking at some locations and again really exploring.

C

Some some options, and you know I think the other thing is bloomington. You know.

C

He's been doing a lot of prosecutorial diversion a lot of work just around bail.

C

You know to make sure that the diversion with their downtown resource officers.

E

Have been doing that as well as well as we have for problem-solving towards, we.

C

Definitely have a lot of resources. I really thought the needle exchange.

C

Either yeah, I you know, that is obviously a big issue in indiana, as evidenced by.

C

The hiv outbreak in scott county- I know I know you- were down there last.

F

Year- and you know that was the first place- that we were able to get a needle.

C

Exchange but that has been absolutely huge amount of community and just so.

C

That harm reduction. What I just feel like that, it's not just about me toes.

D

It's about them coming together with the community and making changes for people.

D

They reach out, they help the dozen essential part of a needle exchange like.

D

You know it's not about people are like. Oh there's, no.

D

Really doing that, they took their time. They work with people, their mom, they're.

D

Teaching you how to safely use that so teaching the community? How to you help.

D

Somebody, if they overdose like they do stuff like they're, not sharing out.

D

Needles, I know my daughter is tonight: they helped her. They got a scholarship.

D

For treatment, program and she's been doing amazing since so, I think part of.

B

The needle exchange makes it controversial is like methadone clinics.

B

Like a lot of strength, it's how you do it and sometimes that's been done very poorly without that component. You just mentioned and let other times it's done.

B

Very well and it's essential to keeping a lid on you know it's not just a.

E

Syringe that you need to meet you again, it's not just host of things, and so.

E

What's interesting is remember, leaves and all this is how common sense and.

B

Obvious all this, no, you just tell me one things.

B

This realization came to me early on a good way through. The book was like.

B

Actually existed, all these things need to be happening, and yet, in our culture.

B

It's like somehow a revelation.

D

And maybe that connection and then make it another connection, well with that she.

B

Knows I think is saying earlier is that the root of all this is a profound.

B

Isolation in almost any form of lightning that the facet of life in.

B

American today you want to mention professional political, cultural.

B

Neighborhood on and on and on and on you see this inability to see that if you.

B

Work this way it doesn't really go very far and he had work this way and.

B

Actually, you know obvious ideas suddenly become like such a beautiful.

B

Distillation of the whole idea, which is what could be more simple than a cup of.

B

Coffee and yet it just seems to have a ripple, in fact, there's no other way to.

B

Do it, in fact, we are in a situation now where we have drug trafficking groups in.

B

Mexico in china, maybe other parts of the world as well on for sure who behave.

B

Like multinational corporations with sophisticated ability to shift.

B

Production and marketing and distribution in ways will be when I.

B

Lived in mexico ten years and I always got used to people from the drug.

B

Trafficking world being kind of like hillbilly types, yahoo was shooting the.

B

Guns on three in the morning, a little party I think.

B

That's not who they are anymore, and we live with that that isn't constant. That.

B

Is something every every policy has to take into account when it deals with.

B

This in this realm- and I think that that that's, why focusing on strong.

B

Communities, whatever drugged-up has become down.

B

Pipeline is really the issue you cannot say well, so morgan asks earlier this.

A

Month, npr published a story, highlighting quote another epidemic, that's been.

A

Brewing quietly but vigorously behind the scenes methamphetamin as communities.

A

Become more and more hyper focused on the opiate epidemic, how do we ensure.

A

That we are providing resources and passing legislation that supports all.

A

Peoples experience substance, use disorder, not just those using opiates.

A

And I would say that to understand that we are not in may have started my.

B

Research thinking of an opioid epidemic, addiction, epidemic and now I'm just.

B

Thinking of an addiction, epidemic and so foreigners are finding in.

B

Toxicology reports, people dying with four or five drugs and their siblings.

B

Antics to see all that other stuff too, and so I think again it's getting back.

B

To the focus has to be on cementing, creating and cementing community.

B

Alliances, ways of working that naturally reach out to a wide variety of people.

B

For one thing, for example- and this is a big part of what I'm writing in my next.

B

Book one one example would be: churches. Churches have been great for years at.

B

Dealing with people who families were in kid has leukemia. The father has a injury.

B

On the job can't work churches through magnificent job coming together, they.

B

Don't do a really good job when it comes to rape, sexual abuse, child abuse and in.

B

It, but I think the crucial component in all this is that churches need to be.

B

Involved because so much of what goes on in a church has helped to stifle the.

B

Discussion of this, and if you look at where this this opioid epidemic got.

B

Going first, it's in very, very healthy church areas. All you know, you're talking.

B

About appalachian front of west virginia kentucky tennessee indiana. All these.

B

Places have lots of churches and churches were not, or maybe even part of.

B

The silence problem, if you ask many frankly, they they need to be brought in.

B

That is where community is created every sunday they it's not like, it would be.

B

Nice is it absolutely, they have to be part of.

B

Them they have to understand that their role is, is essential in creating the.

B

Problem and essential and beautiful when when they can be part of the solution,.

B

And so it's using the community approach to not worry about is it? Is it harold.

B

Today's a felon today is it: is it math, it's all in addition, and all is treated.

B

You can't treat methamphetamine with medically assisted treatment with.

B

Suboxone and though the trouble you can treat all of this with a community, I.

A

Would really love to know from your perspective, do you see you talk a lot.

A

About the undoing the silence and how that played a really huge role in a lot.

A

Of these communities, the solace great britain yeah sure, um are you seeing.

A

Families being forthcoming, hear about this problem.

F

I mean you are super brave, coming talking about, you know, being vulnerable.

A

Are other people, like you, rdc a group of families coming together to try to work.

A

Against this problem, yeah, do I see a lot of.

D

I worked with a lot of people daily that want help and they come in and ask for.

D

Help and they want to make changes in their life. I also see families that you.

D

Know like me, I had to separate yourself because, like you said, you have to start.

D

One person at a time you got to help you, but I've also, you know, like the.

B

Contagion, addiction almost like a disease kind of a virus. I can't believe.

D

You turn around like really the people that are getting sober today, I'm just.

D

Really, the focus has been on the building community and building.

C

Community partnerships across the board, I mean it's: if you look at even the.

C

Faith community, you know in bloomington we have the interfaith winter shelter.

C

Where churches have really come together to ensure that you know homeless, people.

C

Have access to at least a safe place to take the church.

C

Drop-In center yeah, regardless of whether what you want you can come, get a.

C

Cup of coffee- and you can talk to someone kind of figured that way through.

C

But I think the point of you know recognizing the vulnerability of our.

C

People- and that was one thing that we haven't mentioned yet, but but was a real.

C

Eye-Opener for me in your book was how people are specifically targeting the.

C

Most vulnerable people, whether it's people at methadone clinics or people's.

C

You know standing outside of treatment center that we have to really like have.

C

A community to support people, we have to have the counties who are willing to be.

C

Brave and in every church and people do have stories that they can share and the.

C

Way to start making kind of the flipside more transparent and open, because you.

C

Know there is a heck of a market we're going to have to continue to deal with.

C

Yes, I think that's that's true, and we need to understand, I think, for example, I.

B

Get back to churches just because I noted made way not too long ago. You.

B

Think about it, I was in eastern tennessee.

B

Problem if there so many churches would not be the community that you would need.

B

To keep people from this and turns around, I think one of the reasons is.

B

Because people in church yeah part of it is they don't want to deal with this, but.

B

Then also, I will say this: a lot of addicts don't believe they belong in.

B

Turns they feel ashamed like I'm, not I'm dirty, I'm good. I'm good.

B

Enough to be around these people and they may not look you know, then they.

B

Smell they make you know like you baby, it's also learning to be around people.

B

B

When norman told me recently actually couple of days ago in a parking lot in.

B

West virginia, you know, was what you were asking before yeah in terms of you know,.

C

What do we do as a community? It is recognizing again what is most important.

C

To that person it may not be being clean, and so it may be. I need to say a place.

C

To live and looking and helping work, and then you know what comes next so my.

A

Kids, you know so so it really what's a priority for each person is really.

C

Different and having that flexibility to work with them, but also to take our.

C

Services from sort of behind the walls out into a community. How do we support.

C

People in real time, how do we show that yeah well, an important life skill is.

C

Showing up on time to work, you don't show up on time every day. What are the.

C

Consequences and actually helping somebody work through that or you know.

F

They relapse last night, so they don't feel like that worth it coming in today.

C

Going out, you know working with them there, so I think it's a flexibility in.

C

Terms of the way that we work and a recognition of the disease episodes one.

A

Size fits all exactly like working there, just like it was different.

D

You know so it's just been, it's been a.

A

Thank you for sharing it with us and thanks everyone we're coming up on.

A

One o'clock, so we should probably wind our conversation up, but there's more you.

A

Can hear more of sam quinones...

A

Sam right here we'll be talking about his book dreamland and.

A

Much more tonight at the buskirk show here at 6:30.

A

Please join him for this. You can tickets, three buskirk show a box.

A

Office, I think it's they're still available. There's a few a few now it's.

C

Tough, you know, and it's very read, that's right.

A

That dct box office time, thank you so much for joining us today.

A

Linda grove-paul and tammy hooton from center stone and beverly calendar-.

A

Anderson., I'm yael ksander thanks a lot and see you next time.