By Sarah Ladd, Kentucky Lantern

Kentuckians in recovery say the state needs to better educate youth about addiction, digitize expungement for certain crimes and make harm reduction and community-based services more widely available to combat overdoses.

About 30 people gathered at the Women’s Healing Place in the West End of Louisville Wednesday as part of a “Public Health is Public Safety” tour aimed at finding solutions to the opioid crisis and raising awareness about what addiction looks like from person to person.

That tour has made six stops across the state this year — in Ashland, London, Bowling Green, Hopkinsville, Lexington, and now, Louisville.

John Bowman, the Kentucky campaign organizer for Dream.Org, which organized Wednesday’s panels, said drug criminalization often drives people to harder substances.

“We made all these laws on prescription opioids. Everybody went to heroin. We made stricter laws on heroin. Everybody went to fentanyl. We’re making stricter laws on fentanyl, and everybody’s going to xylazine,” he said. “The measures that we’ve got in place now are really, really making it hard for us to keep getting the overdose rates lower.”

Bowman also worries that a 2024 law that supporters called the “Safer Kentucky Act” and opponents said would criminalize homelessness could cause overdose deaths indirectly.

Another provision of  House Bill 5 created a first-degree manslaughter charge when a person “knowingly sells fentanyl or a fentanyl derivative to another person,” which results in that person’s death.

“It’s kind of like a drug-induced homicide law,” Bowman said. “And it’s going to make folks scared to call 911.”

Carson Justice, a 17-year-old from Eastern Kentucky who said addiction has affected her entire community, including her parents, said the state should invest in more harm reduction and less criminalization.

“Instead of bad policies like House Bill 5, we could have prison aftercare, we could have harm reduction resources, we could have IDs, we could have all kinds of things,” she said.

By focusing more on harm reduction, she said, “Not only could it save us thousands of dollars, it could save thousands of lives.”

Lawmakers should also focus on revamping reentry programs, lowering what counts as “intent to distribute” and ensuring people can access a full range of treatment while incarcerated, Bowman said.

Several panelists who discussed their treatment and recovery echoed that point, saying they did not have access to help while behind bars.

Amanda Bourland, who has lived through addiction and incarceration and is now the vice president of mission advancement at Recovery Now, said, “When I got out of prison, there were no resources for me.”

“Four years in prison, in a row, and nobody said, ‘Would you like to learn how to live a life in recovery?’ Nobody said, ‘Do you think you have a problem with drugs and alcohol?’ Bourland said. “What they said was, ‘Chow ladies.’ ‘Lights out ladies.’ ‘Meds ladies.’ That was it.”

‘Trauma is the gateway’

Over three hours, two panels and a series of small group discussions at the women’s campus of The Healing Place, advocates and people in recovery emphasized that widespread access to harm reduction is key to lowering the number of Kentuckians dying from overdose.

Harm reduction is anything that decreases the harm a person may experience — like wearing a seat belt when driving or brushing teeth to avoid cavities. In the context of substance use, harm reduction includes the use of the overdose-reversal drug Narcan, fentanyl test strips, syringe exchange programs and more. Harm reduction emphasizes engaging directly with people who use drugs to prevent overdose and infectious disease transmission, says the Substance Abuse and Mental Health Services Administration

Stigma sometimes stands in the way of recovery, advocates said.

“In this country, we still view substance use disorder as a moral failing,” said Tara Hyde, the CEO of People Advocating Recovery who is also in long-term recovery. “And until we, as a community, really gather together and really start to create more of an argument against that narrative, they’re going to continue with that, because that’s all that they know.”

Stephanie Johnson with Vocal KY said the word “addiction” is still quite stigmatized — and asked the audience, “How many people would not move or have gotten dressed without a cup of coffee this morning?”

“Changing the narrative,” she said, “is harm reduction.”

Focusing on mental health for people in active addiction and recovery is also “huge,” Johnson said.

“You can have a mental health issue without having a substance use issue,” she said. “You will not have a substance use issue without having any mental health issue. We have got to address mental health. Trauma is the gateway.”

Youth education and recovery funding

Lawmakers should codify a requirement for schools to have uniform education on mental health, Hyde told the Lantern. There are “quality” programs available, she said, but “there’s no requirement, so not every school gets that.”

“This is a systemic problem. And we can’t just, (say), ‘Oh well, this school has it, and this school doesn’t,’” she said. “You can’t just make it bounce like that; that’s a really big problem.”

The state could also save itself money, Hyde said, by funding long-term recovery programs. Usually, a person attempts recovery an average of six times before being successful, she said, meaning their treatment could cost around $180,000 by the end of those attempts, which are usually in short-term programs.

Some research suggests longer programs are more effective, especially in dealing with severe cases.

“A lot of that money is already being spent,” she said. “Medicaid is paying for each attempt — six on average.”

Justice’s mother, Beckie Rose, shared a panel with her daughter.

She’s from Pike County — from “coal mines and coal fields and mountains,” as she described it, as well as “ground zero” of the opioid epidemic.

Rose is in long-term recovery now, and she advocates for a better future for her daughter and the Eastern Kentucky community.

“We have way more in common than we have differences,” Rose said. “And I would just like to see our communities and our families come together, and instead of incarcerating disease, start treating disease.”