Community Case Study

Introduction 

The Opioid Crisis in America has immensely impacted the lives of many negatively. In fact, the opium-poppy painkiller sold to citizens not only led to addiction but also the death of at least one hundred people a day following overdoses. According to Califf, Woodcock and Ostroff (2016), the opioid crisis has claimed many lives. Further, it has had a toll on children as well as the workforce. In their research, Califf, Woodcock and Ostroff (2016) note that these consequences are worthy of scholarly attention because presently, there is an urgent need to address cases of violence, old age addiction, and related consequences. It is important to note that whereas people living in urban areas have had easier access to medical services combating this addiction, their counterparts in relatively rural areas have been struggling with this menace. The purpose of this case study, therefore, is to investigate opioid crisis in Youngstown, Ohio under the following subheadings. 

Community Assessment 

Demographics 

Youngstown, Ohio, is a community based on the Mahoning River which is approximately 165 kilometers from Cleveland. According to the latest American census recorded by Anderson (2015), it is reported that the racial composition of Youngstown includes 47% Whites, 45.2% Afro-Americans, 0.4% Native Americans, 0.02 Pacific Islanders, 3.3% other races and 3.7 from mixed races. By approximation, Youngstown is stated to have more than 65000 residents whose median income is the lowest among the cities of US. Calvert (2016) observes that Ohio used to be referred to as “steel valley” due to robust activities of steel ware. The density of the population, according to Anderson (2015), measures around 1,944 and the trend since 2009 may reduce to 1707 by 2019.

One striking feature of Youngstown is its high crime rate. According to Schatz (2013), Youngstown is not only a city that shrinks but is also characterized by organized crime in the US. It is further revealed that the town is rated the 9th most dangerous place in the US. The decline in economic development has lately seen Youngstown record a median income of $24,361 which is relatively lower than American average of $48,849. This presents a poverty rate of 49.7% (William, 2011). Youngstown borders regions such as Cottage Grove, Oak Hill, Cornersburg, and Riverbend among others. The education of the town comprises of Primary, Secondary, and Higher levels. In primary and secondary, there is an estimated graduation rate of 65% (The Vindicator, 2013). A number of colleges offering performing arts, music, engineering, and business among others are also found in this town.

History

The history of Youngstown is traceable to the year 1797 when a settler purchased land around Mahoning region. According to Fuechtmann (2009), around ten families continued living around Mahoning River leading to incorporation of Youngstown in 1802. It is important to mention that in the very year of 1802, a Hopewell Furnace was constructed to deal in coal and iron deposits that had been discovered around the area. Fuechtmann (2009) says that construction of the railway would later begin in 1830 thus connecting Pennsylvania and New York. The continued networks increased trade and settlement so much that by 1890, the population of Youngstown was above 33000. The construction of steel industry in the 1800s attracted many traders such as Hungarians, Poles, and Italians who settled and increased the population to around 170000 when Youngstown became the second largest producer of steel ware (Fuechtmann, 2009).

Increased trade activities also increased conflicts among workers who demanded more pay. This is what has presently led to increased crime as many of such workers who had settled in the region were laid off. Labor movements and trade unions that resisted steel factories had an immense impact on trade and population of Youngstown.  For instance, economic growth slowed down in the 20th century as population also decreased. However, increased unemployment led to organized crime and violence that is witnessed today.   

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Community Culture

Although the steel industry collapsed in the 1970s, the decline in population in Youngstown has not made the cultural heritage extinct. Latest efforts aimed at the resurgence of business in Youngstown have revived rich cultural orientations of the region. The history and traditions of the town have been directly contributed by the mixed community residing in the area. As Calvert (2016) notes, the rebirth of this city has lately revived the celebratory events which are peculiar to the town. It is important to note that Youngstown city highly regards cultural celebrations through events which gather people in restaurants, bars, galleries and other public places. A social gathering is one distinct characteristic of the culture of these people. Sporting activities are highly valued as they bring together people from different racial backgrounds (Calvert, 2016).

One particular cultural in Youngstown is the Canfield celebration that takes place annually. This event is considered as old as 200 years and brings together over 400,000 individuals to celebrate the cultural roots that have been realized due to multiracial interaction in Youngstown (Fuechtmann, 2009). The gatherings are often entertained by tractor pulling, livestock display and other forms of entertainment. There is also a remarkable coexistence of nature and culture in Youngstown city that comes out through folkloric compositions to embrace all cultural roots of all citizens irrespective of the origins.

Health and Welfare Resources

Several health issues have affected the provision of medical care in Youngstown. By way of example, Winstanley et al. (2016) argue that Ohio is rated the highest in terms of an overdose of opioid substances. This has particularly made it difficult to fully address other related health problems having in mind that these addictions are equally tragic to the lives of citizens. By 2014, Ohio was reported to be leading in the number of deaths due to an overdose of opioid and related substances (Winstanley et al., 2016). The Ohio Department of Health, private and public funding sources have been on the frontline in the provision of health and welfare services through various kits meant to counter addiction. Additionally, a majority of health issues in Youngstown and Ohio in general border on matters such as obesity, smoking and high blood pressure among other related issues. The welfare services offered by the Youngstown Neighborhood Development Corporation and Goodness together with affiliated. 

Some of these resources include kits that alleviate the plight of people suffering from arthritis, cholesterol, asthma and addiction cases. Although these bodies have dedicated their efforts to provide healthcare in the town, it is necessary to stress that certain parts of the Youngstown are not easily accessible due to geographical hindrances. This has often led to the neglect of a number of serious ailments which ultimately lead to death. Writing about this, Winstanley et al. (2016) observe that some people have never had access to basic health services and resource due to isolation from accessible terminals. He, therefore, proposes that welfare groups should penetrate the interior of this town to reach the victims of addiction who have highest statistics of death in the region. Strengthening this service would be a sure way to combat health crisis in the town. 

Power Brokers and Social Networks

The question of opioid addiction can be sufficiently addressed if the existing power brokers bring the desired changes in the society. A number of networks exist in Ohio. Addressing this matter, Xu, Ramanathan, and Ramnath (2014) argue that the role of opinion leaders in shaping national result through various social networks is unparalleled. This is simply because they are the spear headers of desired change. The opioid addiction that has become a crisis in Youngstown is currently being addressed by key opinion leaders. For instance, AON, a health insurance broker is a leading think-tank on health matters in Ohio today. Cummins and Doherty (2006) note that AON has been actively involved in emerging health issues such as a pandemic, crisis management, healthcare reform and terrorism. Opioid addiction fittingly falls within this list and is, therefore, one of the issues being addressed by the AON broker and an opinion leader in Ohio.

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It is also necessary to recognize the role of community leaders in shaping the attitudes of citizens regarding drug and substance abuse. According to Jones, Simmons, and Galea (2017), drug abuse has become of special attention to the present and former Senate presidents who reconnect to strengthen social networks aimed at boosting scholarly research on the consequences of addiction on the American society. These networks have lately assisted in the creation of peer support services and education of support doctors who offer emergency services to addicted victims. The sharing of skills, knowledge, and resources among these social networks has contributed to reduced administrative barriers hence reduction of trauma cases across Ohio. 

Youngstown’s challenges with regard Opioid Addiction and crisis 

The present research chose Youngstown due to a number of challenges it faces in the health sector. To begin with, it had been earlier mentioned that Ohio is rated 9th in crime rate and addiction to opioid. This makes the choice an appropriate one worthy of scholarly attention due to the alarming statistics. According to Winstanley et al. (2016), addiction cases are perpetually increasing in Youngstown town since the year 1999. This crisis is what has presently seen the US President declare opioid a health emergency because of the number of lives it has claimed (Grzelewski, 2017). It is equally interesting to note that Youngstown has been cited as one of the towns with limited access to treatment facilities due to its geographical location. This has led to more deaths than any other place in the US. 

Grzelewski (2017) contends that pharmaceutical companies responsible for the manufacture of the opioid drugs have posed a serious challenge in trying to combat this vice. This challenge has not been of greater effect in other towns as in Youngstown. This means that Youngstown has greater challenges in manufacture and distribution of drugs to its drug houses. Other alarming statistics reveal that the mortality rate in Youngstown is very high. Grzelewski (2017) observes that around 4000 deaths are reported in Ohio yearly due to opioid-related cases. This data places Youngstown at a particularly critical point in the drug debate thus warranting immediate remedial action. 

Youngstown has also faced many challenges caused by addiction. For instance, a sharp decline in the workforce has seriously affected the economy of the town thus reducing the median income per household to a figure below the average US figure. The reason behind this, Grzelewski (2017) explains, is due to drug tests employees have to pass before recruitment. They are therefore locked out of lucrative opportunities because of the opioid menace. Against this background, it is critical to investigate the remedial measures that can be taken to avert the already alarming emergency in Youngstown. 

The opioid crisis is posing a challenge to residents of Youngstown because of small staff entrusted with numerous cases of drug addicts. Kolodny et al. (2015) observe that the war on drug addiction is yet to be won because the workforce is still dismally small. This fact is further complicated by the longer distances that have to be often traveled to assist addicts with opioid drugs. This idea is stressed by Jones, Simmons, and Galea (2017) who adds that longer distances are a hindrance to medical procedures especially if patients reside deep inside inaccessible regions.  

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Another challenge faced by Youngstown is the problem of dealing with side effects on children. It had been mentioned earlier that the consequences of this drug have equally taken a toll on children and the old alike.  Statistical information retrieved drugrehab.us website reveals that at least 8 million children in the States have one parent addicted to opiates. This translates to 14% of the cases of children under the age of 2 years and 10% being between 12 and 17 (Grzelewski, 2017). Developmental and behavioral issues that arise in homes are solely blamed on the addiction of parents.

The implications of these effects on future generations cannot be ignored.  It is observed that parents who are addicted to opiates have a higher degree of contracting HIV thus directly affecting the lives of children. There is a direct link between parents’ addiction and the next generation (Carey, 2016). In cases where parents have passed on, foster parenting has left many children destitute thus increasing lamentations on the dire consequences of opioid addiction among parents.  These challenges experienced in Youngstown are not different from the contributions of Quest et al. (2015) who reiterate that urgency of response should be executed because of gaps in drug availability, infrastructural limitations and increased cases of HIV and HCV infections from parents to future generations. A combination of these factors has made a number of patients feel disenfranchised and oppressed yet the cases are beyond their perception.

Theoretical Analysis 

The drug addiction menace in Youngstown requires certain theoretical underpinnings in order to be properly scrutinized. For purposes of this research, Symbolic interaction theory will be used. According to Roark et al. (2013), the interaction among members of the community is responsible for the creation of certain attitudes and perceptions regarding almost everything in the community. This, therefore, means that all that happens in the society is given a subjective look based on the perception of the community members. In this theory, the judgments made in the society are based on the subjectivity of individual members. In the opinion of Roark et al. (2013), every community has the right to embrace what they feel is noble among them. It is at this point that this theory finds its applicability in Youngstown where individuals have constructed positive meaning out of the dangerous opioid drugs. 

Symbolic interaction theory also says that although there might be an objective way of judging a phenomenon in the society, human interpretation often overrules. This is the idea echoed by Vannini (2016) who observes that a community may collectively reason that drugs are cool. This idea, therefore, overrules the actual known fact about the danger of drug addiction. The social learning process is a concept that teaches the individual members of the community to embrace a commonplace ideology even if it is to the detriment of their lives. In Youngstown, the Symbolic interaction theory is responsible for drug and substance abuse, an overdose of opioid and careless giving in to certain diseases because the social concept learning has prescribed these as cool ways of living. There are at least three tenets of Symbolic Interaction Theory.  These include meaning, language and thought.

The correlation among the tenets of this theory and the challenges faced by the nationals regarding opioid addiction is very clear. According to Winstanley et al. (2016), the increase in written prescriptions and dispensing of opioid drugs has made several people believe such drugs are beneficial to their health. This erroneous thought has been developed and practiced among all who apparently are addicted due to the meaning given to the drug. Closely connected to this is the aspect of language whereby individuals involved in drug abuse have formed a language to avoid direct mention of the deviant behavior. Additionally, Vannini (2016) argue that coinage of a code of expression is geared towards reducing labeling among the users of drugs. This is exactly the situation in Youngstown. Lastly, though as a tenet of the theory stipulates that some agreed symbols are binding in nature as a reference to them evokes similar feelings among drug users. 

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Solution/ Intervention 

Having investigated the above addiction and related consequence s of opioid in Youngstown, it is imperative to recommend practicable strategies that can solve the already alarming situation. The recommendations proposed in this case study are collected from the deliberations of social workers who have varied experiences with addicts of opioid. Firstly,   increased access to substance use treatment services is a sure strategy to address the menace. According to Newcomer (2015), there is urgent need to move from abstract knowledge to practical access to information that directly addresses the plight of these addicts. It is undeniable that whereas efforts have been placed on solving this problem in the entire United States of America, delimited attention has hitherto been paid to places such as Youngstown. Against this backdrop, it is a recommendation that thorough coordination should be conducted by practicing doctors to locate the families with such patients so as to give individualized care to the addicts. Newcomer (2015) cushions that social health workers and mental health workers should design accessible programs that reach the victims where they can be found.

Another solution to this menace could take the step of educating local doctors. Many suggestions have been made blaming the consequences of the menace on inadequate education and lack of professional preparedness among the doctors. Vannini (2016) argues that many mental health workers are presently underutilized as their mental faculties are being tasked in other areas like alcohol addiction when indeed opioid menace requires more urgent attention. This is further complicated by the fact that basic training on dealing with rehabilitation and treatment has not been emphasized.  In every hospital, the emergency department should be given special treatment to potential opioid dependent addicts in a professional manner. This will ultimately reduce death cases due to opiate addiction. Integration of education on drug abuse in school curriculum can also assist address this menace in Youngstown and Ohio at large.

War Opioid addiction cannot be completely won without Peer support services in place. The information brokers in the community of Youngstown can offer informational, emotional, instrumental and affiliational care to the addicts without stigma. Solomon (2004) observes that many benefits are reaped when peer recovery services are put in place to combat addiction. This approach is significant in tackling addiction through mobilization of resources and team building.  Notably, scholars (Solomon, 2004; Vannini, 2016; Roark et al., 2013; Calvert, 2016)   agree that self-disclosure and the use of rehabilitated stories would be a powerful tool to face the opioid addiction crisis in any country. Therefore, by forming a peer group with a mentor coach, the addict is able to see the role model thus evaluating the possibilities of recovering from the crisis. This is easy to facilitate because the addict identifies with the peers who will ultimately enhance self-observation, tolerance, gratitude, and acceptance. The difference between these systems and institutional approach is that is absolutely free from coercion that characterizes such places.  

Increased staff for the social workers in Youngstown will greatly reduce the effects of opioid addiction in the region. Calvert (2016) is of the idea that any attempt to increase the staff in healthcare automatically reduces the ratio of provider to the patient. The general result is that individualized attention is given thus reduced complaints about disenfranchisement and negligence. The Youngstown case is special because increased staff will penetrate the hidden locales of town. It is only through increased staff that communication can be established and follow-ups made with patients.

Drug addiction in Youngstown equally needs to be addressed through legislative strategies. Winstanley et al. (2016) argue that opiates are leaving drug houses due to laxity by the government to enforce stringent measures. In fact, a balanced approach must seek to ban the manufacture of these drugs in Ohio and America in general. It is shocking to reveal that narcotics and other hard drugs are easily sold on the streets yet the government and health workers are simply watching. It is, therefore, the recommendation of this paper that strict regulations must be passed by the Congress forbidding the distribution of such drugs. It is undeniable that the spread of opiates in America has been caused by the fact that it is easier to prescribe them than non-addictive drugs. This can only be reversed through legislation. For instance, insurance companies in the health department should not allow cases of buying heroin, fentanyl, opium and other related dangerous drugs. This will greatly reduce cases of opioid addiction. Along this line, the policies dealing with patients’ access to pain relief should be revisited and opioids thrown out of the equation.

Finally, Youngstown can dedicate its efforts to scholarly research and campaigns that seek to mobilize people against the drug. This strategy can work especially if the peer support is included because some addicts are already feeling stigmatized and would not open up to treatment options.  The funding can as well be used to expand referral services to the uninsured patients so that they do not bear their burdens alone. The health department in Youngstown can use this financial strategy to develop a reimbursement program for prescription of opium screening or treatment in emergency cases. This will particularly make the addicts feel empowered and joined in the fight against the crisis.

Conclusion

In conclusion, this case study set out to investigate opioid crisis in Youngstown in Ohio. Throughout the research, it has become apparent that many factors contribute to the addiction to opioid both in this specific town and America at large. The historical background of the town has proved to be a great contributor to the present use of drugs among the communities in this town. Using the Symbolic Interaction Theory, the research has established that societies interpret concepts according to subjective perceptions thus influencing greater populations to take drugs. The result of this theory is the present addiction that claims at least 4000 lives in Ohio. The paper has made a number of recommendations that should be taken by the department of health and the government to avert this crisis. Distinctly, the war on addiction should take a practical approach whereby citizens are involved in concrete attempts to address their problems. Collaboration among the government, professional bodies, opinion leaders and the general public would be a sure way to combat this problem that is presently an emergency in America.