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Communities on Drugs

Editor’s Note:  For years, Paul Komarek has been studying, advocating for and building models of restorative justice and community-based addiction/mental health treatment. The data shows that John McKnight was right–that professionalized services are not only too expensive to be sustainable,  but will never solve our social problems because they dis-empower citizens and destroy the very community fabric within which healing occurs.  (See the Starfire Council for a community-based model for dealing with developmental disabilities.) Below, Paul talks about efforts in N.Ky. to address addiction through community volunteers.  Paul can be reached at  


This past week I have been informally assessing how community members view the heroin epidemic, and how willing they are to participate in the work. My conclusions:

  • Community members are saying that lack of treatment is driving overdose deaths.
  • Community members are expressing willingness to commit to volunteer service.
  • Knowledgeable community members support harm reduction (syringe exchange).

On Monday February 1, I attended the Independence KY City Council meeting. Council voted 5 to 1 to endorse syringe exchange as part of the region’s harm reduction strategy. Over thirty members of the public attended the meeting to support that measure. There was no organized opposition to the proposal, although two people spoke against it. The Enquirer reported that the Tea Party was trying to drum up opposition, but that never materialized.

On Tuesday, I attended a faith-based heroin support effort at a Baptist church in Goshen, Ohio. The organizer wore a work shirt with the logo of a large Catholic hospital system. When I mentioned my support for placing leadership for addiction care squarely within such systems, she said she was “just a peon” and could not imagine what it would take to gain her system’s commitment. At the meeting, attended by approximately two dozen people (a mix of people in recovery and family members), there was universal agreement that people are dying because they cannot access treatment. People are willing to commit to recovery, but nothing is available. I mentioned the Addiction Services Council’s phone referral service in Hamilton County. Their typical window for placement into treatment is five days. People at the meeting said that most people who use heroin can’t wait five days. They become discouraged, and disaster strikes. A volunteer-led effort is emerging in Clermont County to try to duplicate Colerain Township’s community outreach program (home visits to people who have overdosed and revived with Narcan). I offered to adapt my state-certified case manager training program to support this effort.

On February 3, I attended a faith community outreach event sponsored by the NKY Office of Drug Control Policy and NKU’s Scripps Center for Civic Engagement at the Life Learning Center. Approximately 80 people attended the event. Sr. Kay Kramer from St. Elizabeth Healthcare spoke about her work with children born with NAS (addicted to opiates) and their families. A facilitated discussion that included interactive polling of event participants revealed that nearly all who attended the session (80 percent) said they were very familiar with issues around heroin. A majority of those attending said participating in a volunteer service and support network for people affected by addiction ranked first or second among their likely next steps.

Since 2012 a large part of my work has been exploring what ordinary people can do about mental health and addiction issues in communities. My last major blog project was called Redesigning Mental Illness. Its tag line is “Ordinary people help each other cope with depression, bipolar disorder, anxiety disorder, PTSD, and schizophrenia every single day in every culture on earth.”  More recently I have been more focused on what to do about the heroin epidemic. I have been writing with Dr. Jeremy Engle, and publishing what we are doing on a website called Heroin Policy Institute. My latest book is SHARP Stop Heroin and Rescue People.



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