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Addressing the Opiate Epidemic in Pennsylvania

The Justice Center for Research recognizes the opiate epidemic is ravaging our Pennsylvania communities.  We are dedicated to a comprehensive effort to address this pertinent and critical issue through collaborations with criminal justice, health, treatment, and community development agencies across the Commonwealth.  These efforts are being coordinated by Dr. Glenn Sterner, Postdoctoral Scholar at the Justice Center for Research.

We are currently engaged in two active projects in collaboration with faculty members across Penn State University, external higher education institutions, and external community partners.  The first project, Identifying and Informing Strategies for Disrupting Drug Distribution Networks: An Application to Opiate Flows in Pennsylvania, is examining hot spots of opiate distribution in Pennsylvania.  The second project, Understanding Individual and Social Network Characteristics of Opiate Users in Rural Pennsylvania, is exploring the networks of individuals using opiates.  Additional information on these projects may be found on their own pages.  These projects will have regular updates, so please check back frequently to learn more about the projects.

We are actively working to expand our projects to include efforts in the Philadelphia area and across the Commonwealth.  More information about these upcoming projects will be updated regularly. If you are interested in learning more about the efforts of the Justice Center for Research to address the opiate epidemic in Pennsylvania and across the United States, please contact Dr. Glenn Sterner at ges5098@psu.edu.  

Identifying and Informing Strategies for Disrupting Drug Distribution Networks: An Application of Community Policing to Opiate Flows in Pennsylvania

This project seeks to understand, describe, and disrupt networks of illicit sales of opiates from a public safety perspective in partnership with Pennsylvania State Police, Pennsylvania Department of Drug and Alcohol Programs, The Center for Rural Pennsylvania, and local treatment facilities. This project will help to understand hotspots of drug distribution and access, while addressing the utility of community based policing in addressing this complex issue.

 

Prior research emphasizes the disruption of the supply of prescription opioids from healthcare sources and increased first-provider access to the opiate overdose reversal drug, naloxone. Additional efforts emphasize combating demand by increasing treatment options for users. Within this context, however, there has been less emphasis on understanding, describing, and disrupting networks of illicit sales of opiates from a public safety perspective. We aim to fill a gap in these efforts by partnering with law enforcement, state agencies, and community organizations to identify and describe opiate distribution of opiates in PA and the geographic hotspots of sales within urban and rural PA communities to inform recommendations aimed at disrupting the supply of illegal opiates (including heroin, fentanyl, and diverted prescription opioids). We will develop tools to identify and describe opiate distribution networks and geographic hotspots of opiate activity from administrative data and community input that will be of broad interest to public safety and health experts in other communities in PA and other states.

Project Team

  • Principal Investigators: Glenn Sterner, Post-Doctoral Scholar, Justice Center for Research, Department of Sociology and Criminology, ges5098@psu.edu; Ashton Verdery, Assistant Professor of Sociology and Demography, Department of Sociology and Criminology, amv5430@psu.edu; Shannon Monnat, Associate Professor, Sociology, Maxwell School of Citizenship and Public Affairs, Syracuse University, smmonnat@maxwell.syr.edu
  • Co-Investigators: Pete Forster, Associate Dean, College of Information Sciences and Technology, pforster@ist.psu.edu; Gary Zajac, Managing Director, Justice Center for Research, gxz3@psu.edu; Scott Yabiku, Department of Sociology and Criminology, sty105@psu.edu

      About the Project

      • The National Institute of Justice made an award of $990,002 to Penn State to support this project, for the period  January 1, 2018 – December, 31, 2019.
      • The Pilot Study for this project was supported by the College of the Liberal Arts.

      Research Questions

      1. What are the characteristics of heroin and fentanyl distribution networks? We will focus on their hierarchical structure, number and strength of connections, clusters of distribution possibly associated with different organizations, susceptibility of distribution networks to disruption, and geographic spread.
      2. What are the characteristics (same as #1) of prescription opioid distribution networks?
      3. How do the distribution networks of heroin, fentanyl, and prescription opiates compare?
      4. How do residents’ perceptions of the geographic locations of opiate distribution compare to police collected data on opiate arrests, opiate seizures, and distribution locations?
      5. What are the differences in demographic and socioeconomic characteristics and major highway access between neighborhoods with high versus low opiate distribution as defined by arrest data?
      6. What are the differences in demographic and socioeconomic characteristics and major highway access between neighborhoods with high versus low opiate distribution as defined by participatory mapping?

        Project Objectives

        1. Identify and document the structure of heroin and fentanyl distribution networks in PA.
        2. Identify and document the structure of diverted prescription opioid networks in PA.
        3. Compare heroin, fentanyl, and prescription opioid distribution networks in PA and their connections to each other.
        4. Develop and apply tools to record resident identified locations of local opiate distribution in 6 Pennsylvania Counties.
        5. Compare resident identified locations of local opiate distribution to relevant arrest locations.
        6. Describe the demographic and socioeconomic characteristics of neighborhoods with high vs. low distribution (as measured by arrest records and respondent reporting).
        7. Provide recommendations for law enforcement to better target heroin, fentanyl, and prescription opioid distribution networks in ways that increase network disruption.
        8. Provide recommendations for improving intelligence gathering activities related to documenting and disrupting opiate distribution networks.
        9. Create stronger community and law enforcement connections.
        10. Disseminate information for opiate treatment and reporting of illicit activity at study sites.
        11. Create a portable data fusion model that other jurisdictions can employ to document, detect, and disrupt opiate distribution networks.

          Implications

          Looking more broadly at the value and impact of a geo-spatial approach to understanding opiate markets and avenues for their disruption, opiate abuse has tremendous consequences for the welfare of drug users, affecting their long term involvement in the criminal justice system, as well as their health, employment and employability, family relations, and other outcomes. Drug use and the criminal justice system involvement that often follows have consequences for the wellbeing not only of addicts and dealers themselves, but also for their families and more broadly their communities. Improved interdiction approaches that can result from our proposed study has benefits not only for the criminal justice and public health systems that are responding to the opiate crisis, but also for the communities that are harmed by widespread use of these substances, where such harm includes public health impacts, violence and social disorder. Our project will also encourage broader collaboration between researchers and law enforcement, especially in rural communities, and will set the stage for further applications of research and analysis to the study of opiate and other drug abuse in other communities beyond PA, demonstrating the importance of this approach and testing methods and innovations that can be diffused across many law enforcement settings nationally. We have an extensive plan to disseminate this information to a broad audience, including local and state criminal justice organizations, local, state, and national government officials, academic organizations, non-profit organizations, treatment and addiction centers, and task forces.

          Although this study is limited to six counties in PA, the analyses and results from this study will have the ability to inform policy and practice across the Commonwealth and the United States. First, our innovative approach to data fusion will be of interest to law enforcement agencies to use as a model for addressing complex criminal justice issues. We are utilizing datasets from multiple units within the PA State Police to develop understandings of drug distributions. Similarly, we are utilizing community-based data gathering and existing data to gain clearer understandings of drug sales in neighborhoods. By tackling this issue from multiple perspectives, we are able to provide recommendations for police enforcement policy and practice to ensure efforts are maximized to disrupt the distribution of opiates. Integration across inter-departmental agencies and across jurisdictions is a model that could be applied to the opiate epidemic and other criminal justice concerns. Second, by identifying the common characteristics of communities where significant distribution occurs, we can inform criminal justice agencies on potential areas for concentrating officer targeting.

          Project Partners

          Justice Center for Research, Penn State College of the Liberal Arts, Pennsylvania State Police, Pennsylvania Department of Drug and Alcohol Programs, and The Center for Rural Pennsylvania.

          Share Your Opioid Story: A Collaboration between Independence Blue Cross Foundation, The Department of Drug and Alcohol Programs, and Penn State University

          This project will tell the individual stories of the opiate crisis in the Philadelphia Region, addressing the stigma associated with opioid addiction.

          Project Team

          Principal Investigator:  Glenn Sterner, Ph.D.
          Co-Investigator: Gary Zajac, Ph.D.
          Researcher: Elaine Arsenault, M.A.

          About the Project

          Bucks, Chester, Delaware, Montgomery, and Philadelphia counties continue to present some of the highest rates of overdose from opiates in Pennsylvania. In 2015, 1,338 individuals lost their lives in the five county Philadelphia Region. Along with this loss in our community, addiction treatment, law enforcement issues, and disruption of family life all accompany those affected by the opioid crisis in the Philadelphia region and beyond.

          The story of the opiate crisis in the Philadelphia Region, much like the rest of the country, continues to be told through the use of staggering statistics including the deaths reported above, rates of overdoses, uses of opiate reversal therapy, amount of people seeking treatment, amount of additional resources needed to treat those suffering with addiction, amount of opiates seized from law enforcement, among many others. However, these numbers fail to capture the effect of opiate addiction on individuals, family members, friends, and communities. 

          Glenn Sterner will coordinate a team of individuals that consists of Penn State University researchers and IBX professionals on a project to tell the individual stories of the opiate crisis in the Philadelphia Region and Philadelphia more broadly, addressing the stigma associated with opioid addiction.  Dr. Sterner, a Post-Doctoral Scholar in the Justice Center for Research at Penn State University, is an expert with regards to the opiate crisis.  He is involved in numerous research projects across the Commonwealth of Pennsylvania to address this issue, and he is Chair of the Pennsylvania Coalition to address Heroin and Opioid Addiction.  Through this project, the aim is to illuminate and give voice to those affected by the opiate crisis to raise awareness of how pervasive and invasive this crisis is in the Philadelphia region and across the Commonwealth. The Pennsylvania Department of Drug and Alcohol Programs has signed on as a partner in this project to expand its reach across the state.  Through the collaboration between Penn State University researchers, IBX professionals, and the Pennsylvania Department of Drug and Alcohol Programs, we hope to tell the stories of individuals of the opiate crisis in our Philadelphia communities to reduce the stigma associated with addiction and thereby enable others to talk more broadly about this critical subject to receive the help they desperately need.  This effort is funded by the IBX Foundation, and all products of the project will be made available to the public through an interactive website.  In addition, we will be engaging student interns from the Rehabilitation and Human Services Program at the Penn State Abington Campus to host community events in the summer of 2018 to facilitate community conversations around stigma associated with the opioid crisis.

          Project Objectives

          Through this phase of the project we aim to:

          1. Interview 3-5 individuals from each of the 5 counties in the Philadelphia Region (Bucks, Chester, Delaware, Montgomery, and Philadelphia) who have been affected by opiate addiction.
          2. Produce 10 short videos that will tell an individual’s story.
          3. Produce 30 short print stories that will tell each individual’s story.
          4. PSU team will work with IBX Foundation’s communications staff to prepare and broadly disseminate findings and stories through blog postings and articles.
          5. Produce a website that highlights the stories of opioid addiction.
          6. Host community presentations on the stories and website, and assess the impact of these presentations on audiences.
          7. Increase awareness of the broad spectrum of people affected by opiate addiction in the Philadelphia Region and across Pennsylvania.
          8. Increase awareness of resources available to those affected by opiate addiction in the Philadelphia Region and across Pennsylvania.

          Implications

          This is an incredibly important project, as it will help to begin to explore the diverse experiences associated with the opioid crisis currently ravaging our communities.  By helping to address the stereotypes associated with opioid addiction and those affected by opioid addiction by illuminating the myriad diverse individuals in our study, we may be able to increase those seeking help for opioid addiction and expedite this process.  Stigma associated with opioid addiction can lead to shame associated with this disease, which delays the initiation into addiction counseling services.  By beginning to help to address this stigma through our research, individuals may be more apt to seek services earlier, leading to quicker positive outcomes.

          Through our website and outreach activities, we hope to be able to connect those affected by the opioid crisis on a broader scale.  We also hope to give voice to those stories associated with the opioid crisis.

          Additionally, this project will help to examine the effects of the opioid crisis and opioid addiction on individuals, helping us to examine research needed to document the ways that this crisis may be differentially affecting communities and marginalized individuals.  We anticipate that this will uncover narratives that will differ across experiences, leading to further expanded research.

          Finally, this project will help to further understand the depth of impact on individuals in our sample by the opioid crisis and opioid addiction.  While quantitative studies document the propensity of this issue, this project is specifically designed to provide greater context of the statistical analyses, and may uncover additional areas for quantitative research opportunities.  This project will help to provide a needed understanding of the life altering experiences associated with the opioid crisis and opioid addiction.

          Project Partners

          Justice Center for Research, Independence Blue Cross Foundation, Pennsylvania Department of Drug and Alcohol Programs

          Participate in the Project

          Telling the Stories of the Opioid Crisis – We want to hear from you

          Have you lost a loved one or a friend to an opioid overdose?  Are you in recovery from opioid addiction?  Are you currently struggling with opioid addiction? Or maybe you have been affected by the opioid epidemic in some other way.

          We want to talk to you, because we would like to hear your story. 

          Dr. Glenn Sterner from the Justice Center for Research at Penn State University is working to collect the stories of the opioid crisis in our Philadelphia communities. We want to show the human side of the opioid epidemic, how it affects people of all backgrounds, and the impacts it has had on individuals, family members, friends and communities.

          We have two goals.  First, we want to reduce the stigma surrounding the crisis and help people to talk about opioid addiction more openly. Second, we want to connect those affected by the opioid crisis, so you can know that you are not alone.  By doing so, we hope to assist those affected in getting the help they desperately need.

          If you live in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties, we want to sit down with you and hear your story of how the opioid epidemic has affected your life.  From this interview, we will document your story and post it in on an online website we are in the process of creating that will share your story and the story of others across the Philadelphia region and across Pennsylvania.

          If you are interested in sharing your story, please email shareopioidstories@gmail.com or call 814-867-3295.  We will connect with you as soon as possible.  Thank you for your interest.

           

          Understanding the Individual and Social Network Characteristics of Opiate Users in Rural Pennsylvania

          This pilot project will explore the individual, community, and peer network characteristics of those who use heroin and who misuse prescription pain relieves in Allegheny, Fayette, Greene, and Washington counties in Pennsylvania. Results from this project will help to understand more fully the mechanisms through which peer networks influence opiate abuse behaviors, including initiation, progression, frequency/severity of use, and entries into substance abuse treatment.

          Understanding the Individual and Social Network Characteristics of Opiate Users in Rural Pennsylvania

          Opiate abuse (nonmedical use of prescription pain relievers and heroin use) is a critical US public health and policy issue, especially in isolated and economically depressed rural areas where abuse and overdose mortality have skyrocketed in the past decade. Opiate abuse is particularly problematic because this may lead to an increase in the likelihood of future economic precariousness, relationship instability, poor health, and criminal justice involvement, resulting in major individual, family, and societal human and economic costs. Peer and family networks are known to be important mechanisms for initiation, progression, and duration of substance use, but there has been almost no research on the mechanisms through which peer networks influence opiate abuse behaviors, including initiation, progression, frequency/severity of use, and entries into substance abuse treatment. We propose to conduct exploratory analysis on the individual, community, and peer network characteristics of adults who use heroin and who misuse prescription pain relievers in four PA counties as part of a data collection pilot to inform the ‘preliminary analysis’ and ‘methods’ sections in proposals for external funding.

          Project Team

          Principal Investigators: Ashton Verdery, Assistant Professor of Sociology and Demography, Department of Sociology and Criminology, amv5430@psu.edu; Shannon Monnat; Associate Professor, Sociology, Maxwell School of Citizenship and Public Affairs, Syracuse University, smmonnat@maxwell.syr.edu

          Co-Investigators: Glenn Sterner, Post-Doctoral Scholar, Justice Center for Research, Department of Sociology and Criminology, ges5098@psu.edu; David Hunter, Professor and Head, Department of Statistics, dhunter@stats.psu.edu; Mark Feinberg, Research Professor, Department of Biobehavioral Health, mef11@psu.edu; Robert Turrisi, Professor, Department of Biobehavioral Health and Prevention Center, rjt13@psu.edu; Khary Rigg; Assistant Professor; Mental Health Law and Policy; University of South Florida; rig@usf.edu; Katherine McLean, Assistant Professor, Department of Administration of Justice, Penn State Greater Allegheny, kjm47@psu.edu

          About the Project

          • Seed funding was provided by the Justice Center and the Social Science Research Institute at Penn Sate
          • Time line is August 1, 2016 – May 31, 2018
          • Pilot project for a National Institute of Drug Abuse Grant Proposal

          Research Questions

          1. What are the characteristics of individuals, their communities, and their peer/family networks that are associated with opiate use, with a particular focus on current and recent (past-year) high-risk overdose behaviors (e.g., injecting; poly-substance use [including alcohol and other prescription medications]; use after periods of abstinence; use in isolation). Specific questions include: what precipitated opiate initiation; do individuals mostly use alone, with romantic partners/family members, or in larger groups; in what locations do individuals/groups most typically use; what is the frequency, type, and modes of use (e.g., oral, snorting, injecting); how do individuals gain access to opiates; how are opiates disseminated throughout the network; and do network members discuss experiences in treatment and/or overdose experiences?
          2. How does opiate abuse affect the composition of individuals’ personal networks, including: what proportion of friends are using prior to and at the time of initiation and at critical periods of escalation and/or desistance; how does the strength of relationships to users, non-users, and family members differ between individuals at different levels of abuse/addiction/dependence; and how do users with different durations of abuse differ in their position in the broader social network of users uncovered by the sampling method?

          Project Details

          The main objectives are to solidify local community partnerships; test the feasibility of our protocol, sampling, and data collection methods; collect pilot data; and conduct exploratory analyses on the individual, community, and peer network characteristics of adult opiate users in  Allegheny, Fayette, Greene, and Washington counties in PA. Specifically, we will:

          1. Solidify existing and develop new relationships with county drug abuse and prevention agencies and treatment providers in four PA counties who will serve as community partners and venues for sample recruitment and data collection. This includes forming an Advisory Committee to provide feedback on survey instruments and protocols and ways to disseminate our findings to ensure they reach appropriate stakeholders.
          2. Develop sampling and survey protocols and instruments to collect information about the individual and peer-network characteristics of opiate users.
          3. Collect survey data from a sample of 150 and interview data from opiate users using respondent-driven sampling, focusing on four adjacent southwestern PA counties.
          4. Analyze users’ individual, peer network, and community characteristics to identify their associations with current (past-month) and recent (past-year) opiate use behaviors, with a particular focus on high-risk overdose behaviors (e.g. injecting; poly-substance use; use after a long period of abstinence) and attempts at/experiences with treatment.
          5. Explore and test the feasibility of leveraging social network approaches for intervention and data collection innovations. We will pilot prospective data collection by using information respondents provide about their social network contacts to increase retention, with an aim of collecting data at 2 separate time points (within a 6 month period) from 20 respondents. We will also explore the feasibility of network approaches to intervention opportunities such as using peer network referrals to enroll high-risk respondents into HIV testing and counseling, drug treatment, and drug court diversion. The goal of this aim is exploratory rather than confirmatory, and we will focus on developing such interventions and assessing their feasibility with respondents and community partners (we will not actually conduct or test any interventions at this point).
          6. Develop a proposal for external funding to extend this research to a larger geographic area and test interventions identified in this pilot project.

          Implications

          This research has the potential to illuminate possible points of individual and peer network intervention in the trajectories from initiation to recreational use to opiate addiction for vulnerable individuals. The results could be disseminated to PA state Department of Health (which is currently in the process of designing a new prescription drug monitoring program), local physicians who prescribe opioids, and substance abuse treatment programs, including the ones from which we recruit respondents.

          Related Presentations & Publications

          Brainstorming Discussion of Methods for Sampling Rural Opiate Users
          Monnat, S., Sterner, G., & Verdery, A.
          Panel presentation: Penn State Mini-Conference on Social Networks, Infectious Disease, and Hidden Populations

          Partners of Project

          Justice Center for Research wordmark

          Social Science Research Institute wordmark

          Community Treatment Center Representatives

          Cheryl Andrews
          Executive Director, Washington County Drug and Alcohol Commission, Inc.
          Washington, PA

          Jana L. Kyle
          Executive Director, Fayette County Drug and Alcohol Commission, Inc.
          Uniontown, PA

          Melissa Ferris
          Assistant Director, Fayette County Drug and Alcohol Commission, Inc.
          Uniontown, PA

          Erica Usher
          Prevention Supervisor, Fayette County Drug and Alcohol Commission, Inc.
          Fayette County Health Center
          Uniontown, PA

          Brian Reese
          Treatment Supervisor, Fayette County Drug and Alcohol Commission, Inc.
          Fayette County Health Center
          Uniontown, PA

          Karen Bennett
          Administrator, Greene County Human Services

          Lori Gregan
          Communities that Care Mobilizer, Greene County Human Services
          Waynesburg, PA 

          Alesha McGough
          Clinical Supervisor of Drug & Alcohol Services, Mon-Yough Community Services
          McKeesport, PA

          Penn State Extension Representatives

          Maureen Hogan
          District Director, Allegheny County Extension
          Assistant Director, Penn State Center Pittsburgh

          Joseph C. Conklin
          District 10 Director, Penn State Extension, Washington, Greene, and Fayette Counties
          Washington, PA

          Additional Partners

          Stephanie Bradley
          Managing Director, EPISCenter, The Prevention Research Center
          University Park, PA

          Barry Denk
          Director, The Center for Rural Pennsylvania
          Harrisburg, PA