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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

This pilot project seeks to understand, describe, and disrupt networks of illicit sales of opiates from a public safety perspective in partnership with the Pennsylvania State Police 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.

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

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 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, Postdoctoral Scholar, Justice Center for Research, ges5098@psu.edu; Ashton Verdery, Department of Sociology and Criminology, amv5430@psu.edu

Co-Investigators: Shannon Monnat, Assistant Professor, Department of Agricultural Economics, Sociology, and Education, smm67@psu.edu; 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

About the Project

  • Timeline is July 1, 2016 – December, 31, 2017
  • Pilot Study for larger NIJ Grant to be submitted Spring 2017

Research Questions

  1. Do residents’ perceptions of the geographic locations of opiate distribution match arrest and intelligence gathering data?
  2. What are the differences in demographic and socioeconomic characteristics and major highway access between neighborhoods with high versus low opiate distribution?

Project Objectives

  1. Develop and apply tools to record resident identified locations of local opiate distribution in Adams, Cumberland, Dauphin, Franklin, Perry, and York counties in Pennsylvania.
  2. Compare resident identified locations of local opiate distribution to arrest locations of opiate distribution.
  3. Describe the demographic and socioeconomic characteristics of neighborhoods with high vs. low distribution (as measured by arrest records and respondent reporting).
  4. Provide recommendations for policing and arrest strategies for law enforcement for targeting heroin, fentanyl, and prescription opioid distribution centers to increase network disruption.
  5. Provide recommendations for improving intelligence gathering activities related to documenting opiate distribution.
  6. Create stronger community and law enforcement connections.
  7. Disseminate information for opiate treatment and reporting of illicit activity at study sites.

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

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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: Shannon Monnat; Assistant Professor of Rural Sociology, Demography, and Sociology; Department of Agricultural Economics, Sociology, and Education and The Population Research Institute; smm67@psu.edu;  Ashton Verdery, Assistant Professor of Sociology and Demography, Department of Sociology and Criminology, amv5430@psu.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, 2017
  • 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

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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