Pathway to Hope, Part 3: The Battle is in Your Backyard

Hear from Steve Williams, mayor of the epicenter of the opioid epidemic, Huntington, West Virginia, about the unforgettable experience that led to his epiphany about the scale of the opioid problem in his city, and how the pathway to hope in his community was built by individuals collaborating and building a trust that led to innovation and evidence-based solutions.

This discussion took place at the University of Notre Dame's Summit on the Opioids Settlement: A Pathway to Hope which focused on how to most effectively distribute the nearly $50 billion in settlement dollars to maximize the impact on our communities and citizens.

Held in August 2024, this summit brought together attorneys general from across the country to discuss best practices to proactively evaluate the efficacy of opioid abatement programs and develop strategies to best distribute the funds. Led by the University of Notre Dame’s Poverty Initiative, the summit explores how evidence-based practices can inform decision

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Transcript

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We're delighted to move from research to policy to get the perspective from those directly involved in the communities. And so I am delighted to introduce Mayor Steve Williams, who was elected mayor of Huntington, West Virginia in November 2012. Re elected, In November 2016, and again in November 2020, making him Huntington's first three time mayor. Since taking office, he has utilized his diverse background in economic development, finance, and state and local governments to shepherd a renaissance in Huntington that has not been seen in decades. Huntington also has gained recognition as the city of solutions for innovative programs to address the opioid epidemic. This includes the formation of a crisis intervention team that pairs mental health professionals with police officers to assist individuals suffering from a mental health crisis and or substance use disorder. The City of Huntington also was one of nine cities in 2018 named as a winner of Bloomberg Philanthropy's Mayor's Challenge for its Compass Center. An innovative program that assists first responders with combating compassion fatigue as a result of the opioid epidemic. Mayor Williams is a past president and current board member of the West Virginia Municipal League. He also serves on the Board of Directors for the National League of Cities and the US Conference of Mayors. We're grateful to Mayor Williams for joining us to share about the impact of the opioid crisis on communities. Good morning. Let's try it again. Good morning. you know what the difference is between major surgery and minor surgery? Major surgery is when I'm having it. Minor surgery is when you're having it. This is exactly what we've been dealing with across the nation. Because every neighborhood, every household in the nation, is experiencing major surgery. And they could give a flip what's happening in another neighborhood, but it's happening in my own backyard. This number says so much. And you might get a little bit torn as to what the number is. This number is 145 billion. 285 million, 246, 490 opioid pills have been distributed within our community. That says it all right there. That's what Bill was alluding to earlier, that's where it started and that's how we end up right where we are right now. And every neighborhood. in the nation is experiencing major surgery. And so many of the people who have experienced major surgery are finding that some didn't make it out of surgery. From 1999 to 2023, it's like I was already following behind Bill taking all his numbers down, and yours were probably much more accurate than mine, but Between 1999 and 2023, there was 1, 254, 547 overdose deaths compared to 1, 216, 290 battlefield deaths since the American Revolution. This tells us exactly what we're dealing with. The battle is not somebody coming in to Our borders and attacking us, our battle is internal. And we've got problems that we have to deal with. We were warned in Huntington. I had a great chief of police. And he came to me after I'd been in office for a year. He came to me and said, Mayor, there's something that's happening. Opioid pills are making their way in, and there's, we're starting to see a presence of heroin. Now the way I reacted to it is that I've got a great chief of police. I've got a police department that is being recognized as the top police department within the region. The police, they've got this. And then I found myself walking down the street a couple of months later. Somebody pulling me aside said, Mayor, you've got to do something. we don't feel safe in our neighborhood. I'm at the grocery store. Somebody comes up to me, Mayor, you've got to do something. We don't feel safe allowing our children play in our backyard. I'm sitting in the pew at church. And someone comes up, Mayor, you've got to do something. We have to do something. But my police department has this under control. And I'm not criticizing my police department. What was life changing for me, is I got a call one evening, saying, we have 500 grams of heroin that had been distributed to this one house, and we're going to raid it in the morning. We want you to come and observe what's going on. And I went in, and honestly, everything that I started seeing scared the living daylights out of me. I've never observed anything like that. My background's in finance. I was an investment banker, a stockbroker. I don't know anything about this stuff. But as we were preparing to go up at the top of the hill where all of the vehicles were assembled. I was the very last vehicle that's going to be coming down the hill. They even had an armored car that was going to come down right up front because all our intel told us where the cameras were, where the bathrooms were, if certain cars were there, who would be there. We had the detail. And then as we came down that neighborhood, down the street in that neighborhood and drove up into the Front lawn, RIP the door right off of the front. My throat, my heart was in my throat. My police officers, my SWAT team, were all at risk. Because as I said, there were cameras, could see what was coming in, but we didn't know who was in or what we were walking into. Fortunately, nobody was in there. With that 500 grams of heroin that had been delivered the night before, there was only 35 grams left. 465 grams of heroin had been distributed overnight and I came to understand how sophisticated their delivery system was and I came to understand with every gram Of heroin, there's 10 separate hits. 4, 650 hits had been delivered that evening. Overnight. And people throughout the city of Huntington were now getting their fix. I was just over, overwrought. And when driving back to the office, my mind is just racing. And as a Sitting at the stoplight about to turn to where City Hall is, I look over and the most precious sight you would ever imagine to see. This was in early August. A row of children holding on to the rope were walking down the street with their kindergarten teachers going on a field trip. And then I realized, that's their target. That's who they're after next. And I went walking into my office, and I internally was screaming, Somebody's got to do something! And then all of a sudden it hit me. What are you going to do about it? I realized then, as mayor, I had to own it. I'd come to understand through history, if you name it, you can own it. And we started stating it for exactly what it was. Stating it, that we have a problem that's here, that it's coming into our neighborhoods, and yes, I'm acknowledging that we have to fix this. And we tried everything. Everything. Once again, I've got my police department and we organize Sheriff's Department, State Police, other counties, Sheriff's Departments all to come in to our arena and one morning we had Every, we were distributing to everybody any, every single warrant for arrest We were going to deliver. This was a roundup we Came together in the arena and then at 8 a. m. Boom! We hit the streets. And the word got out real quickly. See, we had a huge problem with folks coming in from Detroit and actually peddling this stuff. And we had a bus every day that would come from Detroit in and Detroit out. We got word about 10 o'clock. Boom! That bus was full. Everybody was just scattering to get out. There was one that was even, couldn't get on the bus, so he rented a taxi, and was going across the river, going to drive all the way back to Detroit, and we nailed them right as they were going across the bridge, and there was all sorts of money, and there was all sorts of guns, and there was all sorts of dope. And I thought, yeah baby, we've got this. They know in Detroit you don't go messing with Huntington, West Virginia. We're going to send you right on to jail. They just replaced them and continued selling the stuff. Then I came to understand, you can't arrest your way out. We've got to do something else. Fortunately, we had a visit by Mike Botticelli, who was at the time the Director of the National Office of Drug Control Policy, and he came in and I was watching him going around meeting with individuals, talking to them from where they were to identify what's needed in the area and how we The Obama administration at the time would be able to work to respond to this and I thought we need to do this. We created our own, our little town, created our own Office of Drug Control Policy. And what we ended up finding at the time is that we just, we didn't know what we didn't know, but we knew that we had to do something. And I assembled a former police, a retired police officer, I assembled a statistician and the spunkiest firefighter you would ever find in the world right there, Jan Rader. And they went out and started meeting with everyone. What ended up developing is that they started coming together and started putting together A comprehensive plan as to how to approach this. What we did is we created the first syringe exchange program in the state of West Virginia. The Harm Reduction Program. And as we were starting to talk with others, we started then making sure that every one of our police officers and firefighters were being equipped with Naloxone. Back at that time, that was controversial. They were saying we're not going, and you know how we made, how we ended up making The justification why every police officer needed to have it is because There was fentanyl that was making its way into the area and as it would become airborne We needed to make sure that our first responders Could have naloxone just to revive themselves or revive, And if we have that in our, on our own self, and we see that there's somebody is overdosing, then we have a legal responsibility to make sure that they're revived. And we started making some progress. What we ended up learning is that you start talking to individuals, start communicating with one another, start cooperating with one another, then you start creating a collaboration. In that collaboration establishes a level of trust. That trust leads to partnerships. That's the pathway to hope. We're not bringing large groups into big ballrooms, it's one table at a time. And then there's individuals that you start finding that are hiding in plain sight. Like Jan Rader. There's this one very innovative businessman named Joe Murphy. Decided that he was going to help and he ended up coming up together to hold it up, Joe. The Opioid Naloxone Emergency Box. They've distributed 13, 000, 13, 000 of these boxes around the country in every state. So that individuals, there is an instruction tutorial as to how to actually go about using it. Not yet though. Everybody's going to come and stand in line for you. Eyes are up here. They'll be down there in a little bit. So the whole idea is individuals coming together, when you get brilliant people around the table, it's amazing how much brilliance is actually discovered. And what we ended up learning in Huntington, as small of a town as we are, we like to say in municipalities that cities are the laboratories of innovation. If that's the case, then the small cities are the petri dish. And what we have found that we could do is that we can bring people together just around these and we start worrying about, where's the data going to come from? Evidence based solutions? Bull! Bring some ideas forward. Grow a pair. Go do something. ThinkND. Because the whole idea is that everybody comes together and then we start moving ourselves forward. I can, I've said all along, I want to be the pilot project. We will be the pilot project. I was talking to former mayor of New York City. We were having a conversation about this and the one thing that he ended up saying. Talking about, how is it that you're doing so many things? And I said, you know the difference between New York City and Huntington, West Virginia? Nothing but zeros. Nothing but zeros in your population. We're dealing with the same stuff. The difference between New York City and Huntington is, we can identify sooner what works, quicker what doesn't, and facts and faster how to fix it. And once I do that, then we can scale it to the larger cities, to the larger states. In August of 2016, we were feeling pretty cocky. Overdoses were trying to work their way down, starting to work their way down, and then mid August, one afternoon, fentanyl arrived. 28 overdoses in a four hour period in a three block radius. Two people died because they shot up alone. The other 26 people did not die. Mike Botticelli came up to me at a meeting of an opioid task force that we had over in Covington, Kentucky a few days later. And bless his heart, I stand over top of him and he's, I felt like I was being called to see the principal. I said, the director wants to meet with you. I go walking in and he looks up at me, grabs me by the shoulders, tears in his eyes. I said, because of what you're doing, there weren't two dozen funerals. But we found out that all we did was revive them. We learned later that not one person of that 26 who had not died was referred to treatment. One lady. Six weeks after this occurred, six weeks after this occurred, got it accepted into a suboxone program. But she died two days before. Her family, six months later, in February, got word that she had been accepted into a treatment program, and they had to call and say, we buried her in September. If we don't Move people to treatment. We're not saving their lives. Only when we get people moving to treatment are we saving their lives. And as a result of that, we ended up creating the quick response team. That within 48 hours, after an overdose, we have a team that comes together that was explained to you to some degree last night. The fact of the matter is, everything is moving, everything is changing. We're dealing with homelessness, we're dealing, as Bill pointed out, the level of meth, amphetamines, being mixed with fentanyl. Honest to goodness, I don't really know what we do next. All I know is we can't give up. And the one issue is, I keep hearing people say, and we heard it last night, and it's everything I can do to keep from groaning, because I understood, I understand why people are saying there's no silver bullet. But when I've been to those meetings and people are saying there's no silver bullet, I feel like, alright, you're just making an excuse. Actually, we do have silver bullets in Huntington. 46, 000 of them. Every person has an assignment. Every person has to step forward. And if you're not willing to step forward, then get out of the way. We have settlement money into the billions to be able to work with, but if we're not willing to make aggressive, innovative, entrepreneurial decisions, And making sure that we have real time data. Real time data. Only then will we be able to figure out what works, what doesn't. Figure it out sooner, quicker, and faster, and then be able to make an adjustment. What we have to do, everyone in this room has to be able to make our own decision. Your own commitment. What are you going to What are you going to do about it? And within your community, what are we going to do about it? In our state, what are you going to do about it? Sadly, if we didn't have ever again a gram of heroin, a gram of fentanyl, a single opioid tablet ever be distributed again, We're still going to be dealing with the aftermath of what we have been encountering for the next 40 years. So we find ourselves making a decision. Of those 1, 254, 547 deaths, are we going to make sure that there was meaning in the lives In their struggle. It's in our lap. It's time to go to work. Thank you. Take some questions? Mayor Williams. If you will, we'll do about seven, eight minutes of questions from the audience. We have a couple microphones being passed around. Please introduce yourself and your organization. Hi, Mayor Williams. Thank you very much. My name is Claudia Gross Shader. I work for the City of Seattle. Oh, wow. Yeah. And, I couldn't agree with you more about the access to real time information. Bill talked about how policy makers are always fighting the last war. And that's absolutely true in my experience in Seattle. And we heard it from you today in the stories that you told from, from your city. what are some of the tools that you think that local governments need to Avoid fighting the last war. real time, access to real time data would be helpful for us. Our, toxicology, screening labs in the state, they're way backed up. And real, access to real time data on what is in the contents of our street drugs would be hugely helpful. Because we have adulterants coming into the street drugs in Seattle, Xylosine or Trank. that interfere with the naloxone, the resuscitation. And so our first responders need to do rescue breathing then, in addition to administering Narcan. So we need, access to that real time talk screening. I think that we also need access to real time information from pilots in other jurisdictions about, What is working in these other jurisdictions? It would be nice to, for cities to be able to learn from each other in real time. And then in terms of the research community, it's great when there is rigorous research that's published, but rigorous research isn't very accessible to, policymakers because it's behind a paywall, usually. And also, it's not written for policy makers, so access, real time access to translation materials are things that I think would be helpful, and I know you've been thinking about it hard too, and would love to hear from you. we have access, as was indicated, I'm on the board of both the U. S. Conference of Mayors and National League of Cities, it's amazing the research that we end up drawing out of that, and how. Bringing municipalities together as, we even had a task force of cities and counties coming together early on to start identifying where we can find the real time data. How we can start doing that. I was meeting, with the director of the CDC recently at an event where we were speaking and I said, my problem is your data is dated. Because when I try to rely on something from the CDC, it's as though I'm in a baseball game and the pitcher throws the pitch and I'm two innings later swinging the bat. there's no way I'm able to get, and I told her that, and I said, Now, I do understand. The only way you, CDC, gets real time data is that if we change our healthcare system so that I, Once again, I'm coming with a bias from the brokerage and investment banking We have the most sophisticated, free enterprise system in the world. And the publicly traded companies every quarter report their earnings. Every quarter. How are we not able to do this within our own healthcare system? But it's because of our healthcare system that we just don't have that. But, the way that we end up getting it locally, are the three C's that I was talking about. Cooperation. Communication. Collaboration. Leads to partnerships. Establishes trust. As I, as we have a, in Marshall University we have a medical school. we got them involved and then all of a sudden there was a Division of Addiction Sciences. Jan worked in the emergency room in her off time from being, Police chief and firefighter and everything else in the emergency room, we were able to go and make sure that the emergency room were providing real time data as it related to overdoses from the emergency room. don't let the fact that research is complicated and lengthy, don't let that get in your way. Every one of you have access to academia to be able to plug in to that research. You get five people around the table. There's talent hiding in plain sight there. And it's amazing what we're starting to see. All the things that we're seeing developing in our little town. Simply by Everybody coming together and learning to communicate, coordinate, collaborate. And then the outcome is hope. There is a pathway to hope. And the pathway to hope is at every table that you have here.