How Community Policy is Fighting the Opioid Epidemic in Pennsylvania

by Teghan Simonton

From the outside, the house would be nearly indistinguishable from the rest. An old, Victorian-style house with bright yellow paint and a porch swing swaying in the back yard, the Bird Sisters transitional home looks like any other house in Waynesburg, Pennsylvania. But the reality of the women inside is very different from their neighbors.

In the southwest corner of the Commonwealth, the women in the Bird Sisters home are on the front lines of the epidemic plaguing much of the United States. Nationwide, 115 Americans die every day from opioid overdose, including prescriptions and illicit opioids like heroin or fentanyl, according to the Center for Disease Control. And Greene County, which is located near the border of Pennsylvania and West Virginia, is situated between two states with “statistically significant increases in drug overdose death rates” in the past three years.

In fact, Pennsylvania was identified by the CDC as one of the five states with the highest rates of death due to drug overdose, with 37.9 deaths per 100,000—and in 2017, Greene County made up at least 13 of those lives lost.

At a time when there is no concrete solution to the epidemic, the women in the Bird Sisters house find themselves taking charge of their own recovery process.

They are former addicts—mostly of heroin—living together as they rebuild their lives.

They wake up together, drink coffee together, and go to Narcotics Anonymous meetings together. They have house meetings, where they make schedules for fundraisers and public forums, talk about how they will pay the bills, and address any problems between residents. Aside from a facilitator who makes sure they follow the basic sobriety rules, the women are in charge of their themselves.

The house is “democratically-run,” said Tonya Palmer, resident of 10 months who holds the title of president. She struggled with addiction for years, always leaving in-patient programs before completing them, because she wanted to see her children. Palmer chose to try the Bird Sisters program because she would still be allowed some degree of independence.

At the Bird Sisters, a branch off the Oxford House organization, each resident is given a specific position. New applicants are interviewed by current residents and are voted in by an 80 percent majority.

“We all work together as a team to try to help people and share our experience, strength and hope,” said Palmer.

It’s about supporting one another through recovery, she said.

The Oxford Houses represent one way communities seek to aid the suffering, with homes and chapters in states all over the country. But progress is slow, and resources are limited. More often than not, Bird Sisters must turn women away from their doors, for lack of space.

“I’m terrified now of anybody that’s using,” said Palmer. “I’m just waiting and waiting for a phone call. I don’t want to have to turn people away and have no help or resources or anything to do for them, because what’s going to happen if they pass that night?”

Brett Ketchum, a recovery specialist at a men’s Oxford House across town, said it is easy to get discouraged. There are 12-step programs, religious groups and NA meetings—but is any of it working? Will any of it work, ever?

He has been involved in recovery efforts across the country—including his own—for the better part of eight years. He knows it’s an uphill struggle.

“It’s very hard,” Ketchum said. “For people to have futures that are different from their past.”

When Karen Bennett, administrator of Greene County Human Services, answers the phone, she sounds breathless and exhausted.

“I’m always busy,” she said, driving back from a three-day conference in Harrisburg, where she sat through one presentation after another from administrators across the state.

The head of a county office serving more than 37,000 people, she begins rattling off a long list of initiatives she is organizing. She is trying to solve problems communities across the United States are all too familiar with—child abuse, human trafficking, gambling addiction. But these old problems have taken new shapes.

“Every area that we touch now has to address the opioid issue,” Bennett said.

Whether it is family services, charity programs, intellectual disability or mental health services, Bennett said the opioid crisis has infected everything. All told, Bennett estimates about 80 percent of her time is spent talking about the opioid crisis, in one way or another.

It’s difficult, she said, because with all of the overlap, each case is infinitely more complex, trying to find the best combination of programs and provide a person with the care they need.

This is especially true considering the rural nature of Greene County, where there is no access to state hospitals and few specialists in the area. In an area where there is great need, there’s a scant little structural support to offer them.

“My day is troubleshooting and brainstorming and trying to think outside the box with these cases,” she said.

In the past several months, residents of Greene County have been witness to drastic measures to address the high overdose rate, like lawsuits filed against 23 different pharmaceutical companies, accused of pushing opioid prescriptions. Greene County initiated an Overdose Task Force in February. The team incorporates the perspectives of various concerned community members in healthcare, law enforcement and other professional disciplines. At their last public meeting, the task force also announced that “addiction navigators” are being introduced to the government payroll: individuals meant to help addicts along the recovery process.

For those most impacted by the opioid epidemic, Bennett’s programs may be the most concrete connection to getting help.

Bennett, who began her career as a certified drug and alcohol specialist, has spent 18 years as administrator of her office. She is located on the third floor of a hundred-year old hotel refurbished to be an office building, a testament to the staff’s resourcefulness. For her, the key to the job is creativity, and the determination to never give up on someone seeking help.

“You’ve got to do what you have to do, and I push boundaries as far as I have to push them,” she said. “If you’re black and white, you can’t work in this field. It’s not cookie-cutter. It’s not in the box.”

At this point, the county is trying everything. The task force was formed with the help of the University of Pittsburgh’s Overdose Prevention Research Program, and modelled after a successful program in neighboring Washington County, whose overdose death rate is even higher than Greene’s. With a growing list of invitees, the team aims to collect data and form some sense of direction for what to do next.

Greene County’s Human Services department is now a balancing act, trying to address all of the area’s needs and hope for change. And Bennett runs from meeting to meeting, takes phone call after phone call, overseeing more than 70 county employees, trying to keep it all afloat.

“There is not a quick fix,” said County Commissioner Blair Zimmerman, a lead member of the task force. “But I guess the goal is to get people to talk about it and get a perspective of what might make things a little bit better, and what might help try to control it.”

Pennsylvania has been in a state of disaster emergency for the opioid crisis since January. Greene County is still struggling.

Pennsylvania Gov. Tom Wolf made the declaration just months after the Trump administration announced the opioid crisis as a national public health emergency. Wolf’s plan for Pennsylvania includes a bolstered drug monitoring program, expanded access to treatment and tools for families and first responders.

The outlook seems optimistic—the number of overdose deaths in Greene County have decreased in the last year from 20 people to 13, for example. But the area still lacks a detox facility, leaving addicts in need no choice but to check into the local hospital’s psych ward. Then, once they are clean, there are limited options for rehabilitation.

State Rep. Pam Snyder of the 50th Legislative District, agreed that treatment options are limited in the state system, but believes the future is still bright.

“I think we are challenged here in southwestern Pennsylvania, in terms of treatment and long-term treatment,” said Snyder. “But I think there are folks and organizations working on that.”

On the state level, Snyder has co-sponsored legislation meant to curb the pattern of addiction and overdose in Pennsylvania, starting with drug education at the middle-school level. She is also addressing the epidemic on the local level, through her involvement with the Greene County Overdose Task Force: her role in the group is to bridge the gap between state and local government efforts – providing the community insight to the state’s actions.

“We bring to the table what the state has already tried to do and we’re also there to brainstorm other ideas that I may be able to do legislatively,” she said.

As is the case all over the country, Snyder said, it is important for all government and community entities to be involved and work together.

“We need to all be working toward the same mission, which is to eradicate this from our communities and peoples’ lives,” she said.

But for the people actually living within county lines, the outlook doesn’t always seem so positive.

At the Bird Sisters home, Palmer said as house president, she must often turn women away—there’s simply a lack of space. It’s hard, she said, especially when there is no place else to send them. She thinks about the importance of having a support system during recovery, and the guilt of denying that from someone in need.

That’s what led a group of the women in the house to lead a trip to Harrisburg, to take up the issue with the state senate. They asked for three things: a halfway house, a rehabilitation/detox center and more youth outreach programs to prevent future cases of addiction. They invited state legislators to come back to Greene County and into their home, preparing a meal for them and making their case.

They’re making incremental change, Palmer said. They just have to keep trying.

The system is flawed, most experts agree, but there doesn’t seem to be any one right answer. Ketchum, the Oxford House recovery specialist, said it’s at least encouraging to have the conversation started, and to see everyone doing the best they can—even if the process is slow.

“It doesn’t seem like a lot of stuff has happened, but a lot of stuff has happened,” he said. “It would be premature to say that there is not a lot of results…I know we haven’t had any time to see what this task force can do.”

Snyder said that with a problem as multifaceted as the opioid epidemic—affecting nearly every socioeconomic class and every location—no approach can be discounted.

“I think absolutely that everything helps,” said Snyder. “You know, we didn’t get to this crisis point overnight, and this is not an issue that can be fixed easily, unfortunately. But I think everyone working together, everyone coming to talk about it…I don’t think there is anything we can do that will not help. We can’t do too much, that’s for sure.”

Despite the multitude of approaches, the ultimate goal is to bring people together, Bennett said. It isn’t just a health problem, or a criminal problem—it’s a community problem. That’s why the task force is community-based, with the explicit goal of cooperation. No one will be “isolated,” she said.

It can be frustrating and challenging to meet the county’s needs, Bennett said. But it’s worth it. She has hope.

“You have to want to help people and help them make changes,” she said.

She isn’t the only one – despite the constant battle, the recovering community in this small, rural county remains closely tied and dedicated to working together on the issue. They might lack the resources or structural support of larger or more urbanized areas, but they refuse to let that be an excuse to do nothing or to throw up their hands in defeat.

“I think, at this point, moving forward, there is a lot of opportunity to help people,” said Ketchum. “Some of this stuff is just kind of hitting the ground; it hasn’t had the chance to take hold.”

And any given afternoon, the women in the Bird Sisters house can be found relaxing together on the back porch, reclining in lawn chairs and sharing an ashtray. To someone walking past, they might seem like any of their neighbors, rather than a living, breathing example of a county trying to tackle a problem that no one seems to have the solution to.

They make plans for the evening.

They tease each other and they celebrate their victories of the day.

As the sun begins to sink, and they feel confident in the eventual outcome, as they stick together through recovery.


Teghan Simonton is a Journalism and Public Relations major from Waynesburg University. She is the President of her university’s chapter of the Society of Professional Journalists, and the Managing Editor of The Yellow Jacket.


The views expressed in this article are those of the writer. The Contemporary takes no position on matters of policy or opinion.


The photo above was taken by Teghan Simonton.

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