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Public Libraries Respond to the Opioid Crisis in Collaboration with Their Communities: An Introduction.

The nation is experiencing an opioid epidemic. In October 2017, the federal government declared a national public health emergency under the Public Health Services Act. As communities across the country feel the epidemic's impact, public health and human service organizations are implementing responses that include healthcare, education, law enforcement and the judicial system, emergency services, drug and addiction counseling, and community services. Public libraries around the country are choosing to be part of this response.

With funding from a grant from the Institute of Museum and Library Services (IMLS, project number LG-00-18-0298-18), OCLC and the Public Library Association (PLA) will identify, synthesize, and share knowledge and resources that will help public libraries and their community partners develop effective strategies and community-driven coalitions that work together to address the opioid epidemic in America. This project is called, "Public Libraries Respond to the Opioid Crisis with Their Communities" and resources relating to the project are accessible through the project website (https://www.web-junction.org/explore-topics/opioid-crisis.html).

By the end of 2019, this project will:

* produce eight case studies that explore a diverse set of communities in which the library is an active partner in response to the opioid epidemic;

* gather additional insights and resources from government agencies, public health and human services organizations, philanthropic and community organizations, and library leaders;

* synthesize the research and cross-sector perspectives into a call-to-action white paper that offers resources and recommendations for how libraries might respond to the opioid epidemic in their local communities; and

* broadly share the information with public library directors and their staff so that they can more confidently make better-informed decisions about their libraries' strategies, policies, and activities in relation to the opioid epidemic in their communities.

The project also is raising awareness among other sectors that libraries are community anchors, and make powerful partners. This realization will encourage more, and stronger, coalitions and networks that include libraries as key partners. The findings and summary results of this work will be disseminated widely, including through free public webinars, conference presentations, and publications, such as this journal.

As the project team collects data and information, a steering committee will provide ideas and advice on the project, from the selection of libraries for the case studies through the development of the data collection instruments and the interpretation of the data analysis and findings. The steering committee comprises library leaders and community experts with experience spearheading and implementing similar work. Some steering committee members have shared in-depth information about their libraries' approaches and strategies for addressing the opioid crisis in their communities, and as the three examples listed below illustrate, one common theme arises: the need for community partnerships and collaboration.

Blount County Public Library

The Blount County Public Library and the county's Recovery Court are collaborating to combat the opioid epidemic and drug addiction in their Tennessee community. Recovery Court is an alternative sentencing program offered to nonviolent offenders with a history of drug and alcohol abuse. The program aims to lower habitual criminal activity by providing treatment, monitoring, random drug screens, required employment, community service, education, and payment of fines. The library developed a curriculum that teaches Recovery Court participants necessary skills to succeed as a contributing member of the community. The library works closely with the Recovery Court, and the court has fully embraced the curriculum and was a part of its development. The library director recognized the library was a natural fit for this role because of its work providing soft skill services to the community. "I see librarians as teachers. We provide educational services," the library director said. "I don't care what we call it. If it's education for fun or jobs, providing educational services is what we do." This Life Skills Curriculum includes seven modules:

* Communication

* Finance

* Social Health

* Physical Health

* Nutrition

* Personal Appearance

* Career Development

Library staff anecdotally recount success stories of people who have completed the program, including participants who made a full recovery and transition back into the community, thanks to the Life Skills program. The program has also paved the way for strong partnerships and a community approach. Further, the Recovery Court is a part of the broader Blount County Community Justice Initiative, which strives to ensure public safety by effectively addressing criminal behavior and its many underlying causes for the benefit of the citizens of Blount County.

Gates Public Library

The assistant director of the Gates Public Library in Rochester, New York, perceived a need for discussion and education in her local community on opioid addiction and the widespread crisis happening across the region. Through research she discovered widespread frustration with navigating both prevention and recovery services, and the misinformation of data and a misunderstanding of substance use disorder and its impact on their communities, neighbors, friends, and families.

As a result, the Gates Public Library hosted community forums to provide connection and help better inform the public about pressing community topics. Library colleagues collaborated to develop a series of three panels that brought together medical experts, law enforcement officials, and advocates in the addiction community. To maximize attendance, panels took place in three different locations during the summer. The assistant director described program attendees as, "... a mix of people from the community at large, including community residents, church congregants, and those from advocacy organizations; all displaying a passion for this community rallying effort. It was beautiful and empowering to see the community come together like this."

Because of the success of these panels, librarians throughout the US have contacted the Gates Public Library, and the library was recognized by local and state legislators for its work. The right people were in the room thanks to the purposeful recruitment of panelists and participants, so addressing the opioid crisis did not stop with these library forums. As a result of connections made at the panels, the Gates to Recovery program was formed--a drop-in referral center at the Gates Town Hall for those seeking help with drug addiction. Gates to Recovery has expanded their services to four different locations across the county.

Denver Public Library

In response to opioid overdoses occurring on site and in their library, Denver Public Library (DPL) developed a Community Resources Program comprising four social workers and six peer navigators to support community members and patrons in accessing the services they need. The program provides social work and peer coverage through a strengths-based, trauma-informed, and harm-reduction lens for the entire DPL system. The library also provides Narcan training and distribution of Narcan throughout the library system, which has trained more than 500 staff members. The library also lowered their bookshelves to improve line of sight to patrons and their activities, and added sharps containers to their bathrooms.

To implement their opioid prevention programming, DPL worked with many other city personnel, including the Mayor's Office, city council, and other city agencies like the Denver Department of Public Health and Environment, other local public health departments, Public Works, Office of Children's Affairs, Office of Legal Affairs, and the Office of Behavioral Health. Other advocacy organizations also were involved, such as the Colorado Consortium for Drug Abuse. DPL initially requested funding and resources for this work from the Mayor's Office, but it was not until a serious overdose incident occurred that citywide collective efforts began. The mayor asked organizations to work together via the Citywide Opioid Task Force. As a result, the library operates the Community Resources Program daily, has saved lives with 23 overdose reversals, connected patrons to much needed services, improved their connection with the community, and strengthened and built new partnerships. A community partner staff member says, "The library does not back down on that this is a free, public space for everyone, regardless of whether you think they smell or you do not like them. Even though it is different than what library staff typically are doing, they have been a model for many other communities. People often don't think of the library as a city agency and now they are becoming aware of this."

Initial Learnings and Themes

As the data are being collected, there are some preliminary learnings and themes being generated from the first three site visits related to the opioid programming development.

* Have a champion at both the library administrative level and at the partner community organization administrative level for the development and sustainability of an effective program.

* The support and buy-in of key city personnel can propel the work forward through garnering resources and mobilization.

* Be proactive with a media communication strategy.

* Be transparent with the board and internal staff to gather buy-in and support.

As a result, interviewees indicated their programming was a success because they prevented overdoses, connected patrons to needed services, educated the community, and strengthened community partnerships.

Summary

As these three examples illustrate, libraries are experiencing the nation's opioid crisis firsthand and are choosing to respond to it in collaboration with their community and partners. When partners and libraries come together to better serve their community, they make a real impact. OCLC and PLA look forward to sharing knowledge and resources identified and synthesized in this broader project to help public libraries and their community partners develop effective strategies and community-driven coalitions to address the opioid crisis in America.
Figure 1. Community Demographics: Some key demographics about the
communities represented in these profiles.

                         Denver, Colorado            Blount County,
                                                     Tennessee

Library's service area   683,096                     127,253
population (2)
Library locations (3)    One central, 25 branches    One central
Education level (4)      47% at least a bachelor's   23% at least a
                         degree, 87% at least a      bachelor's degree,
                         high school diploma         89% at least a high
                                                     school diploma
Median household in-     $60,098                     $51,172
come (5)
Poverty rate (6)              15%                         12%
Unemployment rate (7)          3.3%                        3.1%
Lack of health                12%                         11%
insurance (8)
Opioid prescribing rate       35.1                        80.2
(per 100 persons) (9)
Drug overdose deaths          19                          23
rate (per 100,000
persons) (10)

                          Rochester, New York (1)

Library's service area     28,400
population (2)
Library locations (3)     One central 37% at least a bachelor's degree,
Education level (4)       90% at least a high school diploma
Median household in-      $55,272
come (5)
Poverty rate (6)               15%
Unemployment rate (7)           3.4%
Lack of health                 6%
insurance (8)
Opioid prescribing rate        42.7
(per 100 persons) (9)
Drug overdose deaths           15
rate (per 100,000
persons) (10)


Michele Coleman (ml.coleman.24@gmail.com) Independent Research Associate

Lynn Silipigni Connaway, PhD (connawal@oclc.org) Director of Library Trends and User Research, OCLC

(1) For Rochester, New York, the non-IMLS statistics are for Monroe county

(2) "2016 Public Library Survey Data," Institute of Museum and Library Services," https://www.imls.gov/research-evaluation/data-collection/public-libraries-survey/explore-pls-data/pls-data

(3) 2016 Public Library Survey Data," Institute of Museum and Library Services," https://www.imls.gov/research-evaluation/data-collection/public-libraries-survey/explore-pls-data/pls-data

(4) Community Facts, "2013-2017 American Community Survey 5-Year Estimates," United States Census Bureau, https://fact-finder.census.gov/faces/nav/jsf/pages/community facts.xhtml

(5) Community Facts, "2013-2017 American Community Survey 5-Year Estimates," United States Census Bureau, https://fact-finder.census.gov/faces/nav/jsf/pages/community facts.xhtml

(6) Community Facts, "2013-2017 American Community Survey 5-Year Estimates," United States Census Bureau, https://fact-finder.census.gov/faces/nav/jsf/pages/community facts.xhtml

(7) Bureau of Labor Statistics, "November 2018 Unemployment Data," United States Department of Labor, https://www.bls.gov/data/#unemployment

(8) "County Health Rankings," University of Wisconsin Population Health Institute, http://www.countyhealthrankings.org/

(9) "U.S. County Prescribing Rates, 2017," Centers for Disease Control and Prevention, https://www.cdc.gov/drugover-dose/maps/rxcounty2017.html

(10) "County Health Rankings," University of Wisconsin Population Health Institute, http://www.countyhealthrankings.org/
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Title Annotation:From the Field
Author:Coleman, Michele; Connaway, Lynn Silipigni
Publication:Collaborative Librarianship
Article Type:Essay
Geographic Code:1USA
Date:Jan 1, 2019
Words:1946
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