Senior Consultant, JSI New Hampshire
You’re based in JSI’s New Hampshire (NH) office. What do you see as the most critical public health issue facing NH right now?
No doubt, opioids. Before the crisis, it was hard to get people in high-level positions to make changes, or seriously acknowledge substance misuse and its compounding of other health problems from sexually transmitted infections and traffic accidents to depression and anxiety. It took three or four years of data and policy work to get marginal changes made. With the classification of the opioid problem as a public health crisis/epidemic, the response has ramped up significantly.
Now, lawmakers, parents, community leaders, and people of all walks of life are beginning to understand the extent of the problem and are more willing to act on it. Dedicated funding to and legislation on opioids are affecting entire systems—courts and sentencing, community mental health, primary care, schools, and so on. It’s tragic that it took a crisis to force positive change, but it’s preferable to denial and inaction.
How did you get to JSI?
I have been with JSI for 11 years now, but I first got to know JSI when I was working on substance misuse prevention with a coalition of schools and community organizations. Jonathan Stewart (current director of JSI New Hampshire) was our evaluator. I went on to work at the Public Health Department overseeing alcohol, tobacco, and other drug prevention services on the state’s contract with JSI. At some point I realized…hey, why don’t I just work with JSI?
What was directing a nonprofit like?
I was the founding director of Communities for Alcohol and Drug Free Youth, a coalition of three school districts and nonprofits that work to reduce adolescent substance use. I enjoyed community work, getting people who were reluctant to talk about substance abuse to do so, and seeing results. We decreased underage drinking significantly and started on the more difficult issue of marijuana. The best thing about the prevention was that we worked with a wide spectrum of the community: the court system, police, social services, media, local libraries, churches, schools, and parents. The organization I led 16 years ago persists, and I am really proud of that.
What aspect of your work is most inspiring?
Stories of recovery. I know it seems like a cliche, but when you sit in a room and listen to people talk about being in the throes of addiction and how hard they had to work to overcome it, it can have a tremendous effect. Personal recovery stories really do give me goosebumps.
Another thing that’s affirming about the work is the tangible success. JSI wrote our state’s Access to Recovery (ATR) grant so people seeking recovery, particularly targeted populations including veterans, could get services wherever they wanted through vouchers and case management. I know the providers had a lot of problems with ATR for many reasons, and I was never sure if it was really helping anyone until two years after it was launched. I was in a meeting with the adjutant general who oversees services for the military in NH. Unprompted, he mentioned that ATR was positively affecting many veterans. Hearing that from someone who did not know that I was involved in the project was really encouraging.
What is most challenging about working in public health?
The difficulty with public health is that it is massive and endless, like constantly climbing up-hill. Although change can be extremely slow, when it comes to public health it affects systems and norms across whole populations instead of opening one door at a time. Even incremental changes lead to lives being saved.
Yet it can be quite difficult to get people to pay attention. When we presented facts about the root causes of the opioid problem at a policy meeting, NH’s then-Attorney General Joseph Foster sat quietly, only asking questions as afterthoughts or through a staff member. It was exasperating that no one seemed shocked by the spike in fentanyl-related overdoses.Then, as the facilitator was moving to the next agenda item, Foster leaned across the table and asked me how recent the data was. I told him his department’s medical examiner had sent it only a few days before. Soon after, I saw a news item stating that New Hampshire would be one of the states suing the pharmaceutical companies and holding them accountable for knowingly withholding information on the addictive qualities of their prescription opioids while aggressively marketing them to the medical community.
How do you relax and unwind?
I find that hiking helps, and not only because I am away from a computer when I do it. I love to hike in the White Mountains. The trails are fairly popular and there are a lot of young people on them. It’s a relief to see the young adult population doing healthy things, connecting with each other and the world around them. It may sound corny, but it gives me hope.
What is your favorite food?
My colleagues would say it’s popcorn but I’m trying to break the habit. So instead of a favorite food, I’m focusing on my favorite drink: Earl Grey almond milk tea latte with honey.