Gaining a Deeper Understanding of Opioid Abuse in the Context of Public Health

LIFT Healthcare tells the story of two women in Johnson City, TN who have been affected by the opioid epidemic. Using ethnographic filmmaking techniques, two LIFT Healthcare anthropologists interviewed those impacted by opioid abuse in the community and those seeking to make a difference in their lives.

Shelly, 39, Addition Survivor, Elizabethton, TN: This epidemic of drugs is so bad in this area because there’s nothing else to do, and that’s what – you’re a product of your raising. There are so many drugs in this area. It used to be – you know heroin’s here a lot, now it’s just meth, it’s horrible.

The women in this film are addiction survivors. Shelly has been sober for two years and hopes her story can make a difference in the lives of others. She has worked hard to fight her way through the challenges of drug addiction and recovery.

After losing her son to diabetes in 2014, Johnnie and her daughter, Erica, live and work together in an effort to heal from the brokenness brought on by Johnnie’s drug addiction

Shelly: I grew up in a trailer in Gap Creek with five or six dogs, you know, just always there. I remember being nine or ten years old, walking and helping my dad carry jugs of Miracle-Gro through the woods to water his pot plants. I remember helping him trim the leaves off his buds and stuff. I remember doing all that. By 12 or 13, I was still on his roaches.

My first time I ever got arrested was on drug charges. It was three counts of selling marijuana and two conspiracies. They were ounces. My co-defendants were my daddy, my two cousins, and two friends of the family. Basically, it’s like a family drug ring. I went straight from Barbie dolls to drugs, you know?

And I didn’t go – I don’t ever remember going to the doctor. The doctor was just something far. I mean, unless you’re really, really sick, your mom and dad would take you. It was probably the emergency room. We didn’t have insurance.

Niswonger Children’s Hospital opened its doors in 2009 and serves a region of over 200,000 children in Southern Appalachia.

Johnnie, 40, Addiction Survivor, Johnson City, TN: My mom would get sick after she was doing heroin and would puke because evidently she had done too much. But my sister and I would hold her head out of the toilet, and my older sister would say, “Let her drown.” She’d be like, “Just let her drown.” I’m like, “No, it’s my mom, you know? No!” It was what it was. My mom didn’t know how to love, you know? She loved us, I think, but didn’t really know how to show it. Never, never. You know, me and my older sister were, more or less, with child support. We had problems. When she got child support, we were all good. When she didn’t, we were bagged up in trash bags and taken to our dads. When he got child support back, he was great with us. When he lost it and we were back to our moms, that’s just the way it was. I don’t blame that on my mom. I just don’t think my mom knew what she was doing. She was 14 when she had my sister – my older sister. I really don’t think she knew or had a clue how to even be a mom. I mean, I was 15 when I got pregnant with my daughter, so I mean, and I was living… I had nobody, nobody.

It went from Lortabs and smoking pot, and that was it. Lortabs were just for energy, the pot was to relax. And then I went from Suboxone to Subutex, from Subutex to morphine, to Roxies, and then went to meth. And then it was primarily just meth. I mean, for about five years, it was nothing. I was caught, you know, actually making meth. And I’m not gonna sit and say, “Oh, I didn’t use them, use the crap.” I used whenever I was making them, I used them every day, you know? And I didn’t know how to function without them then.

The day before my son had died, Erica had been looking for him. He was hiding. He was so mad about me going to jail, and he was hiding from everybody. I had kept him alive for 17 years, chasing him through the house, giving his insulin every time he needed it. I went to jail for two weeks. Two weeks. And he’s gone. You know, I should have been a mom. I should have been there. That was my responsibility. And I was being stupid with my own drug addiction. And I don’t even remember going to the hospital or anything. It was just… it was bad. So that was my best friend. That was my buddy.

We have tackled rare diseases, performed countless surgeries, and comforted families facing heartbreaking diagnoses throughout the 29 counties we serve.

Johnnie: I’m just here, honestly. I’m not really anybody, I don’t think. I’m Erica’s mom, that’s honestly it. That’s what I look for. I work to pay the bills for me and her to have somewhere to live. And for her, I honestly effed up a lot of her childhood, so I feel like that’s my place now.

Shelly: I’ll try every day to move forward. I’m not going to go back. I mean, I still see somebody that’s got all these imperfections and all these flaws, you know, but at the same time, I see somebody that’s strong and that’s turned their life around.

We can do more. From the impact of toxic stress and adverse childhood experiences to the opioid epidemic and the culture of crisis it creates, families need to be reached outside of the walls of our hospital.

Lisa Carter, Chief Executive Officer of Niswonger Children’s Hospital: I walk around the hospital, and I see Johnnie every day, and I see Shelly every day, and there are stories every day you normally hear of hospitals and healthcare systems just providing healthcare. But this region is different. We have some interesting challenges.

Scott Niswonger, Chief Benefactor: Our mission should be to bring thousands of children and parents who are not there for a broken bone or for cancer coming into the hospital, but we need an outreach where we can break the cycle in this region.

Lisa: And as a children’s hospital, I really want to reach out and develop programs that will combat these issues. If I only serve the kids who are acutely sick and come into the hospital, then we’re missing such a big part of the population.

Alan Levine, President/Chief Executive Officer, Mountain States Health Alliance: I think addressing the opioid epidemic is a big part of what we’re trying to do, and you can’t address the epidemic in parts and pieces. It has to be a holistic approach. I’ve seen so many examples where people will sacrifice their own financial resources, their own time, their own family’s time to help other families that are in need, and that’s what Niswonger Children’s Hospital is. But that’s what a children’s hospital does. It doesn’t live for today, it doesn’t exist for today. It exists to make investments into the future of these children.

Lisa: I’m always amazed by the beauty that’s here. I’m always amazed by the people, and that’s why, again, I take my job so seriously. I truly want to impact this region and especially the kids. Unfortunately, we’re one of the largest prescription drug abusers in the country, and where that impacts us as a children’s hospital is with our increased numbers of neonatal abstinence syndrome, and that is, babies who are born addicted to drugs.

Chris Miller, Adoptive Parent: When we got the call for Levi, we knew that his mother had abused a lot of drugs and alcohol and had had a pretty rough life. I truly believe that these mothers who have had these challenges have a catalyst for them to change their lives and get them turned around can be the experience of that child.

Lisa: Several of the programs and things we’re working on currently are, trying to, first of all, help those babies and families, but my passion is, to hopefully end this problem overall.

Chris: I think that’s a really important part of what the children’s hospital is trying to do is bridge that and say we’re going to have these services for these mothers to help counsel them and get them the support they need because I just believe there’s an inherent nature of motherhood and what that looks like that can be a very powerful component to help them change.