Learn how prevention practitioners joined forces with realtors and funeral directors in Blair County, Pennsylvania to prevent opioid misuse.
About the Collaboration
Prevention practitioners in Blair County, Pennsylvania are employing new prevention efforts with “non-traditional” partners to combat the opioid crisis that has been overwhelming their communities. With funding from SAMHSA’s Partnerships for Success 2013 grant, the county’s substance misuse prevention and treatment agency, Blair Drug and Alcohol Partnerships, is forging relationships with real estate agents and funeral directors to reduce the availability of prescription drugs in the county.
Throughout the U.S., prescription drug theft from open houses is fueling the opioid epidemic. These drugs have a high street value and are diverted into the community for misuse.
After learning from a community health survey that open houses were a source of misused prescription drugs in the county, the Partnerships reached out to Allegheny Highland Association of Realtors—the county’s local realtor’s association, as well as individual realtors, to educate them on the importance of talking with homeowners about locking up medications during open houses.
The survey also revealed that another source of diverted prescription drugs was medication that remained in the homes of the deceased. Prevention Supervisor Tricia Maceno explains, “The story we kept hearing was, ‘We didn’t know what to do with prescription medications when a loved one passed away. No one could tell us where to take it.’”
That’s when the idea of meeting with funeral directors formed. Maceno and her colleagues contacted the Blair County Funeral Directors Association to solicit their support and cooperation in educating families about the proper disposal of prescription medications once a loved one has passed away.
The Partnerships’ ultimate goal for both associations is policy change—specifically, to have both groups mandate the inclusion of opioid prevention education in their training procedures, so that staff are prepared to discuss safe medication storage and disposal with their clients. But Maceno understands that this can’t happen overnight. “First we need to educate and build connections,” says Maceno. “That’s how we’ll lay the foundation for long-term change.”
Elements of Success
Cast a Wide Net, Then Follow-up One-on-One
With both partners, Blair Drug and Alcohol Partnerships started at the association level—asking to attend regular association meetings and, eventually, present at their annual meetings. These presentations played a key role in helping to raise awareness among both members and organizational policy-makers of the county’s opioid access problem; they also sowed the seeds for further discussion around this issue.
Partnership staff then went door-to-door to county realtor offices and funeral homes to personally connect with staff from each office, educate them about the issue, and ask for their assistance. Both sectors were open to learning how they could help, but the funeral directors were especially eager to assist. “[The funeral directors] really welcomed the information because they were getting questions about what they should do with unused medications and had no idea where to send people,” Maceno says. “They were searching for the information we had.”
Make a Simple Ask
For both realtors and funeral directors, the Partnerships came with a specific and clearly crafted “ask”: to share information with their clients to help restrict access and diversion of opioid prescriptions.
For realtors, they developed a one-page fact sheet that highlighted the importance of securing medications, with tips on how to secure medication, and asked that they review this information with their clients.
They asked funeral directors to include in their bereavement packets information about the permanent prescription drug drop boxes available in Blair County so family members would know where to discard unused medications.
Personalize the Message
Partnerships staff made sure to develop prevention messages that would resonate with each of their partners.
“We made the case for why it was important for realtors to talk with their clients about securing their medications,” Maceno says. We reminded them that they already ask people to secure their jewelry to keep it safe—only now they would also be asking them to secure their meds.”
For funeral directors, they appealed to the association’s role as a vital aid to families in mourning. “We told them, ‘You’re one of the major supports to families in times of need,’” explains Partnerships Assistant Director Aleisha Albertson. “Here’s another need we’ve identified. How can we help you with it?”
Seize the Moment
During their visits, Partnerships staff did more than just provide materials for dissemination; they also shared more general information about substance use prevention and addiction which they encouraged their new partners to display in their offices. They also made themselves available to answer questions.
Many of the funeral directors took them up on their offer and began setting out, “You are not alone” cards that included the Partnerships contact information, as well as other brochures, in their lobbies.
Find Your Champions
Partnerships staff are working on identifying champions to support their efforts and who can serve as liaisons to their colleagues. Among the funeral directors, they found their champion and avid supporter in the general manager of a prominent funeral home in the area. “[He says] ‘Give me as much information as you can, I’ll do it,’” says Maceno. “As we move toward the next Funeral Directors Association’s Meeting, we’re going to ask if he will make a presentation for us.”
Albertson recommends looking for prevention champions with a personal connection to addiction. “Addiction touches everyone in some way shape or form. It’s so prevalent,” she says. “It wouldn’t be far-fetched, for example, to see that someone in the Realtors Association has a son or daughter or sister or brother that has been touched by addiction. You’ll see standout people that are more interested in the topic than others, and once you identify that person, that’s an in.”
Be Open to New Opportunities
Partnerships staff were pleased when, after many months of building relationships with funeral directors, one reached out for help supporting families who had survived an overdose death. “. . . We were glad they reached out and identified a need we weren’t aware of,” says Albertson. “They saw us as a partner they could turn to for help.”
To address the need, the Partnerships launched a grief support group for families who have lost a loved one to overdose. Healing Hearts has been in operation for one year. Families meet twice a month for discussion and support.
After observing that people were coming to their funeral homes under the influence of opioids, some directors also asked the Partnerships to train them to use the overdose reversal medication Narcan. To respond to this request, the Partnerships provided the association with a training on how to administer Narcan and distributed the overdose antidote to trainees.
Prescription drop box advertisement Since the beginning of their efforts, Blair Drug and Alcohol Partnerships has reached out to approximately 20 realtors and funeral directors. They are now turning their attention to a new prevention partner—veterinarians. According to Maceno, many veterinarians have seen or suspected that pet owners may seek pet medication for personal use, especially Tramadol and benzodiazepines—some of the most abused medications in Blair County. They plan to conduct focus groups with veterinarians to better understand their needs.
Maceno feels her agency is edging closer to their policy change goal. “Any time you are trying to make a policy change, it is challenging.” she says. “Once we get everyone onboard with giving out the information, I think they are going to see it’s beneficial to make this policy change.”