Reflections on Opioid Crisis Town Hall

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In collaboration with the Public Library Association, WebJunction hosted the Opioid Crisis Town Hall: Library Needs and Responses, on September 12, 2017 (see Town Hall Summary). Three months following the event, we surveyed participants, asking them to reflect on how the session has impacted their work and how their libraries are responding to this issue. Thank you to the 97 people who responded to the survey. Their responses are summarized here to provide additional insight into libraries and the opioid crisis.

The summary shows the range of what libraries are thinking and doing, from contending with fear/aversion to doing deeply embedded work in their community. Some are focused on practical know-how and emergency response, and others on strengthening collaboration and community partnerships. There are libraries in a "wait and see" mode; others have a "prepare for the coming storm" mindset. The responses include a variety of library staff perspectives and experiences, but, overall, the field is interested in understanding more about the topic so that they can make well-informed decisions.

The survey asked, "Have you applied what you learned in the town hall?" and nearly half of the respondents indicated that they have applied what they learned (minimally, somewhat, or significantly). Thirty-four percent say they have not yet applied their learning, but that they still hope to. Many respondents commented that the town hall increased their understanding of the crisis and that they are taking steps to gather information specific to their communities to understand the local impact of the crisis.

Some noted the need for more assessment tools or access to data collections that could help them understand the crisis. One specifically mentioned that this data could help the library better articulate the importance of funding for programs related to the drug epidemic, for example, to hire a social worker.

For those participants who reported being able to apply what they learned in the town hall, many commented that they shared information internally with others on the library team or with key community stakeholders, like local law enforcement or their health department. Some initiated staff training or noted the need for more training in related areas. A few mentioned that their library had acquired Narcan, in addition to staff training, to be prepared to administer in the case of an overdose. But many cited the need for further information to help inform decisions around whether or not libraries should administer Narcan. Evaluating the pros and cons, clarifying the legalities (from state to state), and understanding safety issues for staff all were mentioned as factors to consider.

Some respondents have intentions to more deliberately partner with other agencies, or to join/form a local coalition related to the crisis. But many noted the need for tools on how to better add libraries to the conversation between support groups, law enforcement and the public about how to find solutions and interventions. Many directors, especially in small and rural libraries, are overwhelmed and would like talking points or toolkits to provide a framework for meeting various challenges. "In my state, the library director is often the only professional librarian in the system. A toolkit would provide the support needed by these directors to speak to their funders, county/local commissions, and communities about the importance of this issue.” This need was similarly mentioned in responses to the question "What additional information related to the topic of the town hall would help you take further action?"

There were several comments expressing concern related to library staff role scope creep:

  • “It is a heavy burden to place on a library staff that did not intend to do this kind of work, and I don't think it should be forced upon them/us.” 
  • “Many of our libraries see the opioid crisis as yet another burden being placed upon them so giving them clear, simple things to do in response is appreciated." 
  • "This comment may not be a popular one. At first I was very positive that I wanted to help in this crisis, until I really thought about it. It doesn't make heroes, just more victims. I would be traumatized if I administered Narcan to a person who then vomited on me and became hostile with me, if the descriptions I am hearing are true. I would be equally traumatized if someone died of an overdose in the library and I was unable to stop it. This is a heavy burden that must also consider the library staff and their well-being."

A number of responses indicated that opioid addiction and overdose is not an issue in their communities, but that they recognize the need for dialogue, research and preparation. One participant raised the importance of being able to "Bring more attention to the issues and what libraries can do to help address them, before they become reactionary issues." There are also situations where opioid addiction is impacting the community, but not the library directly, as one respondent recognized that they want to be prepared "...especially for those of us whose libraries are small, where there is a major opioid issue, but yet, no evidence of it in the library."

Participants also shared comments related to the need for more information on how to tell if someone is overdosing or under the influence. In addition to these detection skills, there's an interest in teaching library staff more about what to say to patrons in these situations. And additionally, there's a need for more resources to share with the public related to addiction, prevention, treatment, and recovery support.

Many respondents suggested ideas for programs and services in their comments:

  • Promote a "one book" event using Sam Quinones' "Dreamland"--sure to convince even the most die-hard skeptic of the gravity of the problem
  • Create displays featuring these issues
  • Host community conversations about these topics
  • Create a referral resource list, more resources for the public, including "Easy to modify" posters and cards
  • Provide information on addiction, specific to the community situation
  • Include other social issues in the community that can/are impacting libraries: mental health first aid, homelessness, domestic violence, etc.

And others recognized that staff training can be about many things besides administering Narcan, e.g.:

  • Trauma-informed care, mental health first aid
  • Sharps container safety
  • Safety and security for patrons and staff
  • Understanding signs of addiction and overdose and know how to respond
  • Training on easy-to-understand consumer health information that includes the topics of addiction and mental illness
  • Writing policies or policy statement best practices

WebJunction and PLA understand the importance of and interest in this topic and will seek ways to support libraries as they explore related issues in their communities. We continue to add to Opioid Crisis: Libraries, Resources, Context and Data, and invite you to share any resources or responses you're finding useful in the Facebook group, Libraries and the Opioid Crisis.