Why It Matters
Students who organized as part of the IHI Leadership and Organizing for Change course are working in partnership with community groups to prevent opioid deaths.
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How Students Are Fighting Opioid Deaths in Ohio

By IHI Open School | Tuesday, January 23, 2018

Medical resident Nick Christian, MD, MBA, and medical student Michael B. Holbrook, MBA, are leading an effort to fight opioid addiction in Dayton, Ohio. In the following blog post, they share the leadership lessons that helped them organize students, with the help of IHI’s Leadership and Organizing for Change course.

Dayton, OH, was ranked as the worst big city for drug overdoses in the United States in 2014. We're organizing students to change that.

A new student group, organized as part of the IHI Leadership and Organizing for Change course, is working in partnership with community groups to prevent opioid deaths. In the course, we learned leadership skills to identify a cause worth rallying around and to build a leadership structure that would allow many people to get involved.

Today, students are focused on two projects: providing medication disposal bags to patients who have been prescribed opioids, to ensure they can dispose of any unused drugs safely, as well as leading presentations on the misuse of prescription narcotics, to help providers prescribe opioids safely.

How can you organize students to improve health and health care? Here are a few of the leadership tips we can share based on our experience.

  1. Organize around a cause that your community cares about. A few years ago, Nick asked Marshall Ganz, a professor at the Harvard Kennedy School and a leading thinker on community organizing, how to recruit resources to a cause, during an IHI Open School event. His response? “You have it backward. You shouldn’t have to recruit resources to a cause. You should have a cause that is worthy enough to attract resources to itself.” With this idea in mind, we thought that students might be interested in working on the opioid crisis in Dayton.
  2. Know — and engage — all the stakeholders involved in the issue. In Dayton, the community was already organizing around the issue of opioids when students started getting involved. The Community Overdose Action Team (COAT) is an interagency collaborative between Public Health Dayton & Montgomery County and the Montgomery County Alcohol, Drug Addiction & Mental Health Services. This group comprised all the community organizations vested in reducing the havoc that the opioid epidemic had done in the greater Dayton area: law enforcement, public health, mental health specialists, families of addicts, health administrators, community organizers, and more. When Nick learned about this group in a community health elective, he figured the group would know how students could help.
  1. Don’t centralize power — distribute it among multiple leaders. Nick and Michael formed the Student Opioid Coalition (SOC) to start working on this issue, and it was a quick success. Why? Instead of forming an entirely new organization, the SOC acted be a feeder system for active COAT projects, building on the assets of the students and the community. Simply put, the COAT knew what to do but needed volunteers. The students yearned to be involved, but didn’t know how to help. Instead of doing it all ourselves, the student organization adopted a partnership model.
  2. Get some early wins to build momentum in the long-haul work. The catalyzing event for the SOC was a Naloxone Training Seminar for students hosted by a local branch of the Ohio Department of Health. Many communities are distributing Naloxone, also known as Narcan, a lifesaving drug that can stop an overdose, to citizens and training them to administer it to people they find overdosing in public areas.

By presenting projects as they have become available, students have been able to choose specific projects that interest them and get involved to the extent they’re able. While some students need to take charge and run a project, others are more comfortable taking orders or being a part of a central group of decision makers. In our experience, allowing these power structures to form organically is crucial for the success of a project. Individuals are more likely to be productive and feel empowered in a project when participation feels like a choice as opposed to an obligation.

Nick Christian, MD, MBA, is a first-year internal medicine resident in the Distinction Track for Care Transformation at the Dell Medical School at the University of Texas at Austin.

Michael B. Holbrook, MBA, is a third-year medical student at the Boonshoft School of Medicine at Wright State University and current chair of the Dayton Chapter of the IHI Open School. He can be reached at DaytonIHIOpenSchool@gmail.com or on Twitter @TheBowtieDr.

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