OPIOIDS IN THE BORSCHT BELT
SULLIVAN COUNTY, NEW YORK, has among the state’s highest opioid mortality and opioid prescription rates.
In 2017, 41 people per 100,000 died of opioid misuse, with an opioid prescription rate of 66.5 per 100 people.
The county is vast and rural. It’s about the size of Rhode Island, yet has only two public buses that run twice a week. All major amenities — from chemical treatment facilities to basics like Walmart — are located within a small central triangle, far from many residents in the more distant towns and villages.
While the county is only about 90 miles from New York City, it’s another world geographically and culturally. This is where, in the mid 20th Century, city residents fled the summer heat for Catskill resorts and Borscht Belt entertainment. Today, most of the resorts are marked by ruins.
Researchers at the Rockefeller Institute of Government studied the epidemic on the ground here for more than two years, interviewing well over 100 people on the frontlines of the crisis. Read their findings here.
Sullivan County Public Health Director Nancy McGraw in her office in Liberty, New York. McGraw describes the local efforts to curtail opioid abuse amid a patchwork of state services and thinly stretched county resources.
In this rural county the size of Rhode Island, services are few and far between— from healthcare to recreation and grocery shopping.
Sullivan County — as with much of New York’s “Borscht Belt” — is haunted by crumbling resorts and summer camps turned into motels or rental bungalows. In its heyday, this area was a playground for New York City residents escaping the summer heat.
As I drive around, I stop at a honey stand at the side of the road. When I tell the woman what I’m working on, she tells me her own family’s opioid story. At a bar, the bartender tells me hers, how she’s become a de facto first responder of sorts. They’re everywhere.
A nurse in the county sees the opioid epidemic unfold through an endless stream of daily interactions with patients struggling with addiction. She stays in touch with some, often only to end up a witness to relapse and loss.
With the help of radio producer Kevin Gref (left, above) Julie Pisall launched a weekly radio program to raise awareness of opioid addiction and resources after her own daughter’s death. From a house-turned-radio station deep in the rural part of the county, Julie opens each program with the same introduction recounting her daughter’s story, a sort of weekly eulogy.
Addiction intersects with so many other traumas. At a women’s recovery home, residents share their experiences of sexual assault and violence. In too many cases, systems of addiction and dependence leave people vulnerable to exploitation by doctors, dealers, family, and others.
Law enforcement has been forced to find new approaches to the opioid epidemic, accepting harm reduction strategies, working with community organizations, and rethinking their role as part social worker, part police officer.
Sullivan County is also full of people who have overcome, are overcoming addiction, and helping others to do the same— in support groups, faith outreach, flyer posting, volunteering, writing, and however else they can.
