Here's what's behind that marketing campaign you might have seen all year on billboards, in television commercials and more.

Editor's Note: This is an extended version of the story that ran in the September 2019 issue of Columbus CEO.

It’s a safe and secure place, one where photogenic families watch their children play rec league baseball and enjoy a meal at the local café. The communities are pristine, and perfect parents with their even-more-perfect children bask in the comforts of their well-manicured homes and neighborhoods.

It seems impossible for addiction to happen in Denial, Ohio.

This Pleasantville-style on-screen depiction of Denial—a fictional Ohio city, town or suburb that could double for hundreds of real locales—is exactly the point, say representatives of the Ohio Opioid Education Alliance, a coalition of businesses, trade associations, nonprofits, health care organizations and educational institutions formed in 2018 to educate communities about the nature of opioid addiction and provide steps toward prevention.

The message is clear: No place is immune, and individuals battle addiction in similar places every day. It’s time for everyone to stop living in Denial.

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The Nationwide Foundation provided initial funding of $2 million for the Ogilvy-produced marketing campaign, which features the now-ubiquitous ads that target parents and caregivers, and the alliance has established a donor-advised fund managed by the Columbus Foundation. As of August, $6.4 million had been contributed to the fund.

“We haven't spoken to any organization that hasn't said, ‘We want to be part of this positive work,’ ” says Nationwide Foundation President Chad Jester. “This conversation about the campaign and the alliance started with ADAMH (Alcohol, Drug and Mental Health Board) of Franklin County and (CEO) David Royer’s great leadership, and with Nationwide. Now we have more than 70 organizations from throughout the state of Ohio involved, and many of those partners are also investors in the work.”

While opioid addiction has become a national concern during the latter part of the decade, Ohio long has been considered the epicenter of the crisis due to its high number of overdose deaths. Information provided to the Ohio Department of Health for 2017, the most recent year statewide data was available, showed a record 4,854 unintentional fatal drug overdoses. While that number was the highest in eight years, heroin deaths dropped by 46 percent in 2017 to 987—the fewest in four years—and prescription opioid deaths also dropped to 523, the lowest in eight years and down from a peak of 724 deaths in 2011. 

The high number of deaths can be blamed on rising use of a dangerous synthetic opioid called fentanyl, according to state data.

The alliance emerged as part of the Franklin County Opiate Action Plan, developed by ADAMH in 2017 after the city of Columbus and Franklin County officials worked to adapt a large-scale plan to address the opioid crisis. For those suffering from addiction, the plan takes a comprehensive approach by working with hospitals and the health care community to ensure timely on-demand treatment, the presence of stabilization centers, expanded availability of naloxone to reverse overdose and collaboration with first responders and police.

Jester notes that engaging organizations through the Denial, Ohio, campaign has led to a common response among those who initially thought they had no personal connection to the opioid crisis.

“We’re hearing from people saying, ‘Thanks for raising the awareness about disposing properly of prescription meds because I went home and found an opioid in our medicine cabinet that was 20 years old,’ ” Jester says. “It’s an indication that people don't always dispose of their opioid medication or any medication when they should.”

Maybe the original owners have no plans ever to take that pill, he notes, but one day, their teenage children could. “We know most heroin users will tell you that their first experience with opioids was going through a medicine cabinet,” Royer says.

Nationwide has been working internally around the issue with its employees for the last five years, bringing in speakers from the health care sector, law enforcement and others to provide education about the crisis and how to address it within their own homes.

“We all employ people who might be suffering through addiction, but at the very least, we want employers to be aware of the risks through opioid prescription pills, how to address that risk and then how to talk to children in their life,” Jester says. “We really viewed it as an employer-first mindset that engaged everyone from every sector, including the private sector.”

For Bexley dentist Sharon Parsons, vice president of the Ohio Dental Association, the crisis came to her front door. Her son, Sean Herman, died of a heroin overdose in September 2015 when he was 27.

She often shares the story of how Sean first encountered opioids as a college student when he needed to manage pain after a dirt bike accident. A friend gave him oxycontin to help him cope while he was finishing his finals. That started the path to heroin addiction, a common next step for opioid users seeking to replicate the high.

Through the Ohio Dental Association, which joined the alliance in March, Parsons has used her story to become an industry-wide advocate for prevention and education throughout Central Ohio. She also speaks to national audiences about the medical community’s role in preventing addiction.

“Between the ages of 13 and 26, the prefrontal cortex of the brain is still forming,” says Parsons, who will take over as association president in October. “And in that tender age range, if you're exposed to an opiate, you're five times more likely to become addicted. That’s the time for middle school, high school, college sports and getting your wisdom teeth pulled.”

The common response to wisdom tooth surgery pain? Prescribe a narcotic.

“When I was in dental school, we learned to manage pain,” Parsons says. “I'm old enough now to remember—I graduated in 1981, I'm 62 years old now—that maybe eight to 10 years after that, they started changing their thinking from managing pain to eliminating pain. They were all prescribing for what they thought was a good reason and not realizing that they’re giving people something that could kill them.”

As Parsons speaks to dentists, medical practitioners and families, she emphasizes that denial can also exist as a refusal to change existing habits or mindsets about treating pain—opening another path to addiction.

From the employer education standpoint, Royer of ADAMH stresses the importance of companies supporting employees struggling with addiction or those dealing with family members in the throes of the disease.

“One of the other key conversations we have with employers is that for many people there, there's still an embarrassment factor,” Royer says. “When a family member is experiencing difficulties with opioids or any form of substance use disorder, it's somewhat stigmatizing. We've tried to educate our employers that if an employee comes in and talks about cancer, for example, there's really no stigma associated with that. We all embrace and support that employee.”

He wants addiction to receive that same level of compassion. Relapse will be part of the process, he says. Employers should understand that addiction functions like a chronic disease that is not only debilitating for the individual, but that stretches through the entire family structure. Businesses and organizations can improve the culture of support for employees by offering internal assistance and references to external resources when needed.

And as Parsons advocates in memory of her son, she wants organizations to recognize the role they play in prevention and education.

“Just those two little words made people aware that we really do need to talk about it,” Parsons says. “I saw a statistic that says 192 people a day in this country die of drug overdoses. You can’t keep hiding that this is here.”

Shannon Shelton Miller is a freelance writer for Columbus CEO.