In the run-up to the 2016 election, Jack Shuler was reporting on poverty – most particularly, how it was being experienced in Ohio – and was disappointed that neither presidential candidate had much to say about entrenched poverty and homelessness.

As he delved further into his reporting, he became increasingly aware of the relationship between the economic crisis that so many people in the Rust Belt and Appalachia had been experiencing for decades and the addiction crisis. He focused his reporting on his home community, Licking County, which led him to The Corner (more on that below).

In “This Is Ohio,” Shuler explores our nation’s overdose crisis as a human-rights issue, a crisis in which “every overdose is a policy failure.” He takes us out into his community and beyond to witness the devastation of the overdose epidemic and, most importantly, the efforts to overcome it.

100 Day’s in Appalachia’s Taylor Sisk spoke with Shuler about his forthcoming book, which goes on sale September 8.

The following interview has been edited for length and clarity.

Taylor Sisk: How did you come to write this book and what was the approach that you took to reporting it?

Jack Shuler: In the run-up to the 2016 election, I was focusing my reporting on poverty and how poverty was being experienced in Ohio. I wasn’t hearing from either of the presidential candidates much about poverty and homelessness. And as I started reporting on it, I began learning more and more about the relationship between the economic crisis that a lot of people have been experiencing for decades and the substance-use disorders and crisis.

So, I wrote a few stories about organizing around these issues and the county where I live, Licking County, Ohio, just because that’s where I live. I have small children, I can’t really travel, and I felt like these stories mattered and would matter to national audiences.

I wrote a few stories about organizing. I wrote some stories about people who were trying to deal with the overdose crisis and substance use but with few resources, and I began to see a bigger picture developing. And the people who I was reporting on began crossing each other’s paths. I began to see a larger narrative. It just happened. I just showed up a lot and I got to know these people. 

I really care about these people; I care deeply about these people. There’s a journalist, a documentarian, who I have great respect for from West Virginia, Elaine Sheldon, and we’ve talked a little bit about this, because I was just feeling so intimately involved and connected to these people. And it was good to hear from her that this also happens to other people and that it’s okay. I felt like what I was doing ultimately was, I was trying to be honest about their lives, but also, you know, being empathetic towards them as human beings and not subjects.

TS: You use person-first language in the book. Describe what that means and why you felt it was important to use in this book.

JS: Person-first language means exactly what it says – that whenever you’re talking about someone, you don’t describe them as a pathology. Instead, you describe them as a human being first.

I learned a lot, actually, from a number of journalists who are trying to use person-first language in their reporting. And I could see the flaws in some of my past stories on how when you talk about someone as an addict, you’re leaving it at that. But people are more than just that, right?

It was eye-opening to me to begin to think about the ways that we could do differently in journalism that might work to mitigate the harms of our past work and potentially work to combat stigma. So that’s one of the things that I tried to do [in this book].

TS: So, rather than saying someone is an addict, you say they’re living with an addiction, for example. Is that it?

JS: A person who uses drugs or a person who uses IV drugs or a person with substance-use disorder, yeah.

TS: Tell us about The Corner, which is the focal point of your book. Why did you choose to use it as the scene-setter in your prologue?

JS: There were two women in Licking County who I met at the Women’s March in Newark, Ohio, and they were frustrated with what they had noticed was a growing homelessness issue in the county. And they decided – Patricia Perry and Jen Carnegie – they decided that they were going to just start handing out coats, and so they did that.

And then they set up in a parking lot and they started grilling hotdogs and handing out food, and people began to notice what they were doing. They had to move to a spot just down the street – actually right across from the county jail – and people could see their commitment. I mean, it was very visible, every Saturday. They’re there and they’re always there.

It was also a place where people who were unhoused or who were under-housed and people who use drugs, they felt cared for, they felt safe. They trust Trish; they trust a lot of the women who are down there helping. And I say women, because it really is a lot of women, a lot of mothers and a lot of people who’ve been affected by substance-use disorder, either through their own struggles or through the struggles of family members and who have had family members who were unhoused or currently are.

It also became, over time, a place where there was a little bit of political organizing going on. I mean, they were trying to engage with people who use those services, to get in the fight around how people who are unhoused are treated in that community, how people who use drugs are treated in that community. And I made it my practice to go there every Saturday, and I still go down there pretty often.

I think that there are some people that don’t like [what’s happening on The Corner] so much because it’s in your face. But when I say it’s in your face, it’s beautiful, because people are so committed to helping the people who need help and also helping each other.

What Trish started doing was distributing harm-reduction supplies and naloxone, and the health department has come down there to do Hep A and Hep C tests. There are a couple of folks who come down there and cut hair once a month. I think the more I was there, the more I gained the trust of other people who were running the show, and it helped me meet folks.

TS: You write about community trauma in the book. How does that manifest?

JS: It just kind of dawned on me in the moment – in the book, you actually read where it does dawn on me – that people in the so-called Rust Belt and Appalachian communities have experienced a kind of community trauma – that there was a time when most people there could get jobs working in factories and they could make decent money and, as one person describes it in the book, you can be a bit of a jerk and you could still have a decent life and take your family to Myrtle Beach every summer, or something like that.

But that’s changed, right? And so, in that sort of recalibration that we’re still undergoing here in the Rust Belt and in Appalachia as well, I think it is traumatic, because you have a vision of who you are as a community and that vision has changed. There’s a rift.

And I think the rift increasingly, as far as I can tell, is between a class of people who have more and more money and a class of people who have less and less. And that’s not unusual in the world now. But I’m not reporting on the world; I’m reporting on this county and on these kinds of places. I think if we look at them on their own, we can see the patterns, we can see the role that our modern version of capitalism has had on its communities.

TS: To some extent, were you writing about your community’s recovery process from this trauma?

JS: We see ourselves in the world, and as we write, we create new stories, right? And I think that there were moments that I was writing this book where people were trying to write new stories, to tell new stories about themselves, because it’s the stories that we tell about ourselves that keep us going.

In the United States, we have these narratives about who we are as a people, and every so often those narratives are realized to a certain extent, and most of the time they’re not. But I think that what I was seeing was people who had never been politically active, not necessarily going to city council meetings, who were speaking up in ways that they had never done, feeling like they were a part of the political process for once and getting frustrated as hell by it, but inserting themselves in the public sphere. And to me, that’s the beginnings of creating a new narrative.

TS: In the book, one advocate told you that we don’t have an overdose crisis in the U.S., we have a stigma crisis. Is that what you’re describing when you’re talking about the character Billy that you spend some time with in the book and the shame that he felt?

JS: I don’t think he’s unique in it. People feel bad about themselves because they’re doing this thing, because we’ve decided that there’s such a thing as hard drugs and soft drugs and we’ve stigmatized things so much that we’ve created miserable lives for people. They don’t want to come out into public. There’s a guy that I interviewed who felt so embarrassed about the way he looked that he wouldn’t go to a grocery store.

How are we supposed to create a community or society where people are actually listened to and cared for when people don’t want to even be seen by other human beings? And that made me really sad. It makes me really sad.

But it was interesting too. Big Pharma did something to Appalachia, but the bigger problem is dislocation, it’s poverty, it’s capitalism, it’s all these things. And stigma is preventing us from talking about those things, because we would rather blame people, right? We’d rather blame people than look inward and see the crisis that we’ve created ourselves in some ways.

TS: You did some reporting for this book in Canada. Tell us about what you experienced there in terms of how they’re addressing their addiction crisis differently than how we are here.

JS: In the downtown eastside, what I saw was people who use drugs at the forefront of advocating for and creating spaces for people to use drugs that are safe; that help save lives. They created the first safe injection site, which is an amazing place. 

Then right now there’s a special dispensation from the government to allow them to have what are called overdose-prevention sites. One person I talked to called them lifeguard stations. Essentially, they’re like pop-up safe injection sites with oxygen and Narcan at the ready. It was incredible. As opposed to what we have here, which is people using by themselves, and that’s one of the reasons why a lot of people overdose and die.

But the thing that I took away from that experience was the anger and the desire to actually create something like social justice for people who use drugs. I was so impressed by that. I see that at times in the United States, but I feel like I don’t see it enough. I just was really impressed by their willingness to listen to scientists and to listen to research and to implement that research in how they were dealing with the overdose crisis there.

TS: You write it will take “more than harm reduction and evidence-based treatment to address the overdose crisis – t will take a shift toward thinking of substance use and overdose as a social justice problem, a human rights crisis affecting mostly poor people.” And then you underscore that it’s a criminal justice issue as well. What needs to happen in our criminal justice system to deal more productively – I guess some would say more rationally – with our overdose crisis?

JS: I’m all in favor of trying decriminalization. I think, knowing the way our political system works, it will take time. But I think the first thing to do would be to take all the resources in the Drug Enforcement Administration and put them elsewhere, dealing with a health crisis – because that’s really what we have here. We have a health crisis, and we need to deal with it like a health crisis.

We need to treat the people who are suffering as human beings, as we would want to be treated. But we’re locking people up, and it isn’t effective. It’s never worked. It only just makes life tougher.

TS: Let’s pretend that you’re granted two or three wishes. You can wish for a law to be passed or for a policy to be adopted or for a major investment. What would those wishes be for things that would make a considerable difference in addressing our overdose crisis?

JS: Oh, boy, okay. So, I would say housing for all; everybody gets housing. And I think basic income would be very helpful.

We need to think about how we can create safe injection sites, and they need to be run by people experienced in harm reduction. They need to be safe places for people.

We need to get naloxone in the hands of people who use drugs. I think we’ve come a long way with this, and maybe this is lower on the list than it would have been before, but I still think that there are struggles to actually get it to people who use drugs. It’s easy for me to get; it probably would be easy for you to get. But there are a lot of barriers for those who use, and It should be easy. I don’t think we need to be relying on first responders and police to solve this problem; that’s much bigger than them. I think we put too much on them.

TS: Are we moving in the right direction in addressing this crisis? And do you have a vision of what success looks like?

JS: There are things happening that are positive. But until we recognize that, first of all, the racist origins of the Drug War and the ways in which the Drug War has destroyed the communities of People of Color and poor people around this country – until we actually not only recognize that but actually deal with the consequences of that – it’s gonna be hard to move past it.

The thing that would resolve overdoses would be to actually have a safe supply, and we need to think a little bit more radically. I mean, in Canada the conversation when I was there was not about safe injection sites; the conversation there was over safe supply. They were like, “Let’s get a legit supply of heroin so that people can take heroin and not fentanyl, because they’re dying because of fentanyl.” I was like, “Whoa, that conversation is like miles away from where we are.”

But if you look at the data, it’s true. If you look at the drug supply in Ohio, people are dying because of fentanyl. And they’re dying because of carfentanil. And until we address that, which is also addressing the Drug War issue, then people are going to just keep dying.

TS: What do you most want people to take away from your book?

JS: I would tell people what I was working on when I was writing, and most people were like, “Oh, my gosh; like, that’s intense. I don’t know if I want to read that.” But I actually think that it’s a very hopeful story. It’s a story about re-imagining how we exist in a democratic country. It’s about inserting ourselves into democracy in ways that sometimes we forget we can, and about speaking up for ourselves in the public sphere – people who are the most marginalized and the people that we treat the poorest in this country standing up and speaking. We need more of that. We need more of that.

Jack Shuler is the author of three other books and his writing has appeared in The New Republic, Pacific Standard, Christian Science Monitor, 100 Days in Appalachia and the Los Angeles Times, among other publications. He’s chair of the narrative journalism program at Denison University. His book “This is Ohio” is available on September 8.