John Henry Reith ’22 thought working in health care meant he’d go to medical school and put in years of training to earn a long white coat. He thought the only way he could really help people in his community was by becoming a physician.
When Reith got to Wabash, a world of possibilities opened up for him—especially after the biochemistry major and public health minor took biology Professor Eric Wetzel’s intro to global health course his sophomore year.
“I realized there’s so much more that goes into health care and how we experience it beyond frontline workers,” says the Lilly Scholar. “It’s very interdisciplinary.
“I wanted to dive more into what goes on behind the scenes, and learn how I could help shape those systems for the better.”
And that’s exactly what he did last summer as a data analytics intern with the Allen County (IN) Health Department.
Having grown up in rural Leo, Indiana, northeast of Fort Wayne, Reith was aware of the struggles his hometown experiences with the opioid epidemic, but was unsure of how the community was addressing the issue. So, he reached out to Allen Superior Court Judge Wendy Davis, who had led a local reform program that provided victims of drug abuse disorder treatment opportunities instead of incarceration. She put him in touch with the county health department.
During his internship, Reith analyzed Allen County overdose records collected from police reports, coroner’s reports, and other medical documents. He examined a number of factors ranging from the person’s demographic background to the type of drugs found in the person’s system.
“My job was to consolidate, interpret, and analyze the data, and then, present my findings to the board of commissioners of the health department to educate and provide insight on what intervention plans are needed to help the community.”
Reith found that Allen County had a total of 874 overdose deaths between 2008 and 2019, and that fentanyl was found in two-thirds of all overdoses. Additionally, the data showed that 80% of victims had at least a high school diploma, and 75% were employed or on disability at the time of their deaths.
Before the internship, Reith admitted to stereotyping and using negative language, like “drug addict” and “drug abuser,” to describe people who struggle with substance use disorder. The more he read records and police and crime scene reports, the more he developed empathy for these victims.
“I saw the death record of one of my childhood friends whom I hadn’t seen in years,” says Reith. “I paused when I read his name. It was like, Holy cow. I’ve had surgeries and orthopedic procedures and been prescribed opioids. This could have been me.
“That was the moment I realized how important it is to make people aware of the vastness of this serious issue, and the fact that addiction is nondiscriminatory. It can come for anyone.”
Another part of Reith’s internship included working at a local needle exchange clinic.
“It was eye-opening. I heard people’s stories firsthand, face-to-face. That was really meaningful in helping me contextualize the work that I was doing and why it’s important,” says Reith. “Even if it’s hard or boring sometimes sitting in front of a computer with long lists of numbers, there’s a reason for it.”
When Wetzel heard about Reith’s internship experience and how it changed his perspective, he got choked up and teary-eyed.
“One of the things that Jill Rogers [health advisor and GHI program coordinator] often tells our students is that empathy is our superpower,” says Wetzel. “Behind the numbers, there are people. We can lay out all of the national statistics and get these big numbers, but they need to be understood. There are human stories behind all of them, and it’s a lot more complicated than what it looks like on the surface.
“For John Henry to recognize that, step out into the community to talk to people, and dig into what the data means is what public health is all about,” Wetzel continues. “He’s a natural leader. We need more people like him out in the field.”
After conducting his research, Reith compiled his findings into a 15-minute presentation before the board of commissioners, where he proposed solutions to help address the opioid crisis in Allen County. One approach called for increasing police presence and community policing practices in areas of the county that had the highest rates of overdoses.
“There’s a really big street presence with hard drugs, fentanyl specifically. The opioids get people addicted, but the fentanyl is what’s killing them,” says Reith.
Fentanyl is a synthetic opioid typically used to treat patients with chronic severe pain or severe pain following surgery. According to the United States Drug Enforcement Administration (DEA), fentanyl is a controlled substance that is similar to morphine, but about 100 times more potent.
Fentanyl is being distributed across the country and sold on the illegal drug market. It is often mixed with other illicit drugs to increase the potency, and increasingly pressed into pills made to look like legitimate prescription opioids.
There is significant risk that illegal drugs have been intentionally contaminated with fentanyl, according to the DEA. Because of its potency and low cost, drug dealers and distributors have been mixing fentanyl with other drugs, including heroin, methamphetamine, and cocaine, increasing the likelihood of fatal overdoses.
“We have to find a balance between cracking down on drug distributors and finding help for people who are addicted,” Reith continues. “You can’t just punish the abusers. They are a victim to their disease. The distributors are causing the problem.”
Another solution Reith suggested was increasing the placement of Narcan boxes in affected areas.
Naloxone, also known by the brand name Narcan, is a non-narcotic medication that is an antidote for opioid overdoses. If administered in a timely manner, it can reverse the life-threatening respiratory failure that is usually the cause of overdose deaths.
There are two types of naloxone commonly available to the public/non-medical personnel. One is an auto-injector, complete with voice-recorded instructions for use. The other, Narcan Nasal Spray, is an intranasal device that requires no assembly and involves spraying the drug into a nostril.
Under Indiana law, anyone can buy naloxone without a prescription and administer it to an individual at risk of opioid-related overdose. Pharmacies, local health departments, and other entities can register with the Indiana State Department of Health to sell or distribute and provide training on the drug to anyone who wants it.
“There is a direct relationship between the time of overdose, the first Narcan admission, and survival rates,” Reith explains.
Standing before the board, other local physicians, and community leaders felt intimidating at first, but Reith says thanks to Wabash he felt prepared and more excited to engage with people on such an important topic.
“I think they were happy with the presentation. As always, it’s shocking to see the reality of this issue with the data showing increases in opioid use and deaths every year. I think it was important and provided an extra drive to act,” says Reith. “The plan for the health department moving forward is to continue this project so they can make the best-informed decisions to help the community based on the most current data.”
After graduation, Reith will be attending the University of Notre Dame’s master of science in global health program.
The program has a focus on community-based capstone research, Reith says, and will help him continue to develop the skills needed for a career in public health, “while still connecting with current issues.