Sen. Rob Portman and Neil Tilow

• The shocking human cost of opioids in Ohio (10:11)
• The change in addressing opioids that's finally starting to make a difference (16:28)
• The grieving mother who helped inspire Sen. Portman to action (29:16)
  
• Three ways you can help fight the epidemic (36:21)

ROB PORTMAN: Thank you, Frank. Really appreciate you having me on.

FRANK BLAKE: So I want to start with just a couple of questions about your career as a whole for our listeners.

Are there things about the Senate that you'd want to highlight that maybe regular people don't know, maybe fun aspects of it, or things that aren't so fun, as we look at this very important glamorous job?

ROB PORTMAN: There's probably a lot of people don't know about some of the better parts, because mostly we hear about the negative parts, don't we?

But look, you develop relationships and friendships on both sides of the aisle, and that's how you get things done, just as in any business.

Frank, I first got to know you when you were at EPA as general counsel in the first Bush administration. Later you became CEO of a major U.S. company, Home Depot.

I've watched your career over the years as a lawyer and as a business leader in our country, and that relationship we developed way back in the... oh, my gosh... 1980s.

FRANK BLAKE: We both worked for George Bush's father. We both worked as lawyers for him. Way early in your career. Way early in mine.

ROB PORTMAN: So that's part of what people don't think about, I guess, is that senators are people too. They need to develop relationships, believe it or not, and it's very helpful.

So I've done a lot of work across the aisle. I'm a Republican. I'm proud of that. I'm a conservative. I'm proud of that.

But I also believe that when you get hired, your job is to get something done. And quietly, a lot does get done behind the scenes, that the media doesn't cover, and you don't get much credit for, which is fine.

You don't do these jobs to get credit, you do it to actually, in my view, to move the ball forward for your constituents, in my case the people of Ohio, and for the people of America.

And this issue that you've chosen to focus on today, is one of those.

I've spent 25 or 30 years working on this issue of the substance abuse and addiction issue generally, and more specifically on opioids recently, and I've never really... I think most of my constituents probably are not aware of the work that I've done in this area, because you do it quietly behind the scenes, the press doesn't cover it much, because it tends to be, I would say, even nonpartisan.

But I'm proud of the work we've done, and I'm proud of the way, since the 1990s when we really started working on this intently from a legislative perspective, we've changed some of the attitudes and even the paradigms with regard to addiction.

FRANK BLAKE: So Rob, I remember your recommending to me a book called Dreamland, and it was about... I want to say that was probably around 2015. And I felt like I was early on understanding elements of the opioid crisis, and then in researching for this episode, I realized you've been involved in this issue since 1996. What was it that you saw several decades ago that prompted you to say, "This is a major issue for us as a society?"

ROB PORTMAN: Well, that book, by the way, by Sam Quinones, if people haven't read, it's a good book about the history of the opioid epidemic, and how it came to be. And it focuses a lot on Ohio. It turns out Dreamland is a place in Portsmouth, Ohio. So I recommend it.

Neil Tilow, who's on the line with us here, and you'll speak to Neil in a moment, he would be a good person to talk to about when we actually first got this inkling that the opioid crisis was coming.

But even before opioids, recall that we had a major issue with regard to cocaine, crack cocaine, powder cocaine, more young people using drugs, everything from marijuana through heroin and cocaine, but mostly marijuana and cocaine. And this was in the 1990s.

So in my experience, since the 1990s until now, there have been many different kinds of drug epidemics or drug usage issues, and it's shifted. So at the time that I got involved, which was 1994, we started a coalition. In 1996 we formally codified it.

And this coalition was something that was local back here in Cincinnati. I was a member of Congress, but I became convinced that prevention and education was the way to go, and that these community coalitions were doing a great job around the country.

So I started one here, and then I passed legislation called the Anti-Drug Communities Act, so it was about setting up additional community coalitions, providing matching funds if they met certain strict requirements of engaging all of the community, and dealing with the issue in a scientific way using data. And that has spawned about 2,000 community coalitions.

So honestly, in those days, mid 1990s, the opioid crisis was not on people's minds. It wasn't on mine. My recollection, and again Neil can correct us here, is that about 2000, I started to hear about this issue of the drug. So this would be the Oxycontin in particular in southern Ohio, and particularly in Kentucky it was coming, and from West Virginia, and in southern Ohio.

But also Percocet and other opioids in pill form were being abused, that people were increasingly going to pain clinics, that doctors and pharmaceutical companies were misleading people about the benefits of these drugs, thinking that somehow if you treated people for pain, that wouldn't make them addicted, which of course was ridiculous.

And so we started to hear about it, as I recall, around 2000, and that's where it started, not just in Ohio but around the country. Ohio happened to be one of those states, like West Virginia and Kentucky, that was ground zero, where you had more and more people becoming addicted to these pills.

And the book talks about this, Frank you're very aware of it, but to put it in shorthand, even though it's a much more complicated story, a lot of people who were literally in line to get these pills, were then approached by drug dealers saying, "Hey, I can give you the same high with heroin for a much lower price, and you don't have to wait in this line, and you don't have to get a doctor's order."

And so it was being abused by, at that time, certain parts of the medical profession, and the pharmaceutical companies were exploiting people, but also then these drug dealers were saying, "Try this."

And a lot of people shifted to heroin, and heroin became the bigger issue. And then eventually people started to see this movement toward the synthetic opioid, which has become the most deadly of all, and that's fentanyl.

At that time initially it was coming almost exclusively from China through the mail system, and I passed legislation called the Stop Act, which helped to keep that from happening. But then it cropped up somewhere else, which is in Mexico.

And that's what we see now, is the precursors often coming from China, but the actual production of the synthetic opioid, in particular these pills, Frank, that you've heard about, and people take the pills thinking they might be Xanax, or they might be Adderall, or they might be Percocet, and in fact they are laced with fentanyl.

And probably two thirds of the people dying of overdoses in Ohio today are dying of synthetic opioids, fentanyl being the primary one. So that's the history of it as I see it, and it got a lot better there for a while as we'll talk about.

In 2018 and 2019, we were really making progress. We had a 22% reduction in opioid use in Ohio and overdose deaths, which is how we measured it. 22% reduction in one year in 2018, after going up year, after year, after year.

In 2019, there was a slight improvement, and then the pandemic hit, and it caused enormous dislocation, and I want Neil to talk more about that from a technical or a clinical point of view, why he believes that happened. But the pandemic had this epidemic underneath it that we were ignoring, and it exacerbated the epidemic.

So I think we were making good progress, Frank, with legislation we were passing, like the Comprehensive Addiction Recovery Act, which we can talk more about. But now, unfortunately that's been reversed.

I do believe this year we're going to do a little better than last year, which was a record year in terms of overdose deaths, over 100,000 people, but based on some preliminary data, I think we might be again making some progress, but we've got a long way to go.

FRANK BLAKE: Rob, that's such an amazing overview, and I feel for all of our listeners, this crisis is one of the most... I mean it is talked about, but it isn't talked about nearly enough. I want to give credit to both you and Neil, and let you introduce Neil in a second.

But just to emphasize the statistic that you referenced, that more than 100,000 people died from a drug overdose in the United States in 2021. That means that someone was dying from an overdose, I think it's every five minutes. I mean it's a stunning number.

And as I say, we use this podcast to recognize and celebrate people who are doing good things for others, and the two of you on this issue, I think are just outstanding, and I want to call attention to it, because I think the crisis is so significant.

And Rob, let me ask you to introduce Neil, and give our listeners a bit of his background and how you've come to know him.

ROB PORTMAN: Well, Neil is the CEO of what's called Talbert House, which in parts of Ohio, including southwest Ohio, is the leading provider for all kinds of services related to addiction, from prevention, to treatment, to longer-term recovery. He also has worked a lot in the area of prison reentry, as I have.

And honestly, you were telling me, Frank, over the years about who your mentors have been, Neil's been one of my mentors in this area. And he agreed to join our board of the drug coalition we started here, called Prevention First, but also nationally, he agreed to come to Washington and help me write legislation.

First on Second Chance with regard to people coming out of the prison system, helping these individuals get back on their feet, and then related, because so many of these individuals have drug and alcohol issues, the Comprehensive Addiction Recovery Act, our Community Anti-Drug Coalition Act.

So he's one of the fathers of the national effort. And I mentioned earlier that I'm proud of some of the paradigm shifts that have occurred. At the time at which we drafted the Community Anti-Drug Coalition Bill, much of my party, the Republican Party, was focused on the supply side exclusively.

So drug interdiction, going to countries like Columbia and getting rid of the cocaine production, and prosecution of drug crimes, but not on the demand side, which is where I thought we could make the most difference, and where I think ultimately you have to solve the problem.

Both are necessary, and what's happening in the southern border today with regard to fentanyl, is definitely part of the problem. But you've got to deal with the demand. And I think it's actually a very conservative and Republican idea, that Adam Smith and supply and demand...

So Neil was a big part of that, because he helped us to come up with legislation on treatment and recovery, as well as the prevention work that he had done. And that changed the paradigm. And now it's understood, "Well, of course we have to deal with the demand side." But prior to that, Congress had never focused on that.

And really until several years ago, we had never spent a penny on recovery as an example. Now we realize this is an illness. And that's the other paradigm shift is to treat addiction as an illness, which it is. Your brain literally changes, which Neil can talk about much better than I can.

FRANK BLAKE: Welcome, Neil. Welcome to the show.

NEIL TILOW: Well, thanks for having me, Frank. And Rob, thanks for that nice introduction. If I'm the mentor, Rob is the best elected student I've ever had, Frank. I would say there's no doubt in my mind, I've been at this since 1974, but I don't think there's an elected official-

FRANK BLAKE: Would you say that again, Neil? 1974?

NEIL TILOW: That's when I started in the business-

FRANK BLAKE: Wow.

NEIL TILOW: ... and took over at Talbert House later on in '82. But I don't think there's a more knowledgeable or passionate person that I've ever seen in elected office on this issue, than Senator Portman, period. I mean, if there is somebody, I'd like to meet that person.

I don't think they exist though. And I'm worried about what's going to happen when Rob leaves, as a result, of course.

FRANK BLAKE: So with over four decades in this field, Neil, what do you think people still don't understand about addiction and treatment?

NEIL TILOW: Well, first of all I think, as the senator said, there's a lot of stigma there still, and people still don't treat it as a disease. They think it's a failing on somebody's part.

I also think that folks believe that it's not curable, and talk about everybody relapses. Well that's simply not true.

I mean the relapse rates for asthma and diabetes and hypertension are higher than they are for addiction. That's National Institute of Health data, by the way.

We don't talk about that in the same way, because there's not the stigma there, that there is around addiction. And I think that stigma has started to change, and I think the fact that law enforcement has understood you can't bill your way out of this, or arrest your way out of this.

And there's been some great law enforcement leaders who have said, "Yes, this is the right way to go. We have to do all these things, we can't just do one thing." I think that's helping change it as well.

FRANK BLAKE: There are so many complexities and different angles on this problem, but I'd like first to ask you, Neil, what's the toll that this takes on the caregivers, on people like yourselves, or families who are involved with this?

NEIL TILOW: Great question. Certainly the families are worn out, and many times disfranchised, or estranged from their loved ones, because of all the things that went into this.

If you think about the progression, someone starts out, they may be using the pills for being hurt or something, or there's some other pain they're dealing with, or they're just emotionally not in a good space, so they want to take drugs to escape a little bit.

And pretty soon they're addicted and the families are saying, "What's going on with you? How do we deal with this?"

And then they start taking things from the family to buy the drugs that they need, and the family then tries the tough love, and then they're frustrated.

I get calls, I would say, 20, 30 calls a year, from families at my home, or on my cell phone, who don't know me, or know me a little bit, or are referred by somebody, and my wife says it's my favorite call of the year when I get those calls, because I get to practice a little bit.

Again, not just to be an executive of an organization and get that person connected. But I think the families are struggling so bad. It's really heartbreaking to see that.

I got called this week, three or four times the same person called me, just trying to get... They didn't know what to do. If you break your leg, you know what to do. You go to the ER. If you have a drug problem, what do you do? And there's not that clear pathway for people.

With respect to the caregivers, the professionals, I think that it is a very taxing business, and there's a lot of things in it that don't sit well with some of the professionals.

There's a lot of documentation required, a lot of regulatory from the state. There's a lot of things that just don't work for the professionals. Some of them feel like they're an insurance clerks at times. Some of them feel like the clients won't listen, or they don't have a good breakthrough.

And so they have to feel good about what they do and see the rewards from their work, and sometimes they don't see that all the time.

So it's really important that our leadership and our supervisor staff engage them, and support them, and thank them, and recognize them for all they're doing to change people's lives. And it doesn't take many...

We had somebody to come by one of our centers the other day and said, "I just want to let you know I'm still doing good, and I've been sober now for this period of time, and I wouldn't do it without you guys." And that made all the difference for all those people who work there. That one stop-by.

FRANK BLAKE: I can bet. So Rob referenced that this issue, there started to be progress and then it seems like we took a step backwards during COVID. What were the underlying causes on that, just the isolation from the pandemic? What drove that behavior?

NEIL TILOW: Well I think, we have a very well prescribed process, in our community at least, that talks about... You think about EMS and fire response, police response, all the people out in the community who are helping people.

But when you are sitting at home all the time... A lot of deaths occurred in the home, because the people weren't out in the community to be seen when they overdosed. The access to Narcan and naloxone was a little bit harder to get to, because people weren't going out and getting it, didn't know where to get it.

I think the drug dealers are vicious in their sales practices, and I think they preyed on that. We own a bunch of supportive housing, maybe 400 or 500 units of supportive housing, and they were coming inside of our buildings to sell drugs, walking down the hallway, just totally brazen.

FRANK BLAKE: Inside your rehabilitation buildings?

NEIL TILOW: Inside our apartments. So not in our treatment centers, but in our apartments, where we have sober apartments, with tax credits and for veterans, and for other people. And we were having to call police. We had to have police stationed in the building, so there were.

So it was all out war, because they weren't getting their regular business out on the street corner, they had to go to people. And then people were dying in buildings, where other people weren't there to save them. So I think that was certainly a part of it.

I think the type of narcotic that's being used now, as the senator mentioned, fentanyl, and in the pill form, where you really didn't know what you're getting, but you thought you were getting something legit, because they stamped it and it looked legitimate, but it was totally illegitimate.

I think all of those things are rolled up into it for sure. I think the access to care also shut down some, Frank. We didn't shut down one day, not one day did we shut down, but we had to go to virtual at some of our outpatient locations, but our residentials program stayed open fully during the whole pandemic.

But that wasn't the case everywhere.

FRANK BLAKE: So you referenced, and the senator referenced, that now there's a different pathway to the lethality of the drug, which is, it gets basically cut into... As the senator said, you might think you were taking Xanax or Adderall, or something else. First, how do you deal with that? What's the curative to that? And second, what's the incentive for people to lace fentanyl in a Xanax pill?

NEIL TILOW: Well, I think it's probably stupidity in many ways, because they don't know what they're doing, and they don't care what they're doing, moreover, and I suspect that what they're doing is trying to get as much money as they can, and they're trying to get a product that will give you a big enough high, but won't kill you, because you don't want to kill your customers, but that's in fact what they've done to 100,000 people.

You used to think about the number of people in the Vietnam War who died was about 60,000, and when we passed that we said, "Oh my God. This is terrible."

Now we're almost twice that, and it's really tragic. So I think that they are just mixing and matching. I don't think there's any scientific formula to it. They're just trying to do what they do, and they don't do it very well, except that they do sell very well.

FRANK BLAKE: It's collateral damage from the overall problem.

NEIL TILOW: That's right.

FRANK BLAKE: So there's a campaign now, certainly in Ohio, probably elsewhere, called Beat The Stigma. Can you talk to us a little bit about that, and what you're doing, and how our listeners could help?

NEIL TILOW: Well, the Beat The Stigma campaign is really a baseline campaign to try to educate people, try to be thought-provoking, try to break down some of the myths that are there. What is this really about?

The campaign that we see in Ohio here, is a game show that's like, "Answer this question," and the answer is very obvious to most of us who are in the business, but not so obvious to any of the contestants.

And so I think it's really trying to educate people, that there are lots of reasons that addiction is out there, and we have to think about it in a different way.

I think it's an interesting campaign, and it is, as I said, thought-provoking.

And I'm hoping what will happen out of that, is people who are watching that and being educated by that, will change their mind a little bit about, "Oh, I guess this really is an illness. This isn't just about someone who has a weakness for drugs." That's really not the issue at all.

FRANK BLAKE: Is this unique to Ohio, or is it happening elsewhere in the country, the focus on beating the stigma?

NEIL TILOW: Well actually, I think it started with uh…if I'm not mistaken, with uh… a large insurance company here in Ohio started a local campaign in Columbus, Ohio. And then the state got onboard and said, "Hey, this is pretty good stuff. Let's use some of your material and put it on."

I don't know what else is going on in other jurisdictions, but they're buying a lot of TV time, so it's not an inexpensive campaign, but I'm sure they're getting some donated.

I know when the senator was leading the coalition here in the Cincinnati area, we got a phenomenal amount of paid time donated to us from the TV and radio stations, and that started to make a difference in terms of people just thinking about the issue.

I think also, I mean, such a prominent spokesperson who cared about and was passionate about it, and was so knowledgeable about it, really helped too.

ROB PORTMAN: Frank, I think we need to get back to that. Here locally, when I was sharing the coalition, as Neil said, we got all the TV stations and the radio stations, the major ones, as well as print media, to help us with a media campaign focused on prevention. And I think it was very effective, in the sense that we saw the numbers, which we studied every two years.

We did, as we still do, a survey of our high schools. We were focused on young people, and we saw the drug use go down to low levels that we had not seen previously. And then the opioid crisis hit, and as I say, everything has changed.

But I do believe that there's a lot of room for a prevention campaign right now. So Neil talked about the education campaign to let people think about this differently, so that if you know that you have a relative who has a disease, again whose brain has literally changed with regard to this addiction, you view that a little differently.

And getting that person into treatment is what's important, just as you would with any other illness.

But I think there's a broader campaign that's needed right now, and I would say it's needed on an emergency basis, and that is just to educate people simply about what's happening on the streets in Ohio and around the country, which is that any pill that you take that is not bought from a pharmacy, and therefore legitimate, I mentioned earlier Adderall or Percocet or Xanax, but any pill, never, ever take something from the street.

And there are unfortunately many people who will testify to that, about having lost their loved ones. I gave a speech at the Ohio State graduation this year, two days after two students were announced to have died from taking fentanyl, and it turns out it was Adderall, and they thought they were taking a study drug. Another student was in intensive care at the time.

FRANK BLAKE: Oh, how tragic.

ROB PORTMAN: But it was a wake up call for the Ohio State community, and they're not alone. I mean, it happens on every college campus, that you have these issues. So I think that's worth it.

And the last legislation that we passed, called the Comprehensive Addiction and Recovery Act, we provided some funding for a national media campaign, and my idea was to have the federal government provide, in this case $10 million, and then go to the private sector, particularly the pharmaceutical companies, and get them to do 10 times that much by matching it.

And doing it in a way that the best minds of Madison Avenue, or whoever the best advertising folks are now, as we did it one time with the partnership from Drug Free America, more on a national level, to get the message out in a clear and convincing way, so that people understand the dangers.

That alone I think would reduce overdoses pretty substantially, given again the ever-changing drug threat.

Today, fentanyl is the number one issue, not that it's the only one, and it's being mixed into everything as we said earlier. So it's laced not just into these pills, but also cocaine, heroin, even crystal meth. Even marijuana, which law enforcement told me just recently at a round table discussion that they had.

So I think it's time to do it again, and I think it's urgent we do it again, and I think it could be a very clear and focused message.

FRANK BLAKE: There's a BBC documentary, and I think it's a wonderful documentary, about addiction, and it features actually a community in Ohio. And there's a line in the documentary that says, "Addiction is exhausting."

I mean, it's true for users, parents, caregivers, everyone, and it must be true for both of you as well, having fought this fight for as long as you've fought it. If I could ask each of you, what keeps you going on this?

ROB PORTMAN: Well, let me just start with an answer that also responds to something you asked earlier about caregivers and family members. What inspires me, and has inspired me from the start, are these family members. When I was a first-term member of Congress, a woman came to see me. And she wanted to talk to me about her son's death. He had died of an overdose, in this case huffing gasoline and smoking marijuana.

You can say, "How stupid can you get," but he was doing that with some friends and he overdosed and died.

And I was ready for her. I had all my statistics on drug prosecution, how much we were spending on interdiction of drugs, and what we were doing on the border, what we were doing on interdiction of drugs overseas.

And she looked to me and said, "How does that help me? I've gone to my church and they're in denial. They don't want to talk about it. It doesn't happen here. Same with my school. In my neighborhood I called a meeting, nobody showed up."

That's one reason I got involved in these community anti-drug coalitions, because we needed to get the community engaged and involved. I still have his gold ID bracelet by the way. She gave me a gold ID bracelet. She gave one to Bill Clinton, who was president at the time, and that's when we got started with her.

So, that woman in her grief, channeled her grief towards something very positive, but so many people like that, and Neil knows them, and he mentioned getting calls at home, they are out there.

Tonda DaRe is someone who's really helped me with the legislation over the years, and Tonda lives in Carrollton, Ohio. Her daughter's name was Holly. And she started something called Holly's Song of Hope.

Really brave woman, scrimped together what little funds she had, and then got some funding from friends, and has just done a great job going to schools and talking about the issue about her daughter and what happened.

Travis Bornstein has become a friend. He's a teamster. He's a tough union guy, and he lost his son, who was a star athlete, Tyler. And he started his own group called Tyler's Light. And he's raised funding now he's going to put together this remarkable center that's a treatment and recovery center.

So these are the people that inspire me, Frank.

They just take that grief and they say, "You know what, we're going to make a difference in the lives of our community, so that the next family doesn't have to go through the grief that we've gone through." So, that's what keeps me going as much as anything.

NEIL TILOW: Frank, I think all illnesses and diseases are exhausting. I don't know about you, but I've lost family members from cancer, and from other issues, and it totally wiped me out. And so I don't know why it would be any different for addiction.

You're just going through this slog, and trying to figure out, "What should I do? How can I help?" Trying to figure out, "How do I advocate for the person I care about?"

But what motivates me is the people who are in recovery and successful, and I can't tell you, the people who work for us... We have almost 1,000 employees now, and I have so many people who are in recovery who work for us, and who are just doing a tremendous job.

We have one person who came in who was homeless, and we gave her a job as a clerical person, and then next thing you know she was an aide, and the next thing you know she was a case manager, and now she's a supervisor over our vocational program.

And I'm talking about, she did this in five years with us, six years with us, and was one of our Employees of the Year a couple years back.

There's a guy who I worked with in 1975, who I still keep in contact with, and he had a very tough heroin problem. Was a young guy obviously, to be around that long ago. He had gotten out of prison, and he had a very successful business that he opened up. He has kids. His whole life changed and it's like, "Well, if that doesn't turn you on, I don't know what will."

It has for me.

ROB PORTMAN: That's great.

FRANK BLAKE: Such great inspirational stories. For listeners who hear this and care about the issue, what would you suggest to them as either a resource, or something they might want to do?

ROB PORTMAN: Well, the first thing is get involved in your community. Almost every community in Ohio now has a coalition.

At the time we started the legislative effort back in the mid-nineties, there were only a couple in the state. Now there are hundreds. And so find out who's doing what in the community. You can go online and find that, I'm sure. Just put anti-drug coalition, and it might be focused on prevention, that's what most of them are, but some are also focused on helping people understand what their treatment options are. That's something that's really confusing to people, as Neil said earlier.

There's not good information out there often. If you have trouble finding out what to do, go talk to your first responders. Nobody wants this problem solved more than our EMS personnel, firefighters, police officers. We're in the fight with them, and they understand this is not going to be solved by arresting people, it's going to be solved by getting people into treatment.

And by the way, sometimes that involves the criminal justice system in my view.

I think some people who want to take the criminal justice system out altogether are making a mistake, because I do think it's very hard for most people to go through a treatment program and come out in recovery.

Because this drug grabs you, it grips you, particularly fentanyl and these opioids, and if you have the prospect of incarceration hanging over your head, sometimes that helps to get you to focus. So that's why I like drug courts.

And I've seen so many cases where that's worked for people, and just amazing, inspiring stories. So getting involved there I think is very important. There's always room.

And then Neil can talk more about this, but his organization...

He says he has over 1,000 employees now. He's expanded all around the state of Ohio, and in the region, but he also relies on volunteers to help out.

And it's as simple as helping a neighbor, helping a friend, helping somebody who's struggling, and providing them the support that they need.

Because so many people do come out the other end, not just as recovered addicts, so they're in recovery, but as people that reconnect with their family, reconnect with work, which is desperately needed right now.

We need more good workers, and a lot of people have been sidelined by this issue. And then reconnect with this issue. So many are giving back, and that's part of their recovery.

So they become recovery coaches. So I think people getting involved at a local level is going to be the single most important thing that would happen to be able to turn this around.

NEIL TILOW: I think we want to get people involved. I use this analogy a lot, a funnel. At the top of the funnel is when the problem's not so bad, and at the bottom of the funnel, the justice system has to intervene.

And you want to have, whether it's clergy, employer, family, social services, treatment agency, healthcare, whatever, catch you before you hit the bottom of the funnel. Because the more serious the illness is, the more problems we're going to have. Just like if you can get cancer at Stage 4, it's not as good as you get at Stage 1, right?

Same thing with addiction.

And so we want to intervene early, we want people to help intervene early. So the more they can get involved, catch it before people... Keep them employed, keep out of the justice system, keep them in school. All those kinds of things are so important.

But people just need to do three things. I think if they get educated about this, and then they advocate, and then they donate. Because it does take money to do all these things. And I don't know how much I've really educated Senator Portman over the years-

ROB PORTMAN: A lot.

NEIL TILOW: ... because he's a very, very smart guy about this stuff, but you have to educate people, and then you have to get people to advocate.

And there's nothing more powerful than an advocate, especially someone who's already recovered, or who has a family member who's recovered, or has lost a family member. And so getting connected to those people, it's energizing.

I was just at a meeting at 11:00 for something we called the Hamilton County ARC, Addiction Response Coalition. The senator was out to meet with the steering team a few weeks ago, or a month ago, whatever it was, and it was, I don't know, 100 people in a room just hearing updates on what's going on in the community, what they can do.

And so many people have lived experiences, so many people have family members, educators, police, fire, you name it, they were there.

They say it takes a village, and it really does take a village.

And we've got an interesting little project going now called the African American Engagement Work Group, and it is a group of churches from the black community, who are trying to engage their parishioners in becoming more informed and educated about this.

And in that process, we got this past year about 150 people into treatment through those churches, who normally wouldn't come in the front door, because they sometimes don't trust the care they're getting. And the ministers and others have been able to encourage them.

And it's a really unique program. And you also see the data. Originally a lot of the overdoses were primarily in the white community, but over the years that's shifted quite a bit.

The data you saw this morning, just an hour ago, showed... I think it was about 45% of all the overdose deaths were in the black community now in Hamilton County during the last period of time they're reporting for it.

And that just shows you how important this work is. And it is ever-changing. It morphs into one thing or another, and you can't just sit back and say, "we got this one," because before you know it, it morphs into something else.

FRANK BLAKE: Well, you are both heroes in an unbelievably difficult war, and thank you for that. And we always ask our guests one question at the end that's personal, not related to the topic we've been discussing, but just at a personal level, who is someone who's done a crazy good turn for you over your time? Anybody. It can be a 4th grade teacher, somebody who's done a crazy good turn for you.

ROB PORTMAN: Oh, gosh. For me, so many people. I guess what I would say, is the four or five major community leaders who stepped forward when it was uncomfortable to help on our anti-drug efforts here locally 25 years ago.

Neil's one of them, and he's on with us today. But another is Hope Taft, who was at that time the First Lady of Ohio, who has stayed involved on these substance abuse issues.

A guy named Damon Lynch Jr, who was head at Cincinnati Baptist Ministers' Conference.

Well, Neil can tell you, he's one of the most respected black leaders in our state, and our country really. But he stepped forward. And Neil talked about the importance of the church and how they can be helpful.

And then the other one was John Pepper, who was the chairman of the Proctor & Gamble company, who you know. And John has a passion for this issue as he does for so many issues that relate to, in our case, prevention and young people.

But that was the group that gave me the credibility to launch something that became a model for other communities to do the same.

And again, we ended up with about 2,000 community coalitions being formed, maybe more now. So I appreciate them, and I don't get a chance to talk about them ever, so this is great. Thank you.

And then it's just all the people I mentioned, Tonda DaRe and I mentioned Travis Bornstein, and all the people who are taking their grief and using it in ways to help others. And then all the recovering addicts that I've met.

And I've met thousands of recovering addicts and addicts, being willing to share their stories.

But the crazy good turn, would be people who stepped forward when they didn't have to, and made a difference.

FRANK BLAKE: That's great. That's great. And Neil?

NEIL TILOW: I mean, I certainly appreciate everything the senator's done, no question about it, but when I think about one person recently, as I mentioned, we're into some permanent supportive housing, and we're very interested in the issue of veterans.

I was talking to a local business leader, and I said, "I want to do another apartment building for veterans." And he said, "Why don't you?" I said, "No money."

And we got to talking about it, and we talked for two or three months and he called me up and said, "Neil, I'm in. I'll help you." And I said, "Well, what does that mean?" He said, "I'll give you $2.5 million to help make this happen."

And Rob probably knows Peter Klekamp, or knows the family for sure, and it was the single biggest gift I've ever got, at one time anyhow, from somebody, and we're ready to get approval from that, we hope, from the rest of the funding.

But again, he didn't have to do that. He cared about it. He said, "This is really important, isn't it?" And I said, "Yeah."

And it was more his idea than it was mine. I mean, he just cared about it a whole lot, and so I'll be forever grateful for, to him.

FRANK BLAKE: Well, thank you both so much.

Thank you for all the work you're doing. Rob, thank you. I know you're going to continue to work on this issue long after you've left the Senate, you're going to continue to do amazing things. And thank you for your service to the country.

And Neil, thank you for everything you've done.

ROB PORTMAN: Frank, thanks for providing a forum today and for what you do constantly, in spreading the message about how, in this time of pessimism, there's reason to be optimistic, which is all the people around our great country that do great things, sometimes crazy, sometimes not.

FRANK BLAKE: Doing amazing things. You're doing amazing things, and it's great to celebrate. So thank you both.

ROB PORTMAN: Thanks, Frank.

NEIL TILOW: Thank you.