From Burnout to Compassion: Stories Over Stigma

First responder burnout and stigma

In 2017, residents of Hamilton County, Ohio, made over 4,000 overdose-related calls to 911. That year, 570 individuals lost their lives to drug overdose—the highest number ever recorded in Hamilton County, which is home to more than 800,000 Ohioans and the city of Cincinnati.

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Responding to such a staggering number of overdoses was overwhelming and soon led to another crisis: increased burnout among the county's first responders. This burnout was also associated with an increase in stigmatizing attitudes among first responders, which can deter people in crisis from making overdose-related 911 calls. People who use drugs may even delay or avoid treatment when they anticipate stigma, leading to even more social isolation and loss of support.

We asked Hannah Schilling, Hamilton County Public Health's Community Outreach Coordinator, what compassionate overdose response might look like. She said, "Compassionate response to overdose is centered in lived experience. It's not just a buzz word. It looks like humanizing prevention strategies around the real narratives of individuals who have experienced overdose and using their unique insights to lead community discussions."

Laying the groundwork for compassionate overdose response

Education and raising awareness about substance use disorders can reduce stigma. So can making connections with people who have been stigmatized. "We also know that narrative framing makes data 22 times more memorable than standalone facts," said Hannah.

In 2022, Hamilton County launched Stories Over Stigma as a way to support first responders by providing education and connecting them with community members in recovery from a substance use disorder. This connection gave individuals in recovery an opportunity to share their stories and their recovery journeys. It gave first responders the opportunity to ask questions and build relationships with those in recovery with the goal of reducing stigma and compassion fatigue when working with people with a substance use disorder.

Measuring the impact

Stories Over Stigma is changing the conversation around addiction. Powered by real stories from Hamilton County residents, it's showing that addiction impacts people from all walks of life, that it's a treatable medical condition, and that recovery is not only possible-it's probable.

Among session attendees who were surveyed, 99% found the training relevant and 95% agreed they are confident in their ability to use the skills they learned in their work environment. When asked how they plan to apply what they learned to their professional role, a majority mentioned incorporating better language and more empathy surrounding substance use disorder.

One of Hannah's fondest memories from a Stories Over Stigma session was hearing a first responder say, "The next time I respond to an overdose, I'm going to think of you." It was rewarding for her to see that hearing from someone in addiction recovery had imprinted a human experience.

The future of Stories Over Stigma

Hamilton County launched a second round of Stories Over Stigma sessions in 2024. They expanded it to businesses and organizations beyond the first responder community, including a partnership with the Recovery Friendly Hamilton County program.

Overdose deaths in Hamilton County declined 52% from 2017 to 2024. There is not just one reason that explains why fatal overdoses here have declined—a comprehensive and well-rounded response to the drug overdose crisis is responsible for this change. Stories Over Stigma is one of many efforts (both big and small!) funded by CDC through the OD2A: LOCAL cooperative agreement.