Mille Lacs Messenger
By: Sherri Burke
Staff from Amy Klobuchar’s office, community officials meet to discuss the opioid crisis.
As part of a two-day tour across northern Minnesota, staff from Minnesota State Senator Amy Klobuchar’s office met with Aitkin community leaders, elected officials and advocates at the Aitkin Public Library on Oct. 16 to discuss resources needed to effectively fight the opioid epidemic. Klobuchar’s representatives included Sarah Franz, Kyle Olson and Ida Rukavina. Local representatives seated at the table with them were Rep. Dale Lueck, Mayor Gary Tibbitts, Police Chief Tim Catlin, Sheriff Scott Turner, Judge David Hermerding, and Health and Human Services (HHS) Adult Services Supervisor Kim Larson. Representatives from Riverwood Healthcare Center and other county leaders were seated in the audience.
The meeting opened with a video message from Klobuchar. She described the problem of opioid addiction as spreading “lightning fast.” An estimated 80 percent of addictions start with the misuse of prescription painkillers. Children as young as 12 have taken their parents’ prescription painkillers and given them to dealers in order to get beer. Klobuchar cited some statistics relative to the lethality of opioids. In 2016, the Minnesota Department of Health determined drug overdoses claimed the lives of at least 637 Minnesotans. Approximately 60 percent of these fatalities were related to opioid use.
Klobuchar outlined a three-step plan to help combat the crisis. These include getting needed treatment, prevention and cracking down on those selling illegal drugs, including synthetic drugs. Klobuchar has been on the leading edge of bipartisan legislation at the federal level to achieve these goals. She said the Comprehensive Addiction and Recovery Act (CARA) is one such bill that has resulted in partial funding of $6,000,000 that will be awarded to the Minnesota Department of Human Services to expand access to medication-assisted treatment in Minnesota.
The over-prescription of opioids is an area that needs continued work. The Center for Disease Control (CDC) shows some progress in this area. The CVS pharmacy chain is now giving out a week’s worth of medication versus prescriptions for up to 90 days.
Cracking down on those selling drugs is a particularly tough challenge. Criminals are often able to alter the chemical make-up of drugs to avoid the laws. Klobuchar said it must be made harder for drugs to cross borders and it should be made easier to prosecute criminals who sell and distribute synthetic drugs.
Questions for community officials
Following the video presentation, Klobuchar’s staff opened a dialogue with officials to get a sense of how the opioid crisis presents in Aitkin. Tibbitts said, “The opioid thing is everywhere. It affects every sector of our lives. Heroin is running wild in the Mille Lacs Band. It’s in our neighborhoods and towns. It’s a problem that’s out of control.”
Catlin said, “From a law enforcement perspective, we can see the end result. It needs to start with agencies and groups to prevent the problems.”
Hermerding said, “25 percent to a third of Aitkin County cases are drug cases. But theft, assault and removal of kids from homes can be related to drugs. It’s across socio-economic systems. There needs to be monitoring of prescribed opioids. There are more resources in cities than in rural areas. We hope Klobuchar sees we need that help, too.”
Larson said the agency has been seeing the crisis for quite some time. Aitkin HHS is in the beginning phases of holding discussions on how to get to the root of the problem. Staff awareness related to the crisis is becoming heightened. Larson added that a 2016 report for the county indicated that alcohol is still the primary substance for addiction, followed by methamphetamines and opioids in third.
Turner said, “In the last couple of years, drug cases have risen significantly.” He cited an increase in crimes to fuel drug habits, such as burglaries. There have been more overdose deaths and property crimes.
Rukavina said, “People are coming together in coalitions to problem solve. Is Aitkin yet?”
Turner said it was not happening, but he hoped to start these kinds of meetings.
Riverwood Healthcare Center CEO Chad Cooper said some communities, such as Little Falls, had begun meetings in a team-based approach about three years ago. Little Falls was the recipient of state funding to facilitate the program. Cooper said he would like to be part of this process moving forward, learning from work already done.
Rukavina inquired if Aitkin has seen an increase for out-of-home placements and foster care. Aitkin County Administrator Jessica Seibert was in the audience and said that while the cost continues to increase, it wasn’t clear it could be directly related to the opioid crisis.
Hermerding added that most foster kids are coming in because of chemical dependency. More resources are needed for out-of-home care.
Olson said, “People don’t think of opioids as ‘bad.’ It comes as medicine from the doctor. Is there education in place about that?”
Turner said that people seem to know it’s bad. They get prescriptions and sell them. People are able to get ‘dirty’ urine samples to show they are taking their prescribed medications but in reality are selling them. Tibbitts added that kids are able to use technology to figure out the street value of the medications their parents are taking.
Lueck noted that what starts as a legitimate prescription can turn into a lucrative business. He said there are flaws in the system allowing patients to get prescriptions from different doctors.
What can be done?
Olson said one of Klobuchar’s plans is to get different state agencies to speak to each other. Hermerding stressed a need in schools to educate students about the risks and dangers of sharing drugs.
Riverwood Healthcare Center Pharmacist Shawn McCusker described a program called Take the Drugs Back that is used in some places to encourage people to turn in their unused drugs. He also spoke about the use of non-steroidal drugs that, while not as strong as opioid painkillers, are effective.
Treatment options were discussed. Rukavina noted the lack of places to go for therapy. Larson responded mental health and chemical dependency go hand-in-hand. They need to be looked at in combination. She said a Certified Behavior Health Clinic federal grant was provided to Northern Pines to open chemical dependency services in Aitkin County. The Substance Use Disorder Reform will have a rollout over two years. Treatment facilities will be able to provide service quicker. Medicaid will allow billing for assessment. Fast Tracker is a web-based program for people to see who has openings for treatment. Larson noted transportation to treatment can be a huge barrier.
Turner talked about the Methadone Clinic in Baxter. He described some of the problems associated with the program, including trouble for Aitkin businesses when stops have been made for patients to use a restroom and end up selling the methadone. HHS social worker Rebecca Person concurred that while the standard line is methadone is the “gold standard” for treatment, it often doesn’t appear that way to the county. Some patients can return to successful lives using the drug, but for others there seems to be an ulterior motive. She described it as “state-sponsored addiction.”
Officials concluded there is no easy solution to the opioid problem. Lueck said the problem should be addressed at the top, from the drug companies on down. He said a generation of doctors have been trained to prescribe opioids, and that needs to change. Legislation may need to pressure “Big Pharma” like it did “Big Tobacco.”
Turner summarized, “No one has come up with a perfect response yet. It’s not going to change overnight. It’s going to take years.”