Public health emergency fails to combat opioid addiction


The Eau Claire Health Department is in need of extra funds to fight the opioid epidemic. ©2017 Mike Roemer

By Travis Nyhus and Mike Roemer

Every morning before Sean O’Brien went to school, he got up to walk his dog, then drove to downtown to visit a drug treatment clinic in Eau Claire.

His story is not uncommon as many people across the country are dealing with the impact of opioid addiction. O’Brien says that the effects of trying to get clean are sometimes too much to handle.

“I tried quitting a few times, but I would get withdrawals,” O’Brien said. “I had really bad symptoms and couldn’t take it, and I called an ambulance.”

O’Brien said that when he went to the emergency room he thought that his insurance would cover the trip. That was not the case. O’Brien was stuck with a $4,000 doctor bill. That’s when he decided that help was his only option.

“My parents told me I should try and get help from a treatment clinic, so I went the next day,” O’Brien said.“I met with a doctor and had to tell him what I was doing and that I wanted to quit using.”

Law enforcement and treatment center counselors in Eau Claire are concerned not enough is being done to fight the growing problem even with the recent announcement of a public health emergency and new efforts from the Department of Justice (DOJ).

“There is already an epidemic and there is so much use right now that the funding really needs to be geared towards being able to get people into treatment,” PaMee Chang, a substance abuse counselor for the Eau Claire Treatment Center said. “Because that is kind of the biggest barrier at this point.”

What opioids do

Opioids were typically used for acute pain, but have more recently been prescribed for chronic pain, according to the National Institute on Drug Abuse . Opioids act on the opioid receptors to reduce pain awareness in both the spinal cord and the brain. There isn’t strong evidence that opioids work to treat chronic pain. In fact some opioid users experience hyperalgesia, which is an increased sensitivity to pain due to long-term use of opioids.

The institute says that opioids not only reduce pain but also stimulate regions of the brain that deal with reward, causing a high, which triggers misuse and addiction. Once dependent uncomfortable symptoms develop when the drug is stopped. Continued use can create a level of tolerance that requires higher dosages to maintain the same pain reduction further increasing user’s dependence.

On Oct. 26, 2017 President Trump declared the opioid epidemic a public health emergency in an effort to combat the rising death toll of opioid abuse. A public health emergency provides patients in rural areas, through telemedicine, access to medically-assisted treatment, gives state the ability to hire more counselors and moves funding for unemployment and HIV/AIDS treatment to opioid addiction issues.

With the Public Health Emergency Fund reported to have only $57,000 at its disposal,

some experts don’t believe labeling the opioid crisis as a health emergency does enough to combat the problem.

Source: Wisconsin DOJ

Fighting the rising numbers

Here in Eau Claire, opioid use has been on the rise since 2012. Arrest records show the Eau Claire Police Department has been targeting users more frequently than the dealers, with a spike in arrests for drug possessions over the past five years. In 2012 there were 26 arrests for synthetic narcotic sales and 12 for possession in Eau Claire County. Four years later possession arrests rose to 149. The numbers actually show a decrease in arrests for drug sales over that same period of time.

Sgt. Andy Falk, who heads the Eau Claire Police drug task force, says that targeting small time drug dealers in Eau Claire wasn’t working, because many of the cases were not being prosecuted by the District Attorney’s office, due to a caseload.

“We can go out and arrest small time drug dealers all the time, but there are only so many prosecutors, there are only so many courts, there’s only so much jail space. So if we go out and arrest 100 drug people, and the prosecutor only has time to deal with 50 of those people, what’s going to happen to the other 50,”  Falk said.

To combat the opioid problem, the DA’s office and the police department have mutually agreed to target large drug operations that bring the drugs into the city.

“We had very little or no heroin in this area until around 2010 or so… most of our opioid issues in the Chippewa Valley have been people abusing prescription narcotics, and that’s still the case today,” Falk said.

Falk says that he has seen the opioid problem affect people from early teens in middle school to elderly adults. As far as abusing prescription medication, young adults are the demographic most impacted.

According to Falk, the heroin problem is being grossly overstated in the media, and the real focus of the task force should be prescription drugs.

“There’s not a lot of heroin around our area, the media would have you believe that we’re being destroyed by heroin, but it’s not a huge issue everywhere, and it’s not a huge issue in the Chippewa Valley, or even West Central Wisconsin for that matter,” Falk said.

For those who get arrested for opioid possession, there are special drug courts in the area set up to give people a second chance. After completing an intensive course of treatment counseling and other court appointed stipulations, opioid users are able to get the charges reduced or expunged from their record.

Prevention by education

The Eau Claire Health Department
The Eau Claire Health Department is in need of extra funds to fight the opioid epidemic. ©2017 Mike Roemer

Falk says that not all opioid abusers are bad people, but many times the criminal behavior is fueled by a drug addiction, and removing people who want to be helped from the criminal justice system is the focus.

“The idea behind the treatment court is that some people who commit crimes, do so out of a drug habit,”  Falk said. “They are compelled to get money for drugs to support their drug addiction. And the goal is to break the cycle of drug addiction and criminal behavior.”

The Eau Claire Health Department has seen some additional funding from the Trump Administration, but according to Rachel Manning, a coalition facilitator at the Eau Claire Health Department, the funding is not nearly enough to implement the preventative measures needed to fix the opioid problem.

Carleigh Olson, a health educator for the City of Eau Claire says the health department’s core mission is to reduce the non-medical availability of, and access to, prescription drugs among 12-25 year old’s within Eau Claire County.

“We are really thinking about this issue in the realm of prevention, so rather than somebody that is already addicted to opioids, we are trying to prevent it altogether,” Olson said.  

Manning says that under President Barack Obama, the health department received federal funding in the form of grants from the state. Particularly because she said Eau Claire is a high risk county. But under the Trump administration and the public health emergency, the funding is less clear

“The tricky thing that President Trump did was, the way he went about it wasn’t necessarily declared a public health emergency in a sense that it increased funding, so it is a little unclear as to how the resources are going to be allocated,” Manning said.

Over the past few years the county has seen more resources applied to the opioid crisis. Olson says the biggest help the department gets is with projects in the community that come with reimbursement funds.

“We have a Partnership for Success grant that we received two years ago, that was an effort to address the opioid epidemic and because Eau Claire County was recognized as a high need county,” Olson said.

The health department also hands out portable prescription drug lock boxes to residents, so they can safely store their prescriptions while not at home. Manning said these measures are beneficial because many addictions start with pharmaceutical prescription medication.

Manning also said the health department just finished a media campaign, running in October, which encouraged adults to lock up prescription drugs and dispose of old, unused drugs at designated drop off locations.


Lack of funds for treatment

The Eau Claire Treatment Center, a part of the New Season Treatment clinics, is involved with assisting people addicted to opioids.

Chang, said the goal of the center is reducing the harm opioids cause through medication-assisted treatment.

“Medication-assisted treatment is about harm reduction,” Chang said. “So being able to get the patients off whatever illicit substances they are using, stabilizing them, getting them out of withdrawal by taking the medication and being able to focus on developing healthy coping skills and helping them engage in treatment so they can continue on in their recovery.”

Even with the recent declaration of a public health emergency the resources available aren’t enough to prompt a major change, and Chang said there hasn’t been any sign of extra funding.

“At this time nothing has changed,”Chang said.“We haven’t heard of any extra funding or anything like that with his declaration. ”

Chang appreciates efforts to prevent future opioid addiction, but said more focus needs to go toward treatment because of the nature of the problem.

“The funding should really go towards treatment and education on the treatment programs that are available because there is already an epidemic and there is so much use right now, ” Chang said.

Current efforts

The federal government recently has taken additional steps to fix the problem. The DOJ and the Drug Enforcement Agency (DEA) announced on Nov. 29, 2017 a joint effort and plan to attack opioid addiction in the U.S. The plan doesn’t include funding for drug treatment.

New initiatives included in the plan are  $12 million for state and local law enforcement across the nation to be used to fight heroin and methamphetamine and a requirement for every federal prosecutor’s office to appoint a opioid coordinator who will work to create a strategy to combat illegal opioid sales, use, and addiction.

Even with new plans being developed, Falk says there is no guarantee that progress will be made.

“I’m not aware of any of that money allocation coming to Eau Claire,” Falk said.

Under federal policy, Trump is required renew the public health emergency by the end of January, 90 days after his first declaration, in order for the opioid addiction to remain classified as a public health emergency.

With or without extra funding from the government, Chang says her mission will remain the same: helping those whose lives are affected by addiction back together and avoid the downfalls that addiction causes.

“(Our goal) is stabilize them, so that they have the ability to go to work and have a job so they can pay for their bills and they can have stable housing,” Chang said.

After treatment, the goal is to return to a normal life, and O’Brien credits drug treatment for helping get his life back on track.

“I have way more time for other things,” O’Brien said. “I’m not just looking to get more (drugs) all the time. I was able to graduate, and I don’t think I could have on the drugs.”