The proliferation of fentanyl has nearly every group and agency involved with addiction seeing significant changes in their work in Clark County.
Several representatives of local treatment centers, public government institutions and the criminal justice system spoke about what they saw during a Clark County Council work session Aug. 8. They were there to discuss a potential contract the county would sign with Carelon Behavioral Health, a healthcare services company that would administer millions in funding received through a national settlement from several pharmaceutical companies because of the opioid epidemic.
The county is set to receive about $9.7 million over 17 years through the national opioids settlement. If approved, the contract would have Carelon develop the required regional agreement needed to administer those funds.
The goal of the work session was to hear from subject matter experts who illustrated the issues the county faces with the epidemic, Clark County Community Services Director Vanessa Gaston told the council. It allowed the council to determine what priorities it had for the contract with Carelon, as well.
Fentanyl leads
the epidemic
Fentanyl had the biggest impact of any opioid in the epidemic, those subject matter experts said. It was fairly new to the drug scene; it started entering into the drug supply in early 2020, said Mike Delay, program director for Columbia River Mental Health Services’ NorthStar treatment clinic.
“It wasn’t hugely obvious. It was just kind of popping through in drips and drabs,” Delay said.
Fentanyl accounted for the bulk of a 34% increase of individuals going through NorthStar’s medication-assisted treatment, Delay said. As many as 660 individuals receive treatment through the clinic any given month for opioid use.
He said substance users weren’t introduced to fentanyl because it was added to heroin or prescription opioids with or without their knowledge. It was also in other substances such as muscle relaxers or methamphetamine.
“All of those substances that are available on the street have been impacted by fentanyl,” Delay said.
Chief challenges NorthStar faces are limited hours of operation and lack of transportation for patients, Delay said.
Lifeline Connections President and CEO Andrea Brooks said usually the summer months mean a lull of those seeking treatment, but that was not the case this year.
The biggest changes her organization has seen for substance-use disorders are a result of fentanyl. The drug has a longer withdrawal process, and some medications to mitigate symptoms aren’t as effective compared with treating heroin.
When fentanyl is mixed with xylazine, a drug used to sedate livestock, people can experience other medical complications, including issues leading up to amputation in some cases, Brooks said.
On the criminal justice side of the equation, substance-use disorder was “part and parcel” for the inmate population, said Anna Lookingbill, jail transition manager for the county’s recently-formed jail services department. At least 75% of those incarcerated in the Clark County Jail are substance users.
Alongside many of the others who spoke, Lookingbill said most people with a substance-use disorder use more than a single drug. She recalled a recent conversation she had with someone in the jail who said they used “all the drugs.”
“She said, ‘I use what I can get because that’s how I survive,’ ” Lookingbill said.
The jail’s concentration of individuals with substance-use disorder should make it a prime focus for resources, Lookingbill said.
Clark County Sheriff’s Office Investigations Commander KC Kasberg said the illicit fentanyl is a different animal than what was manufactured by pharmaceutical companies and distributed via prescription.
“There is no consistency in between these pills,” Kasberg said.
He said the sheriff’s drug task force has been reassigned to patrol for the past two months in order to fill other staffing needs within the office. When active, however, the task force focused on finding the higher-up traffickers.
“The mission isn’t to go and hunt down the corner drug user who’s addicted and can’t get back on their feet. We’re looking at disrupting the supply chain,” Kasberg said.
Kasberg said there needs to be a more holistic approach to combating the epidemic. He said, in the past, treatment and prevention was its own path, while law enforcement and incarceration was a separate one.
Through working with Clark County Public Health, Kasberg said it was evident the two separate paths had to converge.
“Sharing information and working together under one roof on these investigations of overdose deaths will move us much closer to disrupting or dismantling the many drug trafficking organizations who are currently poisoning our community,” Kasberg said.
Treatment the biggest priority for council
The council’s priorities included first responder support and prevention efforts. The greatest support came with regard to treatment.
“Everyone who’s overdosed, who is an addict, must have a readily-available bed for detox, medically-supervised detox,” councilor Gary Medvigy said.
Even with all the possible outreach to those affected, a two-week delay for someone experiencing homelessness could mean they would not continue to seek recovery, he said. Emergency rooms only mean a temporary time in detox.
Medvigy wanted to see medically-supervised beds available without barriers like ability to pay. He said addiction hit home for him as he has a daughter suffering from substance-use disorder.
“It isn’t just, for me, a matter of opinion. This is a lived experience,” Medvigy said.
Councilor Glen Yung agreed with Medvigy “100%” on his call for available bedspace. He went further and wished to see caseworkers assigned to specific individuals to see that a successful detox didn’t lead back into relapse.
“I just can’t say enough about how much we need to coordinate, how much we need to know these individuals, know their needs, what are their triggers, how do we get them away from those triggers,” Yung said.
