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Opioid crisis center of discussion with Tester

by Adrian Horton Daily Inter Lake
| September 22, 2018 4:00 AM

Local representatives from the health care, addiction treatment, and law enforcement fields met with U.S. Sen. Jon Tester, D-Mont., in Kalispell on Thursday to express concern over a shortage of resources, finances and manpower to deal with opioids and addiction in the Flathead Valley.

Tester, who is up for re-election against State Auditor Matt Rosendale in November, convened the opioids roundtable at the Agency on Aging to hear from those working closely with opioids and addiction on where to best direct government resources. “I know resources are always hard to come by,” he said at the meeting’s outset. “If it’s a resource issue, tell me. If it’s a manpower issue, tell me. If it’s better protection at our ports stopping this crap from coming in, tell me. Whatever the solutions might be.”

Participants offered a range of responses centering on the seriousness of drugs in the valley and resources stretched too thin to provide the comprehensive care required to fight the intractability of addiction.

Judge Amy Eddy of the Flathead County 11th District Court explained how the current justice system is inadequate to keep people from relapsing into drugs. “The court system is not a solution. We’re not doing a good job — and it’s not for lack of any effort on anybody’s part ... but the whole concept of putting a first-time offender on a deferred sentence or a suspended sentence when they cannot afford resources in the community just is setting them up for failure. They can’t afford a mental health evaluation, or a chemical dependency evaluation.”

The gap in affordable housing and treatment, she said, means that “we’re waiting for them to fail” again, with many people reappearing in her court within a year of a deferred sentence.

Mark Mulcahy, commander of the Northwest Montana Drug Task Force for three years, said that the valley’s most pressing drug issues — meth and heroin — necessitate a mass coordination of resources to fight. “It’s one of those problems where you have to attack it from 10 different directions. You can’t arrest your way out of it. You have to have rehab ... We don’t really have the resources for rehab in our valley,” he said, noting that, without an inpatient addiction facility in the valley, people need to travel to Missoula, Butte or Billings for inpatient rehabilitation.

Even then, successful rehabilitation from the throes of addiction takes more than trained law enforcement and medical treatment — without case managers and social service providers, those battling addiction can easily slip back into dangerous situations, said Jody White, director of the Flathead Community Health Center. People often “come back to no housing, no resources, and then they end up falling right back into the same patterns or the same group of people that they were relating with, so that case management piece and the resources beyond treatment” are extremely important.

Several attendees pointed out that Montanans are particularly vulnerable due to a lack of inpatient treatment space; the Flathead Chemical Dependency Clinic and Pathways Treatment Center are both outpatient facilities, and the state’s other inpatient facilities face a backlog that would derail many patient’s progress.

“If I were to make a referral for a patient today in the Flathead Valley, it could be six months until we get them in,” for inpatient services, said Aaron Boysen, manager of the Pathways Treatment Center in Kalispell. “There’s no longterm treatment in the state ... what we see is even if these people make it to [the Montana Chemical Dependency Center in Butte], in two months we see them back at Pathways.”

For case management and the outpatient providers in the valley, he said, “we just don’t have the resources in the community.”

Amber Norbeck, a neonatal intensive care unit pharmacist at Kalispell Regional Medical Center, and Lisa Smith, a social worker at Kalispell Regional Healthcare, brought up a less visible or discussed concern with meth and opioids: babies born in withdrawal. The hospital NICU and PICU have adapted to treat babies born with exposure to opioids or meth, but the burden is steep and requires assistance, for both mother and child, long after birth.

“Remember that we’re dealing with people who essentially have a brain injury. Their executive functioning is impaired,” said Smith “We don’t fully know the neuro-developmental consequences of babies exposed to methamphetamines.”

Tester wrapped up the meeting by asking each participant to list one thing they would change, if they were in his shoes, to make their jobs easier.

Mulcahy said more funding and training programs for manpower in the “shorthanded” drug task force, while Boyen and Smith pointed again to the lack of inpatient treatment space and opportunities for those climbing out of drug addiction. White praised existing medical training programs such as the National Health Service Corps, but said that it is still difficult to find qualified staff, due to hurdles in education and a lack of openings for clinical training outside of school programs.

Reporter Adrian Horton can be reached at 758-4439 or at ahorton@dailyinterlake.com.