Substance abuse and mental health

The Alaska Mental Health Board and Advisory Board on Alcoholism and Drug Abuse listen to a panel of four community representatives talk about the impacts of substance abuse on public safety in Kodiak.

KODIAK — The Alaska Mental Health Board and Advisory Board on Alcoholism and Drug Abuse met in Kodiak this week to learn more about Kodiak’s substance abuse and mental health issues. On Wednesday morning, community representatives from four sectors that are engaged in these issues took part in a panel discussion, providing a local, up-to-date overview on the effects of substance abuse on public safety.

On the panel were Chief Tim Putney from the Kodiak Police Department; Monte Hawver, the director of the Brother Francis Shelter; Sandra Collins-Jackson, one of the coordinators of the Mayors Summit on Drugs; and a representative from the Coast Guard Special Investigative Unit.

Putney informed the boards that heroin and methamphetamine are currently the “most abused drugs” in the community, and that the use of both has been on the rise since 2012/13. He said that one of the social impacts of this are that thefts and burglaries in Kodiak have “gone through the roof in the past couple of years.”

Putney said, in the last five years, the street value of these drugs has all decreased significantly

“When I first started working investigations in 2011, a tenth of a gram of meth was a couple hundred dollars. When Heroin first came in, it was upward of $500 a gram,” he said. “Now we’re seeing methamphetamine on the street for a couple hundred dollars for a full gram. So ten times cheaper than it used to be just five or ten years ago.”

Last year, according to Putney, drug busts led to the seizure of 11.5 pounds of illicit drugs, with an estimated street value of $11.5 million. This included 765 grams of heroin, 812 grams of meth, 117 grams of cocaine and 300,000 grams of illicit marijuana, eight opioid pills and nine and a half strips of suboxone. He noted that that’s only what was found by local law enforcement.

“We’ve seen fentanyl in town a few different times,” he said. “It’s getting more and more prevalent … now, we just assume that every illegal drug that we come across has fentanyl in it or is fentanyl.”

Putney also noted that KPD sees roughly one overdose reported a week.

“The Police Department is going through Narcan like crazy,” he said, referring to the overdose reversal drug.

Hawver explained that the Brothers Francis Shelter is in the business of “keeping people alive.” He talked about the growing demand for the shelter’s homeless prevention program, saying it’s gone from helping just 50 families to over 200 last year. The poor salmon season this year, Hawver said, has exacerbated this. According to Hawver cannery workers make up a large part of the shelter’s clientele.

“They went from making a fairly meager income … to basically starving,” he said. “Most of them made ten grand this year … so we got inundated. It wasn’t unusual to get five or six families a day seeking assistance through our homeless prevention program.”

Due to Kodiak’s relatively high rent, Hawver said, there are many cases where multiple families are living together under one roof – the stress of which can lead to social problems like substance abuse.

“One of the things I’m sure of is there’s a direct correspondence to needs not being met and substance abuse going through the roof,” he said.

The panel also touched on drug activity in the school system, with Putney saying that drug and alcohol use and distribution has been reported in kids as young as middle schoolers.

“We’re seeing everything in the middle school and up,” said Putney.

Despite this, both boards appeared impressed with Kodiak’s responses to the problem.

“Your community concerns are not that much different to other community’s concerns,” said Alison Kulas, executive director of the Advisory Board on Alcoholism and Drug Abuse and the Alaska Mental Health Board. “There’s a lot of collaboration going on here.”

Kulas explained that the boards visit different communities in an attempt to gauge the scope of substance abuse in areas across the state, by speaking to local law enforcers and medical practitioners, as well as doing site visits. The board then feeds this information back to state legislators.

“One of the things we really look at during Legislative session is any bills that are impacting behavioral health – and the funding as well,” she said. “Because we serve in that advisory capacity, a lot of times we can offer up information about what communities are doing.”

While in Kodiak, board members visited Kodiak Women’s Resource and Crisis Center, the Brother Francis Shelter and KANA’s counselling facilities among other places. Various members of the board commented that Kodiak’s resources are generally successful in meeting the needs of those who seek help. Board members were particularly complimentary of the way in which different agencies work together.

“I think we’ve all been very impressed. It’s a very collaborative community. That’s been our biggest take away so far, is that agencies are talking to one another,” said Kulas. “Sometimes it’s hard for nonprofits to work together, because you’re competing for the same dollars. But we really appreciate that Kodiak’s taken another look at it and said, ‘If we work together, then we can do more.’”

At the center of this collaborative approach is the Mayors’ Summit on Drugs. Sandra Collins-Jackson, a local clinical therapist and one of the summit’s primary coordinators, broke down the summit’s origins and objectives for the board. The summit came about in 2016 after a Providence Community Health Needs Assessment report showed that the top healthcare need in Kodiak was more drug rehabilitation/counseling resources. Since then, a huge variety of local agencies (including Kodiak Police Department, Kodiak Island Health Center, Providence Kodiak Island Medical Center, Kodiak Women’s Resource and Crisis Center, and many others) have put their heads together to strategize ways to more effectively tackle the issue. According to Collins-Jackson, these groups now have a plan to move forward.

“We know that our community is not going to sustain a residential treatment program – it’s too cost prohibitive for our small community and, in truth, the research doesn’t bear out that we have that many people who need something beyond a day-treatment program,” she said. “So what we’re looking at is an enhanced day treatment/partial hospitalization model, that uses a secure supportive structure of housing … that provides that stable living environment.”

The summit currently faces two major issues. One is that the coalition is made up wholly of volunteers. Collins-Jackson said, although there are a lot of people who understand that the issue needs to be address, many struggle to find the time to helpout.

“Probably our biggest hurdle is: upfront, people will be interested in the idea, but when it gets down to the brass tax of working on it, not so much,” she said.

The other ongoing problem has been funding. The summit recently wrote a proposal for funding from the U.S. Health Resources and Services Administration. A small grant of $65,000 was requested, but denied.

One of the things this grant would have funded was bringing a team from the Hazleden Betty Ford Foundation to train the entire coalition in the latest treatments for opioid addiction.

“Probably the most powerful part of it was to take the executives from the various agencies involved and our governmental leaders and put them together in a facilitated discussion, so that they could identify the obstacles that present themselves for collaboration,” said Collins-Jackson.

She explained that there are various issues at the administrative level – like memorandums of agreement and other contracts – which the practitioners themselves are not in control of and that can prevent agencies from implementing ideas.

“We practice-people can have all kinds of good ideas, but it has to come from the top down,” she said.

The grant would also have funded a media campaign to “change norms in the community,” primarily to promote things like approaches to pain management that don’t rely on heavy medication and to teach people not to hoard medication.

“We have to promote a multimodal pain management approach,” said Collins-Jackson. “People don’t know about it. They still think if you have a root canal, you’re going to get a bottle of oxys.”

The grant would also have funded a system to have used needles flown off the island for safe disposal.

“It’s still an issue for us, because we can’t get them off the island yet and have no incinerator,” said Collins-Jackson.

She went on to explain that the summit had come to an agreement with Ryan Sharrat, the owner of a firm that would fly the needles to Anchorage for “a minimum amount.”

In its response, HRSA denied the summit its grant request. The reasons given were that the summit did not provide “a robust description of how it will incorporate the target population into its activities “ and that it was “unclear if the consortium has the time devoted to meet project goals.”

While Collins-Jackson noted that these are fair observations (primarily due to the fact that the summit is made up entirely of volunteers), she said that those involved are not deterred. The summit will continue to look for alternative funding and will be approaching the borough assembly and city council at their next joint work session to request support for the plan to dispose of needles off-island.

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