Local opioid task force talks new facilities

WASILLA — “Never doubt that a small group of thoughtful committed citizens can change the world.”

Commissioner of Public Safety Walt Monegan used that Margaret Mead quote — referenced in a Season Five episode of “The West Wing” — to kickstart his speech to dozens of recovery specialists, medical professionals, politicians, nonprofit representatives and concerned citizens present for the Mat-Su Opiate Task Force’s Tuesday meeting at Wasilla City Hall.

Monegan, who toured Palmer Correctional Center with the task force last week, was one of three guest speakers featured on the agenda, along with Alaska’s Chief Medical Officer, Dr. Jay Butler, and Mat-Su Regional Medical Center CEO John Lee. Each expressed interest in being “a part of the team,” as Monegan put it, helping to combat the Valley’s opioid epidemic.

Monegan was the first to admit he couldn’t do it alone.

“Cops really can’t fix anything,” he said, speaking from 33 years of experience with the Anchorage Police Department. “We’re like emergency bandages (that) kind of stop the action, but the real problem has to be resolved … by society.”

Still, Monegan said he and his people would be willing to contribute to the cause and “help everyone else in their job in any capacity we are authorized to do.”

Earlier this summer, Mat-Su Health Foundation sponsored Mental Health First Aid training for local law enforcement and emergency services personnel, which included substance abuse education and de-escalation techniques.

Program Officer Ray Michaelson said after the Tuesday meeting that the foundation plans to sponsor additional training this fall and hopefully more in the future, until all police officers, state troopers and first and second responders have received the training.

However, it will take more than the education of the authorities to incur societal change in the face of opioid abuse, Monegan said — it will also require a mutual trust.

“Policing is more effective when the officers involved are actually a part of community and feel a part of the community,” he said. “We need to develop those relationships.”

Using his military experience as a metaphor for stoicism, Monegan acknowledged that it’s partially on law enforcement to loosen up a bit and be more approachable.

“There are times you have to be a marine, and I know, I used to be one. But the vast majority of the time you don’t,” he said.

Collaboration part of the solution

As much as the opioid epidemic has already been noted in state and national news, Alaska Division of Public Health Director Dr. Jay Butler says people need to keep spreading the word about opioid abuse and how to treat it.

For too many years, he said, people — himself included — have had a tendency to pass substance abuse issues off as specifically a behavioral health problem, rather than acknowledging the addict’s multi-faceted malady.

“When people at Public Health in the past have said, ‘well, that’s not our lane,’ they’ve got the wrong analogy, because it’s not a swim meet, it’s water polo, and we all have the same goal,” Butler said.

The task force has long had the goal of providing recovering addicts with opportunities for wrap-around services, and thanks to United Way of Mat-Su, can now point people in the right direction. In addition to United Way’s 74-page, online resource guide — which includes information from agencies that provide clothing, education, nutrition and housing assistance, as well as emergency medical and health services — the organization recently produced a condensed list of substance abuse treatment providers for those in need. The one-page document distributed at the Tuesday meeting consists of a table with 30 Alaska providers and 14 categories of need, with indications for what each facility covers.

Accountability and prevention

Butler said there’s still more to be done. He agreed with Monegan that “we can’t arrest our way out of this,” adding that, “we also can’t treat our way out” of Alaska’s opioid epidemic.” As such, more focus should be put on prevention, he said, starting with pain doctors.

“I’m not here to wring hands or point fingers, but I think there is an issue in the medical profession where we’ve changed how we manage pain and that’s not helped the issue at all,” Butler said.

Butler and others referenced the 1998 declaration of pain as “the fifth vital sign,” which led to the 1-10 pain scale still seen today in most medical offices. This development, many physicians agree, encouraged doctors to prescribe opioid pain medication to patients who may not have actually needed it, or who didn’t need as much.

Mat-Su Regional Medical Center ER Dr. Michael Alter, who has been particularly vocal in his opposition to such practice since the task force formed at the beginning of this year, voiced his frustration further at the meeting.

“There needs to be accountability,” Alter said. “Just because you have your medical license doesn’t mean you get to just hand out this poison like candy.”

Because of the local epidemic, Alter said he has paid more attention to the Alaska Drug Monitoring Program database, which allows physicians to see what other prescriptions a patient has obtained from other doctors. He said it’s led him to query the database on patients he “never would have had an inkling” to check on before, with disappointing surprises in some of the results.

“The reality is, treating addiction is hard, and there’s a high failure rate. The best way to treat addiction is to not get addicted,” Alter said.

As far as prevention education in the community, parent John Green suggested more PSAs. In response, Butler said that Public Service Announcements in the newspaper and on television are great, but they’re expensive and perhaps not as effective for the target demographic as information disseminated on social media. Still, he would support such measures, if financially viable, he said.

Facility development

While the Mat-Su task force has been looking at places like Point Mackenzie Correctional Farm and Palmer Correctional Center for use as a potential detox and treatment center, Mat-Su Regional has been making plans of their own.

At the meeting, CEO John Lee told the task force the hospital is planning a “major expansion” over the next three years, to include facilities for psychiatric care and detoxification, which is also being referred to as “withdrawal symptom management.” He said the goal is to double in size — from 75 beds to 155 — by 2020, with 25 beds for behavioral health. This would not be residential treatment, he said.

“We should’ve done this a long time ago,” Lee said, of the expansion.

Lee said the hospital has begun the Certificate of Need application process for the $80-90 million project, and hopes to submit the completed application this coming February.

In the meantime, Mat-Su Health Foundation has contracted the Pennsylvania company, Schafer Consulting, to conduct a two-phase feasibility study for a detox center in the Mat-Su. MSHF Public Affairs Director Robin Minard said the first phase should begin Oct. 15, and the second about 3 weeks later.

Minard said the foundation is not doing the study specifically for the hospital, but that any organization — Mat-Su Regional included — could use the results of the study as needed.

Contact reporter Caitlin Skvorc at 352-2266 or caitlin.skvorc@frontiersman.com.