‘It’s crazy what opioids are doing in this town:’ Bismarck takes the war on drugs to the emergency room – INFORUM

BISMARCK Overdoses have skyrocketed in recent years as opioids flood the area and addicts play a lethal lottery by using street drugs with unpredictable potency that are claiming more and more lives.

Bismarck police reported 22 overdoses and one drug-related death in 2017. By 2019, the Burleigh County jumped to 34 overdoses and four deaths, increasing to 74 overdoses and eight deaths in 2020.

Last year, the toll exploded to 134 overdoses and 19 deaths and the pace so far this year, if it continues, could again double, suffering 270 overdoses and claiming 40 lives.

Thats unacceptable to me, said Bismarck Police Chief David Draovitch, who added that there would be an uproar from the public if Bismarck saw 19 homicides in a year. Its crazy what opioids are doing in this town.

Bismarck police and fellow law enforcement officials vow to crack down on dealers and are advocating tougher prosecutions and sentences to act as a deterrent. But Draovitch and his colleagues know their efforts have limits.

Theres no way as law enforcement that we can arrest our way out of this problem, the police chief said. We just need to take the demand away.

The war on drugs here is headed to the emergency room.

The Bismarck Police Department, together with Heartview Foundation and Sanford Health, has a $900,000, three-year federal grant to start medication addiction treatment for opioid addicts who come into the emergency room. The Heartview Foundation is a nonprofit substance use disorder program with locations in Bismarck and Cando.

Opioid abusers who overdose and are revived by naloxone, a treatment that blocks the drug from reaching the brain, leave the ER with acute withdrawal symptoms, including sweating, vomiting, fever, diarrhea and seizures.

What do they do?" said Kurt Snyder, Heartview Foundations executive director and a licensed addiction counselor. "They go use."

To break that cycle, the treating emergency room doctor will administer a drug that eliminates that craving, and an addiction specialist from Heartview will be in the ER to make sure the person gets referred to treatment.

Officials are preparing to launch the intervention and recovery program soon with a goal of starting in April.

Were really looking forward to this, Draovitch said. Were hoping it will turn some people around and get them the help they need.

Dr. Chris Meeker, chief medical officer for Sanford Bismarck, said emergency room physicians will be able to prescribe enough medication for patients to transition to care at Heartview.

Were working closely with our partners to finalize plans and hope to make a difference soon in the lives of patients and families suffering with addiction, he said.

Those in Bismarck-Mandan who are battling the scourge of opioid abuse say the need for action is urgent. They fear the problem is poised to get worse.

Kurt Snyder, executive director of the Heartview Foundation in Bismarck, speaks during a press conference at the Bismarck Police Department on Tuesday about the increase use of heroin and fentanyl in the area. Next to Snyder is Bismarck Police Detective Jerry Stein and Dr. Melissa Henke, Heartview Foundation's medical director. Bismarck Tribune photo.

Its like its on jet fuel, Snyder said. I think were at the very edge of a huge surge of overdose deaths again.

'Honey spot' for drug dealers

A drug enforcement task force recently confiscated a press for making pills in a Mandan raid a seizure police found alarming, because it means opioid counterfeit pills are being made locally.

Right within our state, people are making pills and selling pills, said Luke Kapella, a special agent with the North Dakota Bureau of Criminal Investigation and head of the Metro Area Narcotics Task Force.

Pill seizures in Bismarck-Mandan have doubled every year since 2019, when agents seized 1,500 pills, a number that last year soared to 9,500.

This year, we are already at 9,500, Kapella said, adding that the task force is on pace to seize 40,000 pills this year.

The influx of opioids seems especially pressing around Bismarck-Mandan, Minot and the Fort Berthold Indian Reservation, an area that has been hard hit since the boom in the Oil Patch, he said.

A dealer can buy a pill for $1.50, turn around and sell it on the street for $50 even $80 at Fort Berthold, Kapella said. One dealer alone estimated that last year he sold more than 100,000 pills, a number representing an illegal profit of $2 million or more, he said.

Thats just seizures in Bismarck-Mandan, Kapella said. Thats what were seeing. Thats what were fighting.

This week, Bismarck and Mandan police warned the public to be aware that they have responded to overdoses apparently involving fentanyl, which is 30 to 50 times more potent than heroin. A dose equal to a few grains of sand can be lethal.

Police have uncovered a pipeline from gangs in Detroit who bring drugs into North Dakota, where they are unlikely to encounter violent rival dealers and have found a lucrative market, he said.

That outside connection since has broadened, with drugs also coming in from Chicago and Arizona. Detroit figured it out first, but other people have followed, Kapella said. Everybodys in the game now.

North Dakota is well-known as a honey spot for drug dealers and is celebrated as a haven for traffickers in rap songs, he said.

The alarming increase in the supply of opioids and the corresponding upswing in overdoses and deaths has prompted a series of roundtable discussions among law enforcement agencies, drug treatment professionals and others. The first was held in the Bismarck-Mandan area.

The idea behind the roundtable discussions is to reignite the conversation about opioids and related overdoses and to strengthen relationships between entities working toward positive outcomes, said Sgt. Wade Kadrmas of the North Dakota Highway Patrol, which is working with the Department of Human Services on coordinating the roundtables.

Draovitch and Kapella say prosecutors and judges need to get tougher on the dealers who are flooding the state with opioids. Our criminal justice system is a revolving door, Kapella said..

The approach to start working on treating addicts when they arrive in the emergency room will be an important part of reducing demand for highly addictive opioids, Kapella said.

Under the current approach, Theyre not getting help right away, he said. This will hopefully get these people help right away.

The program Bismarck police and its partners are launching is called an opioid overdose bridge.

It calls for a comprehensive and coordinated approach to address the opioid overdose crisis.

Through the grant, opioid addicts will start medication-assisted treatment right away, and also will get start recovery treatment right away, rather than having to wait for an opening.

To have a broader impact, the effort also includes increased communication efforts to reduce the stigma associated with substance abuse disorder, opioid use disorder and medication addiction treatment.

The partners will work with a steering committee of clinical professionals, law enforcement officers and survivors.

The program is patterned after CA Bridge , an initiative in California that started in 2018 with eight hospitals and has grown to 155 hospitals providing medication for addiction treatment. A large national study has shown the method is associated with the largest decrease in overdoses and a reduced likelihood of a serious opioid-related hospitalization.

The CA Bridge program plans to be in all California hospitals by the end of 2023. The approach is catching on nationally and is being used in more than 30 states, said Sarah Windels, a national adviser for the project.

Weve had great success, she said, adding that California hospitals have treated about 100,000 patients in the last two years.

Its actually going to be the standard of care pretty soon throughout the country, she said. The Biden White House this week proposed $10.7 billion to fund research, prevention, harm reduction, treatment and recovery support services.

The initiative would include $5.8 billion for interdiction efforts to reduce supply and advocates universal access to medication for opioid use disorder by 2025. The plan would allow providers to begin treating patients with medication for opioid use disorder via telehealth and would eliminate outdated rules that place unnecessary administrative burdens on providers.

People are treated with medication to curb opioid cravings help to keep them in treatment so they can overcome the illness of substance use disorder, Windel said. Just medication alone makes a dramatic impact on lives saved, she said.

Fargo Police Chief David Zibolski said the Bismarck project sounds promising, and hell be eager to learn the results. Since 2016, Fargo has seen drug overdoses jump 200%, and fatal overdoses are up more than 100%, resulting in 98 overdose deaths, including 23 last year.

Thats a lot, he said.

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'It's crazy what opioids are doing in this town:' Bismarck takes the war on drugs to the emergency room - INFORUM