29 October 2023
DULUTH St. Louis County is poised to receive $18 million over the next several years as part of a state legal settlement with producers and distributors of highly addictive opioid medications.
And county officials are still hashing out a plan for how best to put those funds to effective use, even as the growing opioid crisis shows little sign of reaching its crest.
St. Louis County Sheriff Gordon Ramsay told members of the county’s opioid remediation settlement committee on Tuesday that overdose deaths show no sign of decreasing.
“We’re going to sadly have a record year,” he said.
In 2022, St. Louis County recorded 48 drug overdose deaths, and so far this year the death toll has reached 46 with more than two months still to go.
“The numbers are really still trending in the wrong direction,” Ramsay said, noting that the No. 1 cause of non-natural deaths in St. Louis County, by far, is drug overdoses. The No. 2 cause of non-natural deaths is suicides, with the county typically recording 20 to 30 of those in a typical year.
Of course, most drug overdoses can effectively be treated if caught in time. In all, Ramsay said the county is on pace to receive about 600 calls regarding drug overdoses this year, compared with about 520 last year.
“We’ve been working with our partners, trying to do everything we can to ensure that we’re getting folks the help they need,” he said.
But from a law enforcement standpoint, Ramsey said, “We’re not focused on the user as much as we are on the sales.”
Ramsay said the number of repeat drug-dealer offenders has been frustrating for his officers, who arrest and charge people often only to see them back on the streets shortly thereafter, resuming business.
“I would like to see greater accountability for those that are pushing drugs in our community,” he said.
Each drug overdose death in the county is treated as a homicide, and law enforcement always seeks to determine who sold drugs to the deceased, according to Ramsay.
“The problem we have, though, is these are such time-intensive cases that we can’t do as much as we would like on all of them, because we are stretched too thin. So, often the cases are triaged based on solvability,” he said. ”That is a sad reality of where we are at today.”
Ramsay described availability and cost as two key factors affecting addiction rates, and said, “Right now, fentanyl, meth and opiates are cheap. And there’s a lot of it in our communities throughout the county, from one end to the other.”
He characterized the current lively drug trade as a disturbing situation.
“We’re seeing all age groups in every corner, using,” Ramsay said, noting preventative education of young people “is not as robust as it should be either.”
When he talks with young people, Ramsay said, “A lot of kids aren’t aware that one pill can kill and the amount of fentanyl that’s out there.”
He said many young users make the false assumption that pills made to look like genuine pharmaceuticals are safe when they’re actually only facsimiles laced with potentially fatal quantities of fentanyl.
“I talked a little bit about not focusing on the user from the enforcement end. But I do have a lot of families and a lot of former users who talk to me about the benefits of when they were arrested and how the system was helpful,” Ramsay said.
He said it could be useful to ask: “Where is the system being helpful and where is it not.”
But Ramsay continued to stress the need to attack the opioid epidemic on all fronts.
“The deterrence and accountability need to be a factor in the overall plan of reducing drug use in our communities and keeping them safe. And the past few years, we’ve been heavily focused on treatment, as we should be. But I think we’ve lost sight a little on the importance of accountability and deterrence.”
On the corrections front, St. Louis County Jail Administrator Jessica Pete said that with the help of grant money, staff have been working to assist prisoners reenter society as they are released, helping them navigate insurance to provide access to continued support and care.
“Our biggest barrier, because our county is so large, continues to be transportation, especially to the Range,” she said.
Pete said the jail’s reentry team has worked with 221 released inmates since January, when the program launched, and about 80% of people have accepted support services.
Building trust has been a challenge. During the first half of the year, Pete said only about 25% of participants admitted to using opioids upon their release. But six months in, she said the number of clients acknowledging opioid consumption has grown to nearly 50%.
“So, we’re seeing people reducing that stigma and being able to openly talk about their opioid use a little bit more,” Pete said.
Working with its new medical care partner, St. Luke’s, Pete said the county jails have been trying to better address drug use among the prisoner population, as well.
“We’re finding that middle ground of being able to provide consequences and still being successful at making sure when they leave that they’re covered against an overdose,” she said.
St. Luke’s also has been able to provide same-day appointments for inmates battling opioid use disorders,” Pete said. “So, that is more than we’ve ever had before, which is huge.”
St. Louis County Commissioner Ashley Grimm asked if any direction could be gleaned from where other jurisdictions have made progress in reducing opioid use.
Ramsay responded: “From what I’ve seen, there’s not one magic bullet. It’s everything we’re doing in this area. But there are some areas where folks have seen some great decreases. So, I think it is always good to look at what others are doing and where they’ve had success.”
Linnea Mirsch, St. Louis County’s director of public health and human services, said it’s important to put available opioid funds to “the highest and best use.”
“We’re asking: What can we really do with these opioid litigation proceeds to really steward them for maximum impact? It’s a big charge,” she said.
The county’s opioid remediation settlement committee has chosen to focus first on harm reduction, stigma reduction and youth prevention initiatives as it begins to allocate some of the $2.2 million the county has received thus far, and criminal justice supports are up for consideration next.
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