Jill Schramm/MDN Holly Brekhus with First District Health Unit speaks to the Ward County Commission Tuesday. Also, present to address the commission are Capt. Anthony Owens with the Ward County Jail, left, and Sheriff Robert Roed.

Ward County will continue to pursue a grant for a program to address opioid use disorder among jail inmates, despite one commissioner’s concern that the program won’t be effective.

The Ward County Commission previously agreed to serve as the government sponsoring agency for a Reaching Rural grant.

Jennifer Perdue, executive director for MARCO in Minot, was named a fellow with the Reaching Rural Initiative, which brings together rural professionals from around the country to support them in advancing solutions to the challenges of substance use in their communities. Reaching Rural is co-sponsored by the Bureau of Justice Assistance, the Centers for Disease Control and Prevention and the State Justice Institute.

The fellowship comes with a $100,000 federal grant. Perdue’s intent is for the grant to go to Ward County to support drug treatment at the jail. The county’s opioid task force has developed a plan to spend the opioid lawsuit settlement funds coming to Ward County and the City of Minot on a jail program.

Commission Chairman John Fjeldahl asked the commission to reconsider supporting the grant application due to concerns about the value of using opiate analgesics such as methadone and suboxone.

Fjeldahl based his opposition in part on comments from Dr. Stephanie Gravning, health authority for the North Dakota Department of Corrections, who spoke to the commission in August about the treatment program at the state penitentiary.

She spoke positively about the success of treatment programs during incarceration but noted the DOCR’s preferred medication and the standard of care is Sublocade (buprenorphine), an expensive drug administered by injection once every 28 days. Methadone and suboxone, which cost much less, are taken orally, typically daily.

“She basically said the methadone does not work compared to what they’re using,” Fjeldahl said. “Talking to family members that have been through the methadone process it was affirmed to me that it doesn’t work.”

Currently, the Ward County Jail provides methadone to inmates who are already on treatment when they arrive, with payment coming from the state, Sheriff Robert Roed said.

“It’s to prevent recidivism, to keep people from coming back to jail, to try to lower crime rates,” Roed said.

“Unless we have some type of program to help these individuals rehabilitate, we’re not doing our jobs,” added Capt. Anthony Owens, assistant jail commander.

The opioid task force plan calls for hiring of an individual to administer an expanded treatment program, known as Medication for Opioid Use Disorder, that serves inmates regardless of whether they were in treatment prior to incarceration.

“What this does is it moves forward to the next step and says we need to have trained people running this program,” Commissioner Shelly Weppler said. “It can’t just be the jailer. We have to have people with medical backgrounds involved as well.”

The $151,000 estimated by the task force to be available for the program was based on settlement dollars in August that have grown since then, Weppler said. In addition, she cited the possibilities of the $100,000 Reaching Rural grant and a followup $1 million grant.

“What I’m frustrated with, we throw $100,000 out here so we create a way to pay for a program we’re already doing,” Fjeldahl said. “And the end result, as I have talked to people that have had family members go through this, isn’t good. We’re not addressing the problem. We’re throwing money at a problem.”

“I’m in favor of doing what we’re doing – as long as when we get to a point we’re showing that it doesn’t work, or runs out of money, we’re done,” Commissioner Howard “Bucky” Anderson said.

Commissioner Jason Olson presented information from John Hopkins showing the effectiveness of methadone is overwhelming, reducing the likelihood of death by overdose by more than 50%.

“That still means that 50% of the people probably did still die of overdose. So you’re going to have all kinds of failure stories that people can come in with, too, and say, ‘Well, it didn’t work for me,'” Olson said.

A former Minot police chief at a time when the community dealt with bringing its first methadone clinic into town, Olson said, “I do have a little bit of background in doing research, and I am convinced from that and my experience and observation that it definitely works for some people. Is it the miracle drug? A miracle, cure? No. Are there cases where it didn’t work? Yes.”

In speaking to the commission last August, Gravning did not directly call methadone ineffective. She said methadone is an opiate that can make a person high or overdose, while buprenorphine is not. Also, people taking an opiate cannot get past the buprenorphine in their systems to get high or overdose.

Gravning said methadone and suboxone have different dosings for different people, often based subjectively on claims of craving, while buprenorphine is a fixed dose.

Regarding methadone and suboxone, she said. “They’re helpful. They change the rules of the game, but they don’t change the game.”

“This changes the game because you don’t have to do it every day,” she said of Sublocade.

Holly Brekhus, executive director at First District Health Unit and task force member, said Gravning was invited to speak to the commission to present evidence that treatment during incarceration produces successful outcomes, rather than to focus on a particular drug.

Fjeldahl said more accurate information is needed regarding methadone effectiveness.

“I’m not proposing doing nothing. We’re already doing something. I’m saying take a look before we go down this road,” he said.

A motion to reconsider the county’s decision to sponsor the Reaching Rural grant application failed 3-2. Fjeldahl and Anderson voted in support. Olson, Weppler and Jim Rostad voted against.

Kenmare hotel to stay, for now

The Irvin Hotel in Kenmare will remain standing and monitored until next year, the Ward County Commission decided Tuesday.

The county obtained the former hotel through delinquent taxes last year and has sought ways to fund the demolition of the deteriorated building. A request for a state grant was denied, and the commission had suggested to the Kenmare community that it acquire the building from the county as it might have success in obtaining a grant for demolition. However, neither the city nor its community development group have any interest.

The county decided to put the building on hold and seek a grant next year. The cost of demolition is uncertain, with estimates ranging from $180,000 to $300,000.

“This will come out of taxpayers’ pockets completely if we don’t get grants,” Commission Chairman John Fjeldahl said.

In other business, the commission approved the temporary use of space in the 425 Building, also known as the Morgan building or 24/7 building, by Come AlongSide Others at no charge. The organization provides clothing and other items foster children need in transitioning to foster homes or back to their families. The commission agreed to allow storage for up to six months.

– Jill Schramm