Steve Hayburn, a Pretrial Enforcement Division and adult probation officer for Ketchikan, gave a presentation to the Ketchikan City Council at its regular meeting on Dec. 16 concerning the local opioid use crisis.

Hayburn had spoken during the public comment portion of the council's regular Oct. 21 meeting about the challenges in Ketchikan concerning opioid use. Later in that meeting, Council Member Mark Flora requested that Hayburn be asked to return to make a formal presentation to the council on the topic.

Hayburn began his talk on Dec. 16 with a historical overview of the “War on Drugs,” which he noted strengthened during U.S. President Ronald Reagan’s administration in 1982. Next, the “Just Say No” campaign began, which Hayburn said was tied into Central America’s major export of drugs into the U.S. at the time.

Currently, he noted the opioid epidemic, and the introduction of fentanyl as the drug that leaders are focused on stemming.

“I can tell you that I’ve seen fentanyl come mixed … with other drugs, and I’ve seen people test solely, specifically for fentanyl, which is really scary,” he said.

Hayburn said he also has seen people who were tested for heroin and methamphetamines test solely for fentanyl, which also is concerning, as that meant they were switching their drug of choice.

“Will the war ever be won?” he asked rhetorically, answering, “absolutely not. It will never be won, sad to say that, but what we can do is we can win battles.”

He said agencies are winning battles every day.

Hayburn then outlined the challenges involved in fighting those battles.

He displayed a slide that listed the main struggles people face when they try to recover from addictions by entering recovery programs: Long applications, lack of transportation and child care, and living in remote locations.

He then distributed to the council five applications used by various agencies to screen people for admittance to programs, noting how extensive and varied the paperwork is.

“I’d like to see one application for 10 different treatment centers,” Hayburn said.

Every treatment center has different requirements. An example is different rules regarding whether people can bring children.

He mentioned other barriers regarding application for admittance to programs.

One such barrier is having to wait two weeks for an assessment.

Locally, the only two places available for assessments are the Gateway Center for Human Services and Ketchikan Indian Community. The two weeks often turns into a four-week wait time, he said.

If the person misses the appointment, the whole process has to start over, adding another several weeks to the process. The actual assessment lasts six months, he said.

Some people decide to enroll in programs in other cities or states if they are able, Hayburn added. Another challenge, he explained, was that when a person finishes a program, they still might have no place to live, or their only home has people still using drugs. Those challenges often cause recidivism, and the rehabilitation process must start all over again.

Regarding transportation, he said that although bus passes can be supplied to people with no access to a vehicle, some people live far out of the city limits, where bus access might be difficult or impossible.

He next listed the needs that the community has for supporting people who are experiencing addictions. These needs include more social workers, more needle exchange locations, a detoxification facility, and intervention programs to educate youths.

More social workers to help people to fill out the applications would be a definite plus, he said.

A needle exchange program is a way for drug users to bring used needles into a location to receive fresh needles in trade.

Beyond the obvious positives of giving safer needles to people and promoting safe disposal of used needles, Hayburn said that, even more important, such a program is an opportunity to contact users who might not normally make contact with agency representatives.

Hayburn said studies have shown that the more interaction that a drug user has with positive people, the better chance the user has of entering and successfully completing a detox program.

He suggested that the best location for a needle exchange program would be at a detox facility, as there are resources there that could facilitate visitors getting started on applications to enter the program.

Health care providers at a detox center also would provide health assessments, he said.

Hayburn next outlined what a successful detox center offers.

He spoke highly of the Arctic Recovery facility in Anchorage, which is part of the NorthStar Behavioral Health System.

“They have zero barriers,” he said, which helps to get people started on their recoveries and to funnel them into follow-up facilities if needed.

A successful detox center also will use the American Society of Addiction Medicine criteria to assess patients, Hayburn said, which he explained is a “model” for assessment.

In addition, a successful detox center will provide support for transitions into a residential or outpatient facility, will assist clients with applications and will provide exit case planning.

Hayburn said he also is a member of the Ketchikan Reentry Coalition, which is an organization built to support people who are returning to society after incarceration. In its last meeting, Hayburn said he was told that KIC is in the very first stages of planning a detox center.

He said there are people in various agencies in Ketchikan who are working to aid people who are experiencing addictions.

“So, there are a lot of people in this community that care, we just need to start doing a lot of things quicker, and more centered,” he said.

Regarding youth intervention, he mentioned the old programs such as D.A.R.E. — drug abuse resistance education — as needing bolstering with more programs.

He listed mental health, after-school activities, free/reduced-cost athletics and increased training for educators for early identification of families needing support as key factors in youth intervention strategy.

Council Member Lallette Kistler asked Hayburn how many of the people he works with are dealing with alcohol or drug problems.

“There’s a large part that come through us that have addiction issues,” he said, adding, “it’s something we need to get control of soon, because if not, people will continue to die.”

City of Ketchikan Mayor Dave Kiffer asked Hayburn what he would consider the optimal size of a detox center to be.

Hayburn answered it that it would be a 25- to 30-bed facility. He further explained that the Reentry Coalition Housing program now has only five beds total, with another eight planned to be added soon.

“People don’t know, or realize what numbers I see,” Hayburn said. “If I told you how many people I file complaints on in a month, or a year, it would absolutely flabbergast you guys.”

He added, “It’s sad. It really is, so we need to do something about it.”

Council Member Riley Gass asked Hayburn how the application process could be simplified in Ketchikan.

Hayburn said it doesn’t seem possible, as every facility has its own process.

Gass then asked what the rate of acceptance would be for people if they filed all five applications.

“If they stick with it, they will eventually get in,” Hayburn answered. “But the thing is, there’s a waiting list.”

He further explained that success in gaining acceptance can depend on where the person is living when they apply. If a person is in jail at the time of application, he or she will not have priority in a waiting list because the jail is at least a safe place to live. If a person is living on the streets, Hayburn said, that person would be higher priority, as they are in an unstable environment.

Hayburn said that during the COVID-19 pandemic, more restrictions had to be put into place at facilities, making it even more difficult for facilities to accept clients.

Hayburn concluded, speaking to council members, “This is not a city council problem, this is a community problem.”

He asserted that entities such as PeaceHealth Ketchikan Medical Center, KIC and all the others need to collaborate to create solutions.

He ended by sharing information that he’d gleaned recently stating that the District of Columbia Department of Forensic Sciences released data from studies showing that a new synthetic opioid had been found that is stronger than fentanyl.

“It’s going to be a matter of time before we see it here,” he warned. “We’ve got to prepare ourselves, we’ve got to prepare our kids, and our loved ones.”