Lt. Melvin (Mel) Schaaf of the La Plata County Jail wants the public to know something that can be done to combat the rise in drug use and addiction in the area, especially when it comes to fentanyl.

“Education and awareness,” Schaaf said. “The information is out there, but a lot of the time, people aren’t keeping themselves informed.”

Education and awareness is something Schaaf also encourages of those who do not understand the nature of drug addiction and what it takes to effectively help a person who is suffering.

“Everybody’s addicted to something,” he said. “Caffeine is one that comes to mind. Drug addiction doesn’t discriminate, but it’s so easy to condemn someone because of an addiction.”

Illicit drugs often change and grow stronger from decade to decade, and government officials always find themselves with a new mutation, such as crack cocaine or heroin. Sometimes, officials discover that an epidemic of drug addiction has been caused by something as innocent as an opioid created in a lab for medical purposes. One of the most deadly of these lab-created opioid mutations is a synthetic painkiller known as fentanyl.

“We’ve seen a dramatic rise in people on drugs,” Schaaf said. “There’s definitely been a spike in fentanyl use.”

According to the Centers for Disease Control and Prevention’s website, 107,375 people in the United States died of drug overdoses and drug poisonings in a 12-month period ending in January 2022, and 67% of those overdoses was fentanyl-related. Those numbers continue to rise. According to the U.S. Drug Enforcement Agency, fentanyl is 50 times more potent than heroin and 100 times more potent than morphine, making it the deadliest drug threat in the U.S.

The CDC also warns of fentanyl strengthening the potency of already potential lethal drugs like heroin.

“It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous,” states the CDC.

Colorado recently passed a hefty bill to tackle the specific dangers of synthetic opiates, including stricter penalties for possession of even 4 grams of a synthetic opiate substance or mixture. The bill also requires statewide community corrections programs to “assess individuals residing in the programs for substance use withdrawal symptoms and develop protocols for medical detoxification monitoring, medication-assisted treatment, and other appropriate withdrawal management care.”

Schaaf said staff at the La Plata County Jail are ahead of the state when it comes to addressing substance use and drug addiction issues in the inmate population. A program the staff adopted was MAT, or Medication-Assisted Treatment.

“I wasn’t sold on it at first,” Schaaf said, “but then I really looked at what MAT was, and I realized it could make a huge difference.”

Schaaf said the medical staff at the jail have been working out the kinks of the program for almost three years.

Schaaf had been working on the complex and ever-evolving program with two registered nurses and Morgan Williams, a behavioral health clinical supervisor at Axis Health System.

Once inmates have safely detoxed, they are offered a chance to participate in MAT. It is not a mandatory program. Many refuse treatment but many others sign up, hoping for the chance to turn their lives around.

Part of the MAT program is providing an extensive psychiatric evaluation done by an on-site psychiatrist, as well mental health and peer-support services.

“The program teaches skills to deal with mental and emotional impulsivity, regulation, decision-making and the desire and need to want and use,” Williams said.

There is another aspect to the program, however, that has come under scrutiny, and that is the medical treatment part of it. Many medications are used to treat the various addictions of those who join MAT, and the use of those medications can cause a new set of issues.

Opponents of medically assisted treatment insist one drug addiction is simply being replaced with another. After all, suboxone (also known as buprenorphine) and methadone, the most commonly used drugs to treat opioid addiction, are also opioids.

According to American Addiction Centers website, suboxone and methadone are partial opioid agonists, which are “an opioid medication that produces relatively weak opioid effects,” and “reduces withdrawal symptoms and cravings without producing the full effect of other opioids.”

Still, misuse of an opioid agonist like suboxone can lead to drug dependence, which means those who join MAT must be heavily monitored through the process, especially once inmates are released or sent to another facility. That is one of the reasons why use of the program at the La Plata County Jail has been one of trial and error.

“It’s been a chore,” Schaaf said. “... Thankfully, La Plata County officials have welcomed this program with open arms. We’re really grateful for that.”

Despite potential issues with MAT members’ continued treatment and support outside the detention center, Schaaf and the medical personnel are happy with the success of the program within the walls, where community support among the inmates and staff is strong.

“Jail is a weirdly supportive place,” Williams said. “There are barriers to getting help and treatment in the outside world that they don’t have in here. They feel everything’s against them on the outside.”

Schaaf said there is always a chance those who commit to the MAT program will still revert to using drugs once they leave the jail, even with the outside support programs in place.

“If they don’t make it, they end up back in here,” he said. “They come back, and we start all over again and hope they can make it on the next try.”

molsen@durangoherald.com