By Zach Jensen,
Doctors began prescribing mass quantities of opioid pain medications in the early 1990s, and many Iowa counties have begun receiving funds to treat opioid addicts as part of a legal settlement with pharmaceutical companies for more than $50 billion in 2021.
“The pharmaceutical companies knew how addictive these drugs were, and they pushed our medical communities into unheard-of prescription amounts to sell more and more and more and more of their product,” said Shirley Vermace, chair of the Winneshiek County Opioid Task Force. “And, they knew exactly what they were doing, and they knew they were creating addicts, which, then, increased their profits. It angered me — what was happening to people — because of greed — money.”
But, many opioid addicts — especially in rural Iowa — might not know where to turn for help, which is why UCS Healthcare opened a Medication-Assisted Treatment clinic in Decorah.
UCS Healthcare is an Iowa-based non-profit corporation licensed by the state of Iowa to provide medication-assisted treatment through 14 regional Iowa clinics, and local professionals close to the opioid epidemic hope some funding from the multi-billion dollar opioid settlement will be put toward the Decorah MAT clinic, which is located inside Northeast Iowa Behavioral Health.
The 2021 settlement agreement required 39 states to be paid varying amounts of money over 15 years. Each Iowa county will receive annual payments, and Winneshiek County’s portion of the funds will eventually total $283,657, Vermace said. Use of those dollars is limited to education about opioids and the prevention or treatment of opioid use disorder.
Vermace went on to say, while opioids can often be effective in managing pain soon after some procedures and surgeries, they can become problematic if an individual uses them too often, rather than transitioning to over-the-counter medications. The result, according to Opioid Task Force co-chair Jon Vagts, is a different type of drug addict — one he said doesn’t align with stereotypes.
“We don’t hear about the 40-year-old male teacher, who is an addict and still goes to work every day,” Vagts said. “You might not even be able to tell if someone is using opioids.”
Vagts works as a prevention coordinator at Helping Services for Youth and Families of Decorah, under a grant from Iowa’s State Opioid Response Project. The project is aimed at addressing the opioid crisis by increasing access to medications for MAT clinics, increasing treatment options and reducing deaths related to opioid overdose through prevention, treatment and recovery. The majority of opioid users range from 25 to 45 years of age, according to 2023 statistics from the Iowa Health and Human Services, and Vagts said many of them started taking opioid painkillers exactly as they were prescribed by a doctor.
“When somebody develops this addiction, changes happen in their brain, and that substance becomes the most important thing to them,” Vagts said, “They need it. They need to find a way to get. They know the potential consequences, but the substance has become more important than the consequences.”
Registered Nurse Kristin Nolte hopes to reduce the number of active opioid addicts in northeast Iowa. She serves at Decorah’s MAT clinic, which provides several options when it comes to kicking an opioid addiction.
Nolte said most people she sees are addicted to heroin, but some patients were prescribed pain medications, used them as they were prescribed and became addicted to them. And when it comes to treatment, she said rural Iowans are often less open about their addiction than addicts in urban areas might be.
“The problem is here,” Nolte said. “It’s just that no one reaches out for help.”
Nolte, Vermace and Vagts agree the mindset that addicts are weak and rural Iowans must be strong can sometimes prevent addicts from getting the help they need.
“Statewide and nationwide, what’s preventing education and rehab and help for opioid addicts is stigma,” Vermace said. “That’s the biggest obstacle. Statements like ‘They’re just a bunch of drug addicts. Who cares?’ That is exactly why we have this problem — a lack of education, understanding and empathy.”
Nolte noted the three main medications used to treat opioid use disorder — methadone, suboxone and naltrexone — are regulated by the Food and Drug Administration.
“Because these are regulated, we know these medications aren’t laced with fentanyl,” she said. “And, taking these medications can reduce those physical side effects — so the person with substance use disorder can focus on going to their job, participating in their family structure and performing the tasks of daily living while not having to worry about the dreadful withdrawal symptoms. Taking these medications can also help reduce risky behaviors, often associated with drug seeking and can give the clients the time, energy and freedom to focus on their recovery while actively participating in their lives.”
Nolte said those seeking to end their addiction to opioids should start by contacting Northeast Iowa Behavioral Health in Decorah to schedule an intake appointment — she explained individuals must be diagnosed with opioid use disorder before they can be referred to the local clinic. Nolte said wait times have dropped from close to two weeks several years ago to just two or three days today.
“We believe in wholistic care, so you can’t just come in and get a medication and be healed from your addiction,” Nolte said. “You also have to address the mental health side of it. So, NEIBH addresses the mental health side, and we address the chemical side, and we work together for the good of the patient.”
Nolte sees newly-referred clients as they’re going through withdrawal symptoms, like sweating, fluctuating body temperatures, nausea, diarrhea, vomiting and more — all of which can make quitting opioids unappealing.
“That’s what we try to help with,” Nolte said. “Someone can use heroin and receive treatment the same day. You don’t have to go through a withdrawal period — except with Suboxone, you have to be opiate-free for 48 hours before you start taking that medication.”
Vagts agreed treatment is always an option for those experiencing opioid addiction, adding that is a major reason he feels it is important some of the settlement funds received by the state go toward the local MAT clinic.
“Just because somebody has an addiction or a substance abuse disorder doesn’t mean they’re done for,” he said. “They can get into recovery, maintain that recovery and be productive members of society. People are dying from this, and if we can help them get into recovery and stay alive, I think that’s worth it.”
Registered Nurse Kristin Nolte serves recovering opioid addicts at UCS Healthcare’s local Medication-Assisted Treatment clinic inside Northeast Iowa Behavioral Health at 905 Montgomery St. in Decorah. (Photo by Zach Jensen)
Need help?
To use Decorah’s MAT clinic, call Northeast Iowa Behavioral Health at 563-382-3649 to schedule an evaluation for opioid use disorder. For additional information on UCS Healthcare, visit ucsonline.org.
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