The face of drug addiction has changed.
"People have a classification for an addict," said Jenny Anderson of Superior, one of a group of women fighting to raise awareness of the need for more treatment options in Douglas County. "They perceive it as homeless or someone being poor, dirty ... You know, it's not that anymore."
It could be a teen's face, or that of a neighbor.
"Most people we see are young," said Betsy Byler, mental health therapist and chemical dependency counselor with the Human Development Center. "They have kids; they have families; they have lives."
It could be a loved one.
"It affects all walks of life; it affects all colors," said Cheryl McDonald, whose son is recovering from heroin addiction. "It's not just one person that is susceptible to this; it's anybody. It just takes one use to trigger that in a person if it's there, and it's dormant and it's waiting. All it takes is that one time."
The most recent drug epidemic to hit the Northland, heroin, hits hard and early. Nationwide, the average age people first use heroin is 21. Byler guessed that in the Twin Ports area, it's closer to 19.
"We have such a young population using heroin," Byler said. "People are dumbfounded by this."
For Shelley Faul of Solon Springs, the face of addiction is her son's.
David played football in high school and loved helping people. He hunted, fished and was a typical boy. As a young teen, he made the decision to put a meth pipe in his mouth and his life changed. He's now serving a three-year prison sentence for crimes he committed to feed his addiction.
Faul got to a point where she had to turn her back on her son to help him.
"It was the dead of winter," she said. "I handed my son a sleeping bag to sleep in his car and said don't come back, you can't stay here. That was the hardest thing I ever did in my life."
She called law enforcement and asked them to arrest him. When he knew he had nothing to come home to when he got out of jail, Faul said, that's when he got clean. But after four years of sobriety, he started using again.
"I try to make people realize this could be your kid," Faul said. "This could be anyone's kid. This could happen to anyone's family."
A progressive disease
According to the National Institute on Drug Abuse, drug addiction is a mental illness in which compulsive behaviors override a person's ability to control impulses.
"People still believe addiction is a choice, not an illness," Byler said.
The brain of an addict is different, and progression is a guarantee.
"It's like saying 'I've had enough cancer; I'm going to stop here,'" Byler said.
To combat it, they need treatment.
"I don't think your average person who is suffering from addiction is proud of the fact they maybe go out and commit a robbery or break into someone's house and steal their belongings or shoplift," said Superior Police Chief Nicholas Alexander. "I don't think that's the direction they want to see their life continue. But at the same time, the addiction is so strong and it's taking over their body and mind and control of them. If they don't feel there's any potential hope or availability of resources there, what's their incentive to try?"
With mental health issues, people can walk in off the street and get help now, according to Gary Olson, chief executive officer for the Center for Alcohol and Drug Treatment in Duluth.
There's no immediate access to treatment for addicts except for detox, which offers emergency, short-term help.
"This is not treatment, it's only for withdrawal," Olson said.
With about 3,000 admissions a year at the St. Louis County detox facility, which also serves Douglas County, a patient's stay is short. It's not enough time to assess their treatment needs, a required step to enter treatment. So they get out and wait.
Treatment on demand, however, is key.
"With addicts we have to strike right now, today," Byler said, before something pulls them back into the using lifestyle.
"Ultimately, addicts are going to get clean when they want to," Faul said. "When they reach out for the help."
"That's the place we've been trying to get to in the last 25 years - treatment on demand," Olson said.
Alexander said he's spoken to Essentia Health about working toward a solution, even if it was something like a temporary hold to help someone dealing with withdrawal until a permanent bed at a treatment facility could be secured.
Rallying for change
Faul, McDonald and Anderson are members of a group rallying to increase awareness of the need for inpatient treatment options in Douglas County. There are no residential inpatient treatment facilities in the county, and people on medical assistance can't access the ones across the border in Minnesota. The women said they encountered barrier after barrier when their loved ones needed help.
"It was because he was asking for help at that point that we were trying desperately to find something, somewhere and there just wasn't," Faul said. "You could get on the phone tomorrow and call every place around, because I've done it, and they're going to tell you the same thing. That there's nothing available."
What would an ideal treatment model look like?
It would start with a longer time in detox, according to experts. Depending on the drug involved, detox would be followed by starting a patient on medical replacement therapy coupled with psychosocial treatment. That's the only thing effective in the long run for heroin addicts, Olson said. The medication normalizes the brain, but doesn't change anything else in their life. The psychosocial part deals with the addicts themselves.
Byler said intensive outpatient or, preferably, residential inpatient treatment is the next step, followed by a transitional living "halfway house."
Making that model of treatment available to Douglas County residents would involve longer stays at detox, more local doctors capable of prescribing replacement medication like suboxone and accessible inpatient treatment and transitional living facilities.
It's a journey
Addiction is a complex issue with no clear-cut answers, said Dave Longsdorf, manager of mental health, alcohol and other drug abuse and adult protection services with the Douglas County Health and Human Services Department.
"Treatment is not a quick fix, you're not going to feel better tomorrow," he said. "Treatment is kind of putting together a new way of life. Recovery is a life process."
Heroin and meth have both been recognized as statewide issues. Wisconsin has begun to expand medical replacement therapy options into underserved communities, including suboxone providers in Ashland County.
"The state certainly recognized that inpatient needs to be a medical assistance benefit, they need to add it," Longsdorf said.
While inpatient treatment isn't a magic bullet, it does keep addicts safe and sober for 21 days, Longsdorf said. Yet aftercare, recovery groups and support are just as crucial to helping them stay clean.
"It's a lifestyle change," he said. "Without that lifestyle change it's not likely they'll recover. It's a journey."
He emphasized that if people seek treatment and are amenable, there's hope.
"As long as they're breathing, there's hope," Byler said. "Sometimes all people can do is breathe."
Not content to wait until September's Recovery Walk event to raise awareness of the lack of treatment options, Anderson, Faul and McDonald are inviting everyone to a community meeting on drug addiction Aug. 23.
"Our hope is we would bring in people who have been affected by addiction," Faul said, whether they have a loved one suffering from addiction or their garage was robbed last week to feed someone's habit. It is affecting everyone, she said, and it's going to take the community coming together to address the problem.
The meeting takes place from 6-8 p.m. Aug. 23 at Our Savior's Lutheran Church, 1924 Wyoming Ave. Speakers will include Chief Alexander, a narcotics investigator, Sen. Janet Bewley, D-Delta, a Nar-anon member and much more. The event is aimed at increasing the awareness of what drugs are in the community, how they are used, signs and symptoms of drug abuse and the devastating effects drug use can have on one's body, health and life.
"It is our hope that some community education can help lead to prevention or catching a problem before it escalates," Alexander said.
Information on support groups local resources and treatment options will also be provided, along with a question and answer session.