It was January 2017 when Jameson (Jame) Winn of Portage walked into a Reedsburg medical clinic to see Dr. Gina DeGiovanni. When DeGiovanni came into the treatment room and introduced herself, Winn looked her in the eye and said, “I’m Jame Winn. I’m a heroin addict, and if you don’t help me I’m going to die.”
That day was the beginning of Winn’s most intense effort in her battle against heroin addiction. DeGiovanni, who was from the Sauk Prairie area, about 20 miles west of Madison, knew exactly who to call. She referred Winn to the Good Neighbor Clinic in Prairie du Sac.
Winn’s previous attempts to save herself from the grips of heroin on her own were futile. Her addiction began after her use of prescription pain medications — specifically oxycontin beginning in 2010 — to reduce the suffering from a back injury that had resulted in nerve damage to her spinal cord.
She managed her pain that way for a year. But when she found herself nearly falling asleep driving her kids to school, she cut down eliminating one of three pills she took per day. On her next doctor’s visit, she told the nurse that she had cut back on her dosage.
“The nurse said she wasn’t going to refill the prescription and sent me out the door,” Winn said. “Then a friend said, ‘I can help you, but you’re not going to like it.’ That’s when I started using heroin.”
She continued on that course for another six years. In December 2016, Winn and her husband, Michael Fecht, were planning to celebrate his birthday. But that weekend, Winn was so high, there wasn’t much celebrating.
“I was so out of it, I completely lost the time between Friday and Sunday,” Winn said. “When I came out of it, I said I was done. We called a bunch of rehab facilities and no one had a bed.”
Within 24 hours, she was in front of DeGiovanni in the Reedsburg clinic pleading for help.
First steps out of addiction
Winn’s story of addiction paints a picture of how one local community initiative, the Sauk Prairie-based Community Activated Recovery Enhancement known as CARE group, has made strides in fighting heroin/opioid abuse and addiction after it grew to epidemic proportions in that rural community, in the state and the nation.
The Good Neighbor Clinic, funded by donations and the United Way since 1999, is where Winn met nurse Debbie Johnson who gave Winn medications to help her detox through the pain and illness associated with heroin withdrawal. Johnson’s next strategy in Winn’s treatment was to administer Vivitrol, a drug designed to quell the cravings for drugs like heroin, and even alcohol. Vivitrol administration requires a clean drug screen.
Winn managed to show up at the clinic a week later without showing traces of heroin in her bloodstream, and was given the Vivitrol, typically administered about once a month. She was assigned a counselor whose services from the outset were free.
Johnson was appointed as the director of the CARE group in December, which partners with the Good Neighbor Clinic.
The CARE group is part of St. Vincent de Paul Sauk Prairie’s many community programs. It formed in 2014 in response to a growing heroin epidemic from which not even a small, rural community was immune.
The group was a collective community coalition comprised of around 30 law enforcement officers, government officials, medical practitioners, social workers, legal professionals, educators and other volunteers who saw value in a prevention over punishment approach in stopping the cycle of incarceration. This was particularly effective for addicts like Winn, who otherwise may never have committed a crime in their lives beyond getting a traffic ticket.
Winn was caught in a vicious cycle of legal problems brought on by her addiction that date back to 2013 when she was first charged with possession of drug paraphernalia. In 2014, she was charged with bail jumping which was dismissed, but she was convicted of possession and driving while intoxicated. In May 2016, her legal troubles became worse when she was pulled over while carrying a combination of 374 Percocets and Oxycontin pills, enough for herself and some to sell. The district attorney charged her with a felony-level crime of possession with intent to deliver.
But with her strides in recovery, she was able to complete her court-ordered requirements under a deferred prosecution program and was off probation by Oct. 1, 2019.
The recovery process wasn’t easy — nor was it smooth. In July 2017, early in her recovery, Winn was blindsided by a devastating tragedy. Her sister, Katie Rumsey, died from a heroin laced with fentanyl overdose at the age of 38. Her sister had been one of her strongest allies in her fight against addiction.
“When I was detoxing she’d call and check up on how I was doing,” Winn said. “She helped my husband through taking care of me.”
Even through the fog of unspeakable grief, Winn carried on. She sought out well known local 12-step groups like Narcotics Anonymous and Alcoholics Anonymous for added support.
“I couldn’t adopt the higher power vagueness of AA,” Winn said. “For me, I had an issue with God. I’m an atheist. I have my beliefs. But I worked the steps.”
For instance, she developed what she calls a “trigger list,” a list of ten phone numbers of people she could call if she was feeling any urges.
“I’d literally call everyone on the list until someone answered,” Winn said.
Among the most important on her list was Johnson, who had already been in tight contact with Winn through the early, and most difficult, part of her recovery. She is still part of Winn’s support network.
Winn attributes her path away from addition to finding her own inner strength as well as Johnson’s help and the ongoing treatment services offered through the CARE group.
Johnson, along with former CARE director and founding member Joan Mack, saw something in Winn while treating her, even in the first several months of her recovery. In September 2017, nine months after Winn started on the road to recovery, they invited her to speak publicly at a CARE meeting in Baraboo attended by medical and social work professionals, law enforcement and government officials.
Winn said it’s from those kinds of speaking engagements, especially to young people, that she now draws the most strength. She has given presentations to the Pardeeville High School’s health class several times in which she tells her story to students. She said it’s one of the imperatives of staying sober.
Recent decline in opioid overdose deaths
Since 2014, the CARE group, which administers medication-assisted treatment plans, known as MAT, has helped approximately 400 clients who have sought treatment for alcohol or heroin addictions, many of them on probation or parole. In 2017 alone, 86 new clients sought help from the CARE group, 50 of whom were addicted to heroin.
But more recent figures show numbers are beginning to decline for their clients. In 2019, CARE had 49 clients, 18 of whom sought help for heroin addiction.
National figures citing heroin overdose deaths are also in decline. According to an article by Jaime Rosenberg for the American Journal of Managed Care published in June 2019, “the provisional data predict a total of 69,096 drug overdose deaths for a 12-month period ending November 2018, compared with the predicted 72,287 for the 12-month period ending November 2017. If the trend continues through December 2018, it would be the first time annual drug overdose death rates have dropped since the 1990s. In the three decades since, drug overdoses have killed approximately 870,000 people.”
However, Rosenberg also states that deaths based on the combination of heroin and fentanyl are on the rise. “While rates of heroin, cocaine and natural opioid overdose deaths have started to level out, overdose death rates involving synthetic opioids like fentanyl, which is 50 to 100 times more potent than morphine, have continued to increase.”
In the 12-month period ending December 2018, synthetic opioid overdose deaths increased (nationally) to over 31,000 compared with the approximately 29,000 reported in December 2017.
Statewide numbers for overdose deaths appear to be on the decline recently as well. Information obtained from the federal Centers for Disease Control and Prevention estimated Wisconsin’s overdose deaths at 1,172 in 2018 and 1,133 in 2019.
The reasons for a decrease in numbers, both locally and nationally, are hard to pin down, say some experts. Mack, who retired at the end of December, said those numbers may be deceiving because the drug Narcan, often in nasal spray form, used to revive unresponsive heroin overdose victims, is widely used by first responders, police and even private citizens acting as Good Samaritans. The Sauk Prairie Police Department started carrying Narcan in 2015 because the police are usually the first to arrive on the scene of a 9-1-1 emergency call.
The Sauk County Health Department frequently offers classes for the general public in Narcan administration, along with a free bottle of Narcan spray.
“How much Narcan has been distributed and how many times has it been used on one person?” Mack said. “It’s not the full information out there. It’s not a true picture.”
While Mack said she celebrates the common use of a life saving drug, the heart of solving an epidemic is removing the causes of addiction and treating it in the long term. She said the use of drugs like Vivitrol in the beginning to reduce the cravings are merely a good start to a long-term recovery process. However, she added, it is not a panacea.
“Vivitrol was manufactured for alcoholism,” Mack said. “It creates new pathways in the brain. For people who get a high off drugs or alcohol, it shuts down the high. You can stay on it for a year and a half and your brain is rewired.”
A community’s change in strategy
Sauk County’s soldiers in the fight against addiction have waged the prevention over punishment tactic. Officials say this approach to addiction-related crimes don’t just help the addict, but the community overall.
In addition to medication assisted treatment programs like CARE, law enforcement has adopted new methods of helping addicts rather than throwing them in jail for addiction-driven low level crimes.
Two years ago, the Sauk Prairie Police Department expanded on the “prevention over punishment” approach with a pilot pre-arrest diversion program funded under a federal grant that allocated $5 million from 2016-2021, specifically aimed at combating the area’s escalating heroin epidemic.
Sauk Prairie Police Chief Jerry Strunz said the program uses a three-pronged approach that includes holding charges like possession or other minor, non-violent charges in abeyance for six months when those crimes can be tied to an individual’s drug addiction. Instead, that person enters into a treatment program and, if successful, no charges are filed at all or are dismissed by the court.
People with addiction can also be referred to the program.
“A person who is in no jeopardy of being charged and has been referred by a family member, or employer or their own realization they need help, we can put them in touch with resources,” Strunz said. “We’ve referred several to the CARE program.”
Police officers can also refer people to the program if they have routine contact with them and believe that a person may benefit from a referral to treatment.
The program is in the process of evaluating its numbers, but Strunz said he’s witnessed successes.
“The fact that the department recognizes addiction as a disease and why people who are addicted are more prone to committing crimes, that goes a long way,” Strunz said. “Giving people an opportunity to seek treatment pays dividends.”
This month, Sauk County’s Criminal Justice Coordinating Council, appointed by the Sauk County Board, chose a new name for its program which provides services for people in the criminal justice system. It is now called the Justice, Diversion and Support Program, reflective of the county’s proactive efforts in criminal justice and addiction, primarily with the adult drug court. The drug court works to move defendants charged with non-violent crimes related to addiction issues into treatment programs rather than jail.
The CJCC also oversees the Substance Use Diversion and Support program, a voluntary program for substance abuse and mental health treatment when an addict doesn’t qualify for adult treatment court, or hasn’t committed a crime.
Sauk County Health Department director Tim Lawther, hired last year to oversee the department, said public programs to help addicts stay out of jail and be contributing members of the community after release from jail benefit the community as a whole.
“My essential framework coming into this position is a recognition that we have a responsibility to ensure everyone in our community has an opportunity to live the healthiest, fullest life they can,” Lawther said. “Equity is important to me. Not everybody has the same choices, and we need to recognize that.”
HOPE from state legislature’s sweeping opioid laws
Five years and 30 legislative bills have passed the State Assembly since Rep. John Nygren (R-Marinette) began his very personal campaign against addiction with the Heroin, Opioid Prevention and Education initiative known as HOPE. His daughter has spent the last several years in a battle of her own with heroin.
Last month, the State Assembly passed new additions to the package of 30 bills sponsored or co-sponsored by Nygren that, in summary, expand access to safe and reliable recovery housing; ensure state employee protections if participating in Medication Assisted Treatment programs; extend the Prescription Drug Monitoring Program requirements that provide information for healthcare professionals about controlled substance prescriptions that are dispensed in the state; expands access to medication assisted treatment in corrections facilities; allows recovery coaches to bill through Medicaid; and extends the 9-11 Good Samaritan law allowing heroin or other drug users to call police in the case of a companion’s overdose and not face criminal charges.
Nygren’s staff policy advisor Chris Borgerding said the proposed bills that passed the Assembly will analyze what forms of MAT programs are currently used in prisons and jails and fund a pilot program to support those programs when inmates are released and are most vulnerable to relapse into addiction.
Borgerding said one advancement that has not required legislative action is convincing a number of insurance companies to waive a prior authorization requirement to approve payment for medications necessary to initiate a treatment plan for an addict, such as Vivitrol.
“We met with some big insurance providers and they came to that agreement on their own,” Borgerding said. “We didn’t have to pass a bill.”
If you know someone struggling with heroin or opioid addiction, here are resources:Community Activated Recovery Enhancement (CARE) director Debbie Johnson: 608-644-0504 Ext. 12Sauk County Heroin and Opioid Hotline (Sauk County residents) 608-402-4312Wisconsin Addiction Recovery Helpline – 24 hours a day, seven days a week. Call 211 or 833-944-4673Visit 211 Wisconsin onlineDose of Reality – Prevent Prescription Painkiller Abuse in Wisconsin