Laramie County officials address fentanyl concerns during panel discussion

Apr. 11—CHEYENNE — Laramie County had a record 30 deaths due to drug toxicity last year, a number that Coroner Rebecca Reid estimated is up 85% from when she began her role a decade ago.

Law enforcement, legal and medical professionals from the city and county met Wednesday evening to discuss substance use and drug abuse in the community, with a pointed focus on the rise and prevalence of fentanyl.

"It's a lot of families that we're having to notify that their loved ones are dead," Reid said. "It's affecting everybody. It affects the neighbors, their friends, their schoolmates, everybody that's involved. I just want to see an end, and hopefully, maybe we can stop something."

The discussion consisted of six panelists whose conversation covered ways to address the issue, next steps forward, how to support community and family members, addressing a stigma around drug users and, among other topics, initiatives that the community can support to help tackle the growing issue.

Fentanyl is an opioid used to relieve pain. It is approximately 100 times more potent than morphine and 50 times more potent than heroin, according to the United States Drug Enforcement Administration.

Cheyenne Police Chief Mark Francisco said the use of fentanyl has increased dramatically in the state over the past three years, as it has across the country. Between 2018 and 2021, the number of synthetic opioid-involved fatal overdoses — most commonly fentanyl — among Wyoming residents more than quadrupled, while the deaths connected with most other opioids stayed relatively stable.

A typical overdose situation happens when someone is arrested and is put in jail for two weeks, typically, or up to two months if they cannot post bond. They were at a level of fentanyl use before that they no longer have access to and now face withdrawal.

Laramie County Assistant District Attorney Rocky Edmonds said it is not uncommon to see people using 20 pills a day, and he has seen up to 50. When they are released from jail, they assume they can use the same level they used prior to jail. This can lead to overdosing, resulting in death or near death.

Beginning in 2023, Laramie County Sheriff Brian Kozak made it a requirement for all deputies working in the jail to carry Narcan, a naloxone product that reverses the effect of an opioid overdose, when working in the facility.

Innovative tactics

Kozak said around 60% of inmates in the Laramie County jail are diagnosed with a mental illness. Some chronically ill inmates have been waiting for assessment from the state hospital for more than a year.

"Essentially, my jail has become a mental health hospital," he said.

The Laramie County jail is currently constructing one mental health pod and converting two existing pods into special treatment areas for mental health issues and drug treatment.

The jail has also hired a medical contractor and two psychiatric nurses to work full time, as well as two master-level counselors who will focus on suicide prevention and mental health treatment.

This is in addition to the three existing master-level counselors who will be repurposed from correctional treatment to conduct addiction severity index assessments and begin drug treatment group sessions.

This month, the Laramie County Sheriff's Office has also hired a full-time fentanyl-sniffing dog. This year, they've started doing shakedowns and daily cell inspections to ensure no fentanyl is being brought in from the outside.

Inmates also must complete mental health courses before gaining access to entertainment options on the jail's iPads.

Most importantly, Kozak said, is the Law Enforcement Assisted Diversion (LEAD) program. Primarily, they divert people from the criminal justice system before going to jail. Recently, LEAD has been working more with inmates to connect them with resources and programs to support them when they are released from jail.

This year alone, Kozak said officers have administered Narcan to around seven inmates.

Officers in the Cheyenne Police Department have the option to carry Narcan, but it is not mandated. CPD partners with Cheyenne Regional Medical Center to pair officers with mental health professionals to contact people who may not be in a crisis, but need to talk about community support options.

Kurt Zunker is the department head of the Laramie County Treatment Court programs. His program has introduced medication-assisted therapy in the past few years, which is also offered at the county jail. This provides substance abusers with medications that prevent them from feeling a high when ingesting opioids.

"Unfortunately, in our state, access to those medications is greatly limited," Zunker said.

Wyoming is one of 10 states in the country that has yet to expand Medicaid. Zunker said that if it were expanded, 90% of his program participants would qualify and have access to this medication. However, since many don't have jobs, and they have few supporting resources, access is difficult.

"Mental health treatment, substance abuse stuff, the Department of Health... when the Legislature is demanding cuts, those are the first things they kill," he said. "Because they don't have lobbyists ... so they're the most vulnerable people, they're are always getting cut first, when it comes down to it. And our local providers can't be expected to carry these burdens and not receive income for those services. It just doesn't work that way. We all have bills to pay."

Killing a fly with a sledgehammer

In addition to lack of health insurance, Mackenzie Howard, who runs the sheriff's office's LEAD program, said that lack of a sober living facility in the community is a large barrier on the path to recovery.

Edmonds said he has seen defendants transition to sober living centers in other communities, particularly in Sheridan, and have enormous success.

"I hear defendants tell me directly, or tell me through their defense counsel, that he or she needs to get the hell out of here," Edmonds said. "It's people, places and things with addiction. When you're in Cheyenne, you run into the same people, you go into the same places, you do the same things, and you're back in your addiction cycle."

Francisco said getting people committed to the mental health hospital in Wyoming is nearly impossible. Those who have been judged by the court as not criminally responsible due to underlying mental health conditions don't have a place to go other than back out on the street. He said there needs to be more funding and more support for increasing mental health capacity.

"We need more access to residential treatment events, we need more access to transitional living or sober living, we need better access to medicated assisted therapies or cheaper access to that," Zunker said. "... This is addiction, and addiction is a chronic brain disease, and we're not treating it as a chronic disease. We ask our law enforcement friends to go after our addicted neighbors, and it's like trying to kill a fly with a sledgehammer sometimes."

See something, say something

Of the 30 overdose deaths in Laramie County in 2023, four were between the ages of 15 and 24. All four were not reported right away, largely because those calling in feared the repercussions.

Community members who attended Wednesday's event raised questions of how the officials plan to transition the stigma around drug addiction from a taboo topic that is ignored to something that is discussed and reported.

Howard said that it's important to start education from a young age. A lot of users started when they were teenagers, so if they have been using for decades, it is unrealistic to expect a behavior change overnight. Therefore, the younger they reach people, the better.

There are opportunities for both adults and children to submit anonymous tips to CPD or the school resource officers, and Laramie County schools include drug abuse education in their health curriculum.

Laramie County District Attorney Sylvia Hackl said her office practices discretion when prosecuting those who report drug overdoses.

"There's a humanity aspect to all of this, and I'd like to think those of us up here [on the panel] help represent that," she said. "So don't be afraid to report it, because you've got several layers of folks who are going to look at it and take that into account."

Of the four aforementioned cases, nobody was charged.

Zunker said that those coming into his program for treatment are generally willing to make a change.

"Recovery happens," he said. "Seventy percent of the people that get enrolled in a treatment court program in Laramie County graduate. Seventy percent of those that graduate never end up back in the system."

"... There is light, there is recovery," he continued. "It's all about trying to make some connections to the right services. If you're struggling yourself, find a therapist, make that connection. You're not alone in this community."

Noah Zahn is the Wyoming Tribune Eagle's local government/business reporter. He can be reached at 307-633-3128 or nzahn@wyomingnews.com. Follow him on X @NoahZahnn.