Tri-State Ambulance paramedic Eric Ellis encounters a drug user on every shift.
One could be an overdose; the next could be a negative reaction, usually to methamphetamine or heroin.
Heroin users are unconscious, or close to it. Meth users are the opposite: They’re stimulated, unpredictable and combative.
“It’s really frustrating seeing the same people over and over again,” Ellis said. “It makes we wonder if we have enough resources.”
Most users survive.
Hundreds of people in dozens of professions are fighting La Crosse County’s drug problem, but arrests are increasing, more users are hospitalized and one local clinic last year alone distributed hundreds of thousands of needles to addicts.
Some needles end up littered across the city, exposing the public to deadly infections.
“The drug problem is a problem that isn’t easily solved,” Gundersen Health System Dr. Chris Eberlein said. “We’ve tried to arrest our way out of it and clearly that’s a component. The others are prevention and treatment.”
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Methamphetamine is the most abused and available drug in La Crosse, although the market remains saturated with heroin thanks to an influx of out-of-town dealers preying on addicts, said La Crosse police Sgt. Andy Dittman, who heads the agency’s narcotics unit.
Meth killed two men last year, ages 31 and 36, the first methamphetamine-related overdoses in La Crosse County since 2011, according to the medical examiner’s office. There were 24 fatal heroin overdoses from 2010-15 and one likely this year.
La Crosse police in 2014 and 2015 arrested more than three times as many adults for possessing and delivering meth than heroin, according to data provided by the agency. Officers arrested 191 people last year on meth charges, compared to 57 on heroin charges.
La Crosse County prosecutors charged 220 meth cases and 77 heroin cases last year, while the county ranks among the highest in the state for the number of homicide cases filed against drug dealers to hold them accountable for fatal overdoses.
Authorities in October disrupted a massive drug trafficking ring that police estimate was responsible for two-thirds of the meth distributed in the region.
Several of the 17 people connected to the case moved hundreds of pounds of crystal meth manufactured by Mexican drug cartels from the Twin Cities to La Crosse, where other players distributed it to surrounding counties during a four-year span.
The investigation lasted more than one year and more arrests are possible.
“This was a major case when you consider that hundreds of pounds of meth were creating all these addictions and impacting all those lives,” said Tom Johnson, who heads a regional drug task force.
Methamphetamine has reached a crisis level in Trempealeau County, where prosecutors charged 32 possession and delivery cases last year, up from just one case in 2012 and 2013, District Attorney Taavi McMahon said.
Burglary and theft cases are rising as desperate addicts turn to crime to support their habits, while four pregnant women addicted to meth were jailed or forced into treatment last year to protect their unborn children, he said.
“The impact of meth on the community is terrible,” McMahon said.
Heroin use, considered an epidemic in 2012, reached a plateau in early 2015 after a wave of fatal overdoses, Johnson said.
“They saw their friends dropping dead, and it got their attention,” he said.
Eberlein, who co-chairs the county’s Heroin and Other Illicit Drug Task Force, earlier this month warned users that a potentially potent strand of heroin he suspects is cut with fentanyl, a powerful painkiller, had hit the local drug market.
Police are investigating, but noted that doctors may be the first to see drug trends when users seek treatment for an overdose.
“By the time it’s proven, often times there are multiple deaths,” Eberlein said.
He cautions against using any form of heroin — “You never know what you’re getting,” Eberlein noted — but those who do should reduce doses and use with a sober friend equipped with Narcan.
“You need the antidote,” he said. “When these people overdose, the clock is ticking.”
Heroin, a sedative, kills users by respiratory depression. Meth is the opposite, speeding a user’s heart rate until they suffer cardiac arrest, Eberlein said.
Hospitalizations for overdoses are increasing, while doctors also are treating addicts for dangerous side effects of drug use. Needles can break and become embedded in a user’s arm, which could lead to a fatal infection without treatment. In other cases, users who pass out in awkward positions face amputation if blood supply is severed from limbs, Eberlein said.
The AIDS Resource Center of Wisconsin in La Crosse distributed 218,895 clean needles last year, most to heroin users, to prevent the spread of HIV and Hepatitis C, said Scott Stokes, the organization’s director of prevention. The center handed out 138,959 needles in 2014 and just 31,000 in 2010.
Used needles littered across the city expose the public to diseases from an accidental prick. The city’s firefighters are picking up needles daily from bus stops, alleys and parking ramps and lots, Assistant Chief Warren Thomas said.
“They’re everywhere,” he said.
Enforcement, prevention, treatment
Police remain focused on enforcement, targeting dealers to sever supply lines in complex investigations that take patience and strategy through controlled buys, informants, surveillance and public tips.
But addiction is a public health problem and users need access to treatment centers, said McMahon, who argues that — even with treatment courts — the criminal justice system “is not the best place to deal with addiction.”
“Treatment centers are, and I don’t think there are enough of them,” he said.
AMS of Wisconsin treats heroin addicts with medication to curb withdrawal symptoms and cravings, while meth users have to rely on willpower and coping skills.
“There is no treatment with medication for meth at this time,” said Pat Ruda, the agency’s executive director. “That drug is really just awful.”
Expanded state and federal healthcare programs allowed more addicts to access treatment. The agency treats hundreds of patients annually, most between 20 and 35 years old.
About 90 percent of addicts relapse, said Eberlein, who advocates for better research into the science of addiction.
“Every day they are struggling with sobriety because addiction is a disease that is not understood by many people in the community,” said Cheryl Hancock, executive director of Coulee Council on Addictions.
The agency provides counseling to addicts in a clean setting where they can interact with others in recovery and prevention services.
Curbing the drug problem involves early and expanded access to treatment, especially for dealers peddling drugs to support their own habit, and focused awareness and prevention efforts, Hancock said.
“Once they’ve taken that first hit, if they’re an addict,” she said, “it doesn’t matter anymore.”