Tribal clinic cuts schedule II drug doses by half

KESHENA — The Menominee Tribal Clinic has been making an effort to cut down on the amount of schedule II drugs being prescribed to tribal members.

Dr. Robert Chelberg, an optometry specialist who is expected to become a co-director for the clinic next year, announced the news during a community meeting for Keshena held in the Tribal Legislative Chambers.

“Obviously, you’ve heard of prescription drug issues, and health care providers are part of that,” Chelberg said. “Outside of that, there are law enforcement and other things that come into play, and we try to solve the problem. It’s a big problem for all communities in Wisconsin, including all tribal communities.”

In 2015, Menominee County had the highest doses per capita of schedule II drugs, which include narcotics and stimulants, with 41 doses for every resident in the county, according to the Wisconsin Prescription Drug Monitoring Program. This year, that has dropped by almost half to 21.05.

“Obviously, the physicians at our clinic are the main providers, but some of that data also comes from providers in Shawano County,” Chelberg said.

Chelberg said that providers at the clinic are now required to check patients on the PDMP before prescribing drugs. Provider prescribing numbers are reported each month for comparison, and peer reviews take place to look at prescribing patterns.

“All prescription drugs from each provider can be tracked and then also displayed, because that’s public data,” Chelberg said. “That data is managed through me.”

The clinic has been offering medically assisted treatment for opioid addiction using buprenorphine, which is sold under the brand name Subutex and can be administered under the tongue, by injection, as an implant or as a skin patch. Chelberg said this is combined with a behavioral health regimen.

“The clinic has been doing its due diligence to make sure that we’re not contributing to the problem,” he said. “We want to make sure we’re part of the solution, for sure.”

However, that effort has maximized the available behavioral health resources at the clinic, according to Chelberg. In 2016, the clinic has 347 medical and behavioral health visits for narcotic addiction. That number has more than quadrupled to 1,705 in 2018.

The statistics do not include Maehnowesekiyah, the reservation’s drug and alcohol treatment center, according to Chelberg.

He said it is difficult for the tribe to retain and attract medical and behavioral health specialists to the reservation

“Behavioral health is a key thing, and we need to do a better job of stemming these (drug) issues, but the problem is finding professionals who want to come to these rural areas,” Chelberg said.

JoAnne Gauthier, a Keshena resident who said she has been in recovery from drug and alcohol addiction for 23 years, suggested that the clinic utilize the Heroin and Opioid Prevention Education (HOPE) resources in order to help resolve its drug issues. Gauthier pointed out that HOPE grant resources are available both on and off the reservation in Menominee County.

Gauthier also urged the clinic to do its part to bring support groups like Narcotics Anonymous on the reservation to provide an outlet for people who are withdrawing from their addictions.

“It has helped me to have AA and NA and Al-Anon meetings to go to,” Gauthier said. “Occasionally, I have an itch, and I think, where is there a meeting to go to? There’s meetings in Shawano, but do we still have any meetings here to go to? It would be wise to look into this.”

Gauthier praised what the clinic has done in four years.

“You can tell that it’s safer over there,” Gauthier said. “You don’t have as many people hanging around, looking for drugs.”

Chelberg said the decrease in schedule II drug prescriptions doesn’t resolve the drug issues on the reservation, but it’s a step in the right direction.

“This is just the start of the discussion,” Chelberg said. “This issue is not going anywhere for a while. It’s a very complex problem that affects many aspects of the community, but we can at least look at our aspect and try to help.”

lpulaski@newmedia-wi.com