Into the Light

Kalispell’s Lawrence Park, particularly on a bright fall day, is inviting.

On a recent afternoon, the descent into the park’s main recreation area revealed laughing children, bounding dogs and smiling friends sharing a picnic lunch. The grass was green, the playground and gazebos were filling up, and the 18-hole disc-golf course awaited its next foursome. The wide-open lower bowl of the 117-acre park is the hub of activity, but it is surrounded by a steep hillside that gives way to thick marshland and other largely untrammeled spaces. There, wildlife is abundant, shrouded in the thick brush and unbothered by humans who have only limited trail access.

So it was curious, or at least unsettling, when a Kalispell father named Ben Long posted a photo to Facebook of hundreds of used syringes that he found in the woods at Lawrence Park.

“Clearly, folks have been shooting up there all summer,” he wrote along with the photo. “These folks need help but we can’t have this kind of litter where kids play.”

The post struck a nerve. Since Oct. 12 it has been shared 471 times, spurred reports in multiple news outlets, and made its way to the desk of Chad Graham, the president of the Kalispell City Council. At the Oct. 19 city council meeting, Graham addressed the subject in a somber tone.

“It needs to be cleaned out. It needs to be thinned out,” he said. “We need to shine some light down into those areas.”

Shawna Himsl, who works in family planning at the Flathead City-County Health Department, is hoping for the same light to shine, just on a different part of the problem. For Himsl, who runs the county’s 18-month-old needle exchange program and has made multiple offers to install sharps disposal containers where used needles can be dropped at city parks, the uproar over a pile of dirty syringes could finally bring awareness to a growing population of local residents addicted to intravenous drugs like methamphetamine and heroin.

“This is a really prevalent issue in everyone’s family and we just don’t like talking about it,” she said. “It’s not doing us any good.”

Himsl started at the health department in April 2018, and within two months she was already pushing for a controversial new program, or at least one that’s controversial in Flathead County.

The first publicly funded needle exchange program in America was in Tacoma, Washington in 1988, and in the more than three decades since, researchers have routinely come to the same conclusion: the programs work. Tacoma’s effort launched during the height of this country’s devastating HIV outbreak, and the intent was to discourage intravenous drug users from reinjecting used syringes, a practice that can lead to a host of diseases, including HIV and hepatitis. The Centers for Disease Control and Prevention (CDC) reports that syringe services programs like needle exchanges are “associated with an approximately 50% reduction in HIV and HCV (hepatitis C) incidence.”

But Himsl ran into opposition right from the start, including from her own health department.

“I was told a couple of times that there was no way this program would ever exist in this building,” she said. “I kind of took that on as a personal challenge at that point.”

Himsl set to work chipping away at the program’s detractors, eventually convincing the Flathead City-County Board of Health to offer its support, which paved the way for the program’s launch in April 2019.

The needle exchange is funded by a $57,000 CDC grant and is available twice a week, on Tuesdays from 1-4 p.m. and Thursdays from 1-5:30 p.m., at the health department. During those hours, anyone with used syringes can bring them to the family planning department where Himsl will take them back to her cozy office for a one-on-one meeting. There, dirty needles are swapped out for new ones, and an array of other supplies is available, including sharps containers, the life-saving overdose reversal drug naloxone (brand name Narcan) and fentanyl testing strips.

Around 130 people have already used the anonymous and confidential service, almost all of them more than once, and since April 2019 more than 30,000 used syringes have been collected by the program with more than 60% of the new distributed syringes later returned. Nearly 80% of program participants are either Flathead County natives or have lived here at least 20 years, and the average age of participants is 36. Himsl does not pressure her participants to seek immediate treatment for their addiction but does work to “build a bridge” so that when they are ready, they come to her.

In addition to the personal sharps containers she hands out to users, Himsl has also made an effort to get the containers — and Narcan — into the community. The discrete containers come in a variety of sizes, and Himsl has successfully placed them at a handful of local hotels and other businesses where IV drug use is common. Others, however, have recoiled at the thought of displaying a needle collection container, including the city of Kalispell, which does not allow them in any public parks, including Lawrence Park.

Graham is opposed to sharps containers on city property because he said his goal is to eradicate drug use at public parks.

“Needle pickup in the park does not fly with me,” he said at an Oct. 19 city council meeting. “I am not going to go through and put my support behind (drug) use, and kids playing in our park, and dogs catching Frisbees, and FOLF [Frisbee golf].”

“Those two, in my mind, will never coexist.”

But advocates say harm-reduction programs do not lead to increased drug use and no evidence says otherwise, which Himsl said she can back up within her particular operation. Only once, she said, has a participant reported additional drug use while using the needle exchange, and that was because he won $50 off a lottery ticket.

Ann McWilliams, the clinical manager at Gateway Community Services in Kalispell, an outpatient substance abuse disorder and mental health provider, was even more blunt in her assessment of the city’s opposition.

“A healthy person who doesn’t have an addiction is not going to see a sharps container and think, ‘Now I’m going to be a junkie,’” she said. “That’s bananas. If there’s a person that’s going to use, (the presence of) a sharps container isn’t going to be the reason they do or don’t do it. It’s already happening.”

McWilliams is concerned that decisions like the one about Kalispell parks is only the latest in a series of deliberate turns away from the crisis of addiction, one that officials fear is only worsening. The number of drug users in Flathead County is difficult to pin down, of course, but law enforcement officials, Himsl and McWilliams are all seeing disturbing trends.

According to Flathead County Sheriff Brian Heino, methamphetamine prices have skyrocketed since the start of the COVID-19 pandemic, in part because of a low supply of available ephedrine and border closures that have limited international trafficking. In turn, meth addicts are either engaging in more illegal activity to raise money or switching to different, sometimes more dangerous drugs. Heroin and cocaine have become increasingly popular in the county, and methamphetamine is more frequently being cut with fentanyl, a powerful opioid that is fatal even in very small doses. In the first half of 2020, seven fatal accidental drug overdoses were reported in Flathead County, according to Heino, the same number as all of 2019.

Himsl, in her conversations with the program’s participants, is seeing much the same. It’s one of the reasons she has started handing out fentanyl test strips that users can deploy to determine whether or not fentanyl is present in a batch of methamphetamine. A staggering 91% of exclusive meth users reported finding fentanyl in their batch between May and September of this year, and participants reported a total of 38 overdoses — either their own or someone else’s — in August alone. The relatively small number of deaths could be thanks to the prevalence of Narcan, which temporarily reverses an opioid overdose. The drug is carried by law enforcement officers and distributed by Himsl.

“God bless that reversal drug,” McWilliams said. “Just that alone has saved countless lives.”

And that is the point of harm-reduction programs. For people like McWilliams and Himsl, even as they see addicts relapse or encounter those who have used nonstop for decades, there is only one kind of addict who is beyond helping.

“I cannot treat a dead person,” McWilliams said. “At least (in the needle exchange program) they’re using clean equipment and they’re coming in contact with somebody that says there’s help when you’re ready.”

“At the end of the day, if they’re dead, it’s over. Game over.”

It’s been almost 40 years since “Just Say No” was trotted out as the solution to drug addiction in the United States and almost 50 years since Richard Nixon declared the “War on Drugs” had begun. To public-health officials, both of those are symbolic of a failure to properly address a national disaster.

Some of those sentiments, however, still persist. Local police departments and the county sheriff’s office have switched their focus to arresting traffickers and sellers, but plenty of people with addiction issues still wind up in jail, all without immediate access to treatment.

Those who stay out of jail largely use in secret. They include full-time workers with hidden struggles at home, couch surfers who bounce around for scores, and the unsheltered homeless who set up camps in places like Lawrence Park.

“In this town we have a lot of substance use but not a lot of resources,” Himsl said. “And we’re a little bit behind in terms of compassion around it.”

Which brings the conversation back to Lawrence Park, and Graham’s suggestion to open up the thick woodland where those needles were found. Years ago, in Woodland Park, the parks department cleared away some tree cover and vegetation that largely drove out the transient and drug-using populations there, and Graham and Parks and Recreation Director Chad Fincher believe a similar effort could help in Lawrence Park. Fincher also proposed adding trails to the area in an effort to eliminate hiding spots for users, although he said the severity of the problem at Lawrence Park was overblown in the wake of the viral Facebook post.

But to Himsl and McWilliams, those efforts miss the point, particularly in an area with no inpatient treatment options available, no community center for the transient population to gather and be availed of treatment options, and no significant public transit. It means that if efforts to clear out Lawrence Park are successful, there could be fewer needles found but it won’t do much to help a struggling community of addicts or push the problem out of sight.

“I don’t know what people think these people are going to do because there’s nowhere for them to go during the day,” Himsl said. “I get why people get frustrated with the problem, but if you’re not willing to make small accommodations, then it is what it is.”

“These problems are going to continue and they better figure out how to fix them or they’re just going to be dealing with them later on.”

Until the drug problem is confronted head on, Himsl plans to continue her efforts. The daughter of an addicted parent, Himsl has developed a knack for connecting with the users who come through her door. It’s not the primary goal of the program, but because she has relationships with the participants she’s often the one who will refer them to a doctor or a treatment center when they are ready, and she’s had recovering addicts visit her to share their stories of sobriety.

But even for those who do continue to use, and who may use forever, Himsl cherishes the opportunity to care for them. It’s a population that is often swept away rather than embraced, people who are often shunned by a community perhaps intimidated by or unaware of the size and severity of the crisis in their own backyard.

“I don’t think there’s another job in town that I would want more than this … these are my people,” she said. “I’m making a difference because I care about them and they know that I care about them. That’s all I can really do.”

Shawn Himsl’s office is at the Flathead City-County Health Department, 1035 First Avenue West in Kalispell. She can be reached, anonymously, at (406) 751-8256. Gateway Community Services is located at 1312 N. Meridian Road in Kalispell and accepts walk-ins. The phone number there is (406) 756-6453.

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