Thumbnail photo: Rx Safe Del Norte and the Department of Health and Human Services celebrate those recovering from addiction during an Addiction Recovery Awareness Walk in September. | Photo courtesy of Jermaine Brubaker Patient Navigator Melissa Nelson described a tree in the lobby of Aegis Treatment Center’s Eureka clinic to illustrate an important facet of the care it provides. Every patient that celebrates a milestone on their journey to be free of opioid addiction adds a leaf. It’s a reminder that someone cares about them, is available and will show up, Nelson said. That can mean a lot to someone in the throes of addiction. “When you’re in the lobby, if you’re just waiting, you can look over and see what different patients have to say in that process of being celebrated,” Nelson told Redwood Voice Community News. “Maybe we’ll have a whale or something in Crescent City.” On average 30 to 40 Del Norte County patients navigate U.S. 101 south to Humboldt County every day to access their Methadone treatment, Nelson said. Many board a Partnership Health transport van at 4 a.m. to seek care. Aegis is in the process of opening a medication unit in Crescent City to make that journey easier for its current patients and, maybe, urge others to take that first step on the road to recovery. “One of the things we do here is pay attention to when there are blocks and barriers in transportation to get to and from the clinic because daily medicating is such an important piece of successful treatment,” Nelson said. “If someone’s not able to get here daily they can’t reach a therapeutic dose level.” Nelson said she and her colleague, Sean Tew, executive director of Aegis’s Eureka clinic, noticed an increase in Del Norte patients about a year ago. There isn’t an exact opening date for the Crescent City med unit, which will be located at 1070 U.S. 101 at the north end of town, Tew said. Aegis still has to get all of its licensing and permits with the state in order — that’s up to the its parent organization, Pinnacle Treatment Centers — but Eureka staff are setting the clinic up and seeking medical assistants and nurses, Nelson said. “We don’t have an opening date yet because we’re still awaiting licensing and I will be informed as soon as we have any updates,” she said of the med unit, adding that the medical assistant and nurse positions are posted on Aegis’s website now. “We were hanging pictures. It is very much there.” According to Rx Safe Del Norte founder Jermaine Brubaker, while Del Norters can get opioid addiction treatment through Suboxone locally, Methadone, which is more effective, can only be had in a controlled setting. With Rx Safe Del Norte, Brubaker has provided Naloxone kits and training to reduce an opioid overdose to the community since about 2018. She partnered with Aegis to set up harm reduction kiosks that include Naloxone and Fentanyl test strips in various spots throughout Del Norte. “The harm reduction kiosk in the sheriff’s lobby is the most used Naloxone dispenser in the community,” Brubaker said. “It’s the one we have to restock the most often.” In 2023, Brubaker was part of a Del Norte County team participating in a national effort to curb opioid addiction in rural communities. That team also included District 2 Supervisor Valerie Starkey, Darrin McElfresh, Del Norte County Department of Health and Human Services representatives, public defender Elly Hoopes and Yurok Associate Judge William Bowers II. Brubaker said she and her colleagues initially approached Aegis about establishing a mobil medically-assisted treatment unit in Del Norte County, but realized Eureka isn’t close enough for that to be feasible. But, given that 40 residents travel to Humboldt County daily for their treatment, local Methadone access is needed. “Basically we wrote letters, the folks on the opioid litigation team and Rx Safe Del Norte, saying, ‘Yes, we’d love you to be here,’” she said. “We’re one of the only communities that’s asked for Aegis to come.” Still, if there are any naysayers, Brubaker points them to the state Department of Public Health’s California Overdose Surveillance Dashboard. Del Norte County always has some of the highest per-capita rates when it comes to emergency department visits for opioid-related stuff and overdoses, she said. “There’s always a stigma against addiction, always a stigma against substance use and always a stigma against treatment because people don’t understand the whole picture,” Brubaker said. Aegis patients visiting the Crescent City med unit will receive their Methadone dosage and will visit with drug counselors via telemedicine, Nelson said. The counselors will be at the clinic in Eureka. Medication is daily and counseling is weekly, she said. With their counselor, patients formulate a treatment plan, Nelson said. Counselors also help facilitate referrals to other providers if a patient needs a primary care doctor or if they need help finding housing. Every 90 days, the patient and counselor will go over their treatment plan to determine what needs are being met and what still needs to be worked on, Nelson said. “One of our biggest referral sources, both ways, is Del Norte Mission Possible,” she said. “We’ll refer (there) for showers and clothing and emergency housing services. We also refer to Public Health, they’re fantastic over there. But increasing those referral networks is going to be really important.” Nelson said she’s heard tangentially that some are opposed to the idea of a Methadone clinic in their community, but she hasn’t seen direct evidence of it. If people do have concerns, she urged them to reach out via cell phone or email at (707) 572-7586 or melissa.nelson@pinnacletreatment.com and said Aegis could arrange a meet and greet or conduct a question/answer session with the community. “My experience in working with Crescent City closely for over a year now is there’s strong support from community providers and a strong need for individuals affected by opiate addiction in the area,” Nelson said, adding that this is the first time she and Tew have opened a new facility. “If there is concern, then I think it would be important for them to know that this is new for everyone. This is new for us and also new for them, so let’s have a conversation about it.” Nelson, who has worked in the substance abuse treatment field for about 11 years, acknowledged that there were negative stereotypes about Methadone. But, she said, addiction doesn’t discriminate. Tew also added that the scope of people who seek help through the harm reduction model of treatment is broader than the stereotype of “just being homeless.” “There are a lot of clients that are doing really well in the concept of society but struggle with the reality of opiate use,” he said. “The stigma of it being homeless people is just exactly that, a stigma of just not being informed or being aware of the broad reality of what the Fentanyl crisis has produced in our communities.”