Photo by Tom Jenz
Amanda De Leon
Amanda De Leon
According to the Department of Health Services, last year, across Wisconsin, there were more than 1,400 opioid overdose deaths. Milwaukee County had around 650 of those overdose deaths. Dire human statistics. Can anything be done about this?
Community Medical Services (CMS) in South Milwaukee is doing something. Amanda De Leon is CMS’ community programs and integration manager. “CMS offers medication, counseling and other wraparound support services for people with opioid use disorder,” she said.
In other words, do not treat those who suffer from opioid use disorder as criminals to be arrested. Instead, offer ways to alleviate their temporary suffering, allowing them to make an effort to recover.
De Leon has dedicated her adult life to helping people with substance misuse. Both her parents are Mexican. She grew up in the Latino community on the Milwaukee’s South Side, 27th and Mitchell. Her dad is a retired police officer. Through the 8th grade, she went to St. Matthews School on 25th and Scott, then attended South Division High School, but dropped out. She got married and had two children by the time she was 22 years old.
We sat on a bench on the South Side near Lake Michigan and conversed.
“I went through a lot of trauma,” she told me. “But when I was 25, I went back to school and earned my GED in a month. Right away, I was accepted into Alverno College and graduated with a double major in psychology and nursing. I ended up with a bachelors in psychological drug counseling. I focused on psychology with an emphasis on substance misuse counseling.” Amanda De Leon talks fast, her enthusiasm catching, her sincerity spreading.
She went on, “I became a substance abuse counselor in training and worked for an amazing German doctor at Columbia St. Mary’s Hospital. It was a temporary job. The doctor would provide Buprenorphine injections for people who had overdosed on ppioids and who came into the emergency room. Buprenorphine is a medication used to treat opioid addiction. He also provided substance abuse counseling for people with addictions. It was a great program because it did not treat anyone as criminals.”
Fifteen years ago, De Leon got a full-time job for the River Shore Treatment Center on the North Side. Back then, the treatment centers were only allowed to administer methadone as medication for opioid use disorder. A few years later, caregivers were cleared to administer Buprenorphine for Medications for Opioid Use Disorder (MOUD). De Leon did counseling, and then was promoted to manage clinics in Racine. Five years ago, she took the job at the Community Medical Services South Milwaukee (CMS) in West Allis where she is now.
She said, “When someone comes to CMS seeking treatment, we are authorized to administer all three FDA approved medications along with counseling services.”
Narcan and Fentanyl Strips
“I hear a lot about Narcan and fentanyl strips to help people overdosing and prevent them from dying,” I said. “How are they used?”
She explained that Narcan is a harm reduction treatment administered to people who have overdosed. “Narcan will help them have another chance at life. Narcan is administered immediately as a nasal spray if the person is overdosing. It lasts for 30 minutes, so it’s imperative for the person to get to an emergency room for further treatment. If you are someone who is using cocaine, please use a fentanyl test strip to see if it is present in your supply. Fentanyl is killing a lot of people who use other drugs besides opioids.”
The Milwaukee County Department of Health has placed a number of vending machines in the area where people who use drugs can get Narcan and fentanyl strips for free. They are called Harm Reduction vending machines and are located in communities where people are more likely to use drugs.
“What Milwaukee neighborhoods and communities have the biggest problem of drug addiction and abuse?” I asked her.
“The Black communities on the North Side and the Latino communities on the South Side,” she said. “Those are the areas where the highest rate of overdosing is happening. CMS will soon have a North Side and a South Side location but they are not due to open for about another year. Right now, we are in West Allis, south Milwaukee, Fond du Lac, and Madison, and hopefully soon in Pewaukee.”
She added, “Currently, more Black folks are dying from overdosing, but nobody is untouchable. According to ACE studies (trauma scores), if you were a victim of child abuse, domestic violence, living in poverty or a victim of poor parenting, then you are more likely to be drug dependent.”
Uniting the Silos
“Let’s talk about your job,” I said. “From what I understand, your role at CMS is to educate city and county organizations and some nonprofits to adopt the CMS addiction treatment program.”
She said, “My role is to go out into communities and break down the various silos who work with drug addiction, get them to work together. These silos include nonprofits, the fire department, police, city and county governments. There is a stigma attached to people who use drugs. I think we all need to come together with our resources to help these individuals who are in need.”
Opioid addiction and overdosing has become a serious social and health problem. I asked De Leon how people generally become dependent on opioids.
“Everybody’s story is different,” she said. “Some people start out recreationally, then go hardcore. Others get hooked through prescriptions. Many people who try to stop using get so sick that they have to go back on opioids. It is a hard habit to kick. The first 30 days you are physically sick. Then, the mental health comes into play. Depression, Anxiety, Isolation. You can have withdrawal symptoms for at least 15 months. We offer medications, therapy and counseling to help combat withdrawal and allow you to get by, hold your job, be a parent, renew friendships.”
The CMS website makes a promise to clients: ‘We’ll meet you where you’re at, using evidence-based practices to treat your substance use disorder with medication assisted treatment (MAT) along with counseling and peer support services. We offer same-day treatment, walk-in services and we treat patients with confidentiality and dignity.’
I said, “Is the goal of CMS to cure addicts? Is it like Alcoholics Anonymous where an addict has a sponsor that he or she can depend on, or call at any time?”
“Not exactly,” she said. “We use Peer Support Overdose Response Teams, individuals who have lived through drug addiction experiences. They sometimes work with the Fire Department responders. If a Peer Support goes into a house where somebody has overdosed, they are perceived as legitimate because they have lived a life of addiction but have overcome that addiction. We ask overdose victims, ‘What do you need, how can I help you right now?' In other words, our goal is to support whatever their goal is.”
I was interested in the results of treating a person addicted to opioids, and also if most successfully treated opioid addicts go on to lead productive lives after recovery.
She explained that 50% of people who engage in Medication for Opioid Use Disorder (MOUD) will be on and off some form of medication for the rest of their lives. MOUD is the gold standard of treatment.
Community Medical Services is the leading methadone clinic and drug addiction treatment center. CMS has a stated mission, which I read to De Leon: “We help those who are suffering from substance use disorders. We consider these people our patients, and our singular aim is to help them heal. We’re proud that our clinics provide our patients an environment that is free of judgement and condescension and we’re steadfast in treating everyone with the utmost dignity and respect.”
“That is why I’m in this position of doing outreach and bringing groups together, city, county, and nonprofits,” she responded. “Our goal is to be helping people with substance use disorder. We do not charge our clients.”
If You Need Treatment
“If someone is having problems with opioid addiction, how do I contact CMS for help?” I asked.
“If you need treatment,” she said, “you can call or walk right into our clinics. You start your treatment right away. The Milwaukee area fire departments and Rescue Squad personnel are now involved, leaving behind Narcan kits and fentanyl strips when dealing with persons who have overdosed. They make referrals to MORI, the Milwaukee Overdose and Response Initiative, who might refer the people in need to us. A MORI emergency visit will include first responders—two fire fighters and a peer support person who will help someone who recently overdosed. Fire fighters will be allowed in the homes because there is so much respect for the fire department.
We’ve been building a community of organizations working together, and that is my job. For example, I am invited to speak about the opioid crisis at fire and police departments and also explain the services we offer. I love my job. It’s hard for me to take time off because I know there are folks out there who are struggling. By educating the community and our partners, we are all combating this crisis together. We know arresting folks isn't the solution, so why not give them access to treatment by working together as a team.”
If you need help, contact CMS through their website: communitymedicalservices.org/locations/addiction-treatment-west-allis-wisconsin.
Hours are 4:30 a.m.-6 p.m., Monday–Sunday
