BLACK RIVER FALLS, Wis. — Despite action by Congress to address the opioid addiction epidemic, hard-hit areas of the country like this one in the Midwest are finding it difficult to keep up with the fallout from the unfolding situation.

In July, here in Wisconsin’s Jackson County, for instance, 34 children who were taken out of their homes, many a result of a parent’s opioid addiction, remained in foster care. 

Those placements resulted in a $35,000 cost for the county that month.

While down from a year high of 40 in January, the epidemic has presented serious cost concerns for the local health department. The county spent over $1 million in 2015 on child welfare placements, a staggering amount for a health department with a roughly $9 million annual budget.

For the growing number of teenagers entering out of home care, the cost is even higher — up to $70,000 a month to cover seven young adults.

“We’re dealing with not being able to find social workers,” Christine Hovell, director of the county’s health department, said in a recent interview. “I know we’re getting to the point of being in crisis, but I’ve heard from other counties that they don’t even know if they’re going to be able to continue their child protective services because they don’t even have enough social workers.”

This is just one of myriad issues, stemming from the opioid epidemic, affecting towns across the Midwest.

Not forgotten

Incumbent senators canvassed the area over the most recent recess with a message that the problem remains a priority.

“On the opioid front, we’re going to be fighting nonstop,” Indiana Sen. Joe Donnelly, a Democrat, said recently. “Part of the state’s kind-of masterplan of how to handle this opioid situation or deal with it includes $60 million of funding that they are hoping to get through a Medicaid waiver.”

When asked what additional actions Congress could take, Wisconsin Sen. Tammy Baldwin, also a Democrat, said access to treatment is still a major hurdle for rural areas, pointing to individuals who had to drive up to two hours one way to reach the nearest treatment facility.

“Superior’s across the bridge from Duluth, Minnesota, a big city with treatment facilities, but it’s a state border. People with drug addiction in Superior last year had to drive to Chippewa Falls for the closest in-patient treatment,” she said, referencing the approximately 150-mile drive between the two cities.

With a jampacked legislative agenda for the remainder of this year that includes an overhaul of the U.S. tax code and possibly now a major immigration bill, it’s up in the air whether Congress will have time to take additional action on the prescription drug abuse issue.

But for counties in Indiana and Wisconsin, the social and economic impact of the raging epidemic continues despite Congress acting last year to try to address the problem.

Jobs sit unfilled as employers struggle to find individuals who can pass a drug test. Mike Janousek, chief financial officer of FeraDyne Outdoors, a Wisconsin-based company that specializes in bowhunting equipment, recalled a local job fair when, after it was announced on the second day that drug screenings would be a mandatory part of the interview process, three-fourths of the individuals there walked away.

A growing toll

Meanwhile, the costs of placing individuals into addiction treatment continue to skyrocket. And incarcerations as a result of opioid abuse and mental health issues remain high as many of Wisconsin and Indiana’s predominantly rural counties lack the treatment facilities necessary to tackle a problem that has devastated the region.

“What’s happening is that these folks are going to the hospital and needing to be placed somewhere and, at times when they are in crisis, they are sitting at the hospital 12, 18 hours, trying to get to a place or a facility,” Hovell said. “People are literally sleeping in the hallways. There just isn’t enough placements for folks.” 

For Jackson County, the cost of reviving individuals after a drug overdose also presents a major challenge. Hovell recalled a young woman who, in one week, was revived from potentially fatal opioid overdoses three times using a medication known as naloxone.

Some areas have seen small improvements — for instance, when it comes to prescribing habits. One veteran in Indiana’s Blackford County was receiving 180 pills of gabapentin each month, an amount that has since been cut to 120 pills.

“He came into my office, he was out of it,” Jon Oswalt, the county’s veterans affairs director, said recently. “I’ve had other guys come in and I thought, ‘I hope you’re not armed, because you’re right on the edge.’”

While not an opioid itself, gabapentin — used to treat nerve pain — has been linked to overdoses across the country.

Congress took an initial step at tackling the abuse of prescription medication last year. The Comprehensive Addiction and Recovery Act, or CARA, was signed into law and additional funding for states was included in a package of biomedical innovations bills known as 21st Century Cures that also became law last year.

But for many in Wisconsin and Indiana, they have yet to feel any positive effect.

“We’ve not been able to tap into some of the other … grants yet,” Hovell said.