FARGO - Opioids have dominated the discussion of how to confront the addiction crisis, but behavioral health and recovery professionals offer the sobering reminder that alcohol claims three times as many lives as narcotics in Cass County.

That ratio, documented in a recent Cass County coroner’s analysis, was cited by panelists in a discussion held Friday, Sept. 14, as speakers noted that alcohol abuse remains the area’s most persistent and engrained substance abuse problem.

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The discussion, led by Sen. Heidi Heitkamp, D-N.D., came just a day after Fargo police announced a spike in opioid overdoses, including several recent deaths. “We have an addiction crisis,” Heitkamp said, noting an increase in cocaine use as an example, not merely an opioid crisis.

Adam Martin of F5, a program that helps convicts re-enter society, said his organization’s primary obstacles are a lack of housing and transportation for its clients. F5 has 100 peer support coaches around North Dakota, but most are inactive because they are ineligible for Medicaid reimbursement, Martin said.

“They’re just sitting there,” he said.

That was one of many examples of gaps in the network of programs to help those with mental health or substance abuse problems cited by participants in the discussion, who pleaded for more comprehensive solutions.

Lack of funding for more comprehensive treatments was another recurring concern. People with addictions, including the chronic homeless population, have deep-seated and complex problems that must be overcome to achieve sobriety, participants said.

Rep. Pam Anderson, D-Fargo, whose background is in banking, said North Dakota has been unwilling to invest adequately to solve its social problems. She cited a consultant’s report two years ago documenting significant gaps in the state’s behavioral health system.

After the report, there was a consensus to allocated $27 million to address the problems. In the end, the North Dakota Legislature appropriated $383,000, Anderson said, adding that the state relies too heavily on federal funding.

“We don’t put any money in ourselves,” she said. “I think we have a human infrastructure problem in our state.”

There also are signs of progress. Capt. Andrew Frobig, administrator of the Cass County Jail, said the jail recently began treating narcotic addicts medically to enable them to break their addictions, and said one of the first inmate patients has been released and is doing well.

A quarter of the jail’s inmates have untreated mental health issues, and almost 80 percent have a drug or alcohol problem, Frobig said.

Because so many people with untreated behavioral health or substance abuse problems end up in jails, which increasingly are trying to rehabilitate inmates, it would help if jails received reimbursement, he said.

“If expenses were somewhat reimbursed we could do so much more,” Frobig said.