ASAC Clinton and Jackson County prevention director Leslie Mussmann goes through paperwork in her office.

Editor's Note: Over the five Saturdays in March, the Clinton Herald is publishing a series about the use and abuse of opioid drugs in Clinton and how those statistics fit into the state and national scope of the opioid abuse crisis. Today's installment is part two of the series.

CLINTON — When Clinton Police Chief Kevin Gyrion came to Clinton in 2015, he brought with him a message developed through almost three decades as a Chicago police officer. 

The message: Clinton isn't a place to hide while selling drugs.

With a little more than four months under the watch of Gyrion, the Clinton Police Department started to experience some changes in January 2016. That's when officers, including Joe Raaymakers, became part of a targeted enforcement team. 

The concept was simple. The team was in place to target specific crimes hampering the city at the time. If a rash of garage burglaries was happening, the team would focus its effort on that.

In its two years of existence, though, one specific issue has dominated the majority of the team's time — drugs. 

"Most of the problems are narcotics related, so that takes up 85 percent of our time," Raaymakers said. 

It's nothing new that drugs are an issue. In his almost 26 years of experience, Raaymakers has seen his fair share of drug problems on the streets of Clinton. From the days of Operation Bootstrap – a local program in the mid-1990s that focused on community policing in light of increased crime in town, including drugs – to the methamphetamine influx of the 2000s, which continues today, the increase in opioid problems is just another issue in a long line for this river city that is in close proximity to several metropolitan areas. 

Despite some similarities, what Clinton and other communities are seeing with the current opioid crisis in America is a different take on what the perceived drug-user looks like. 

"Back in the day, we knew who the pot heads were," said Raaymakers, who started with the Clinton Police Department in April 1992. "You knew who were using drugs. But if you walk through Walmart today, you may see out of 10 people, one or two addicted to opioids, and you would never know it. It's definitely not your typical drug-user that is addicted to opioids."

The number of incidents in relation to heroin and prescription drugs is increasing for Clinton's police officers. In 2015, the number of opioid incidents totaled 18. A year later, the number ballooned to 62, with 59 prescription drug incidents. 

The department's strategy isn't to just throw everybody in jail and let the court system figure it out. 

"We talk to a lot of addicts during our different shifts," Raaymakers said. "We check on them and see how they're doing. We know they have an addiction. They don't want to be an addict, but they are. We don't just try to find them and put them in jail. You hear this all over the country. You can't arrest your way out of it. We speak with them a lot more and check on them a lot more."

Debbie Diaz understands the notion of addicts wanting to come clean. Her daughter, just a few weeks ago, came home desiring to come clean from her heroin addiction.

It didn't last.

"I said 'I'll help you,'" Diaz said. "She stayed here. She slept, threw up, took a bath. I guess she stayed maybe four days. And then she moved out."

Debbie's daughter's story is not uncommon. She's been to treatment three or four times, Debbie said, and has been charged with five crimes since May 2016. That's coming off a felony substance abuse violation charge in relation to heroin distribution from June 2014 to June 2015 that was eventually dismissed in October 2015, thanks to no probable cause being found. 

Finding a way to help addicts is a daily duty for Leslie Mussmann, prevention director with the Area Substance Abuse Council in Clinton and Jackson counties. Her office provides substance abuse treatment and prevention services from licensed public health officials. 

ASAC provides outpatient treatment and residential treatment. The organization oversees Clinton locations like Hightower Place, a halfway house, outpatient facility for women, and the King House, a halfway house, outpatient facility for men. 

The residential inpatient treatment facility is based in Cedar Rapids. 

Treatment admissions through ASAC are registering an uptick locally, but not to the level of other substances. In 2014, 59 people were admitted to treatment for either a primary, secondary or tertiary use of opioids. In 2015, that number jumped to 84, before falling to 75 in 2016. 

"If there is a positive of this epidemic of opioid abuse is that it's gotten a lot of attention," Mussmann said. "Normally we don't necessarily see that in substance abuse treatment. We know that we're just at the beginning of this being an epidemic.

"It will balloon and we're going to see a lot more people die before people start to really recognize this is a problem."

Compared with other counties in Iowa, Clinton County's opioid treatment admissions rank ninth among 99 counties, with 177 admissions from 2014 to 2017, according to the Iowa Department of Public Health. 

Opioid treatment admissions in Iowa have increased from 608 in 2005 to 2,283 in 2016. 

"There's been examples of people who have quit different substances cold turkey, but opioids aren't really one of those things," Mussmann said. "If you have a pretty significant opioid addiction, you won't be able to say today I stopped using and I'm not going to use anymore. It won't happen."

The inability to complete treatment is something Debbie has seen with her daughter. Debbie doesn't have faith in some of the treatment facilities, since she alleges the patients smuggle drugs into the facilities. 

For those patients in treatment, according to the National Institute on Drug Abuse, 40 to 60 percent will relapse. Even more sobering, Centers for Disease Control Acting Director Anne Schuchat on Tuesday said the U.S. is seeing the highest drug overdose death rate ever recorded in the country. According to data from the Iowa Department of Public Health, Clinton County registered six opioid-related deaths in 2015, and five or less in 2016. 

Diaz believes stricter punishments would deter users.

"Judges in Clinton are no good," Diaz said. "All they do is slap them on their hand and off they go. You have to get strict with these people."

That doesn't always work, Mussmann said. When a task force was created in the mid-2000s to deal with the methamphetamine issues in Clinton County, the thought process was to hand out 10-year sentences to those guilty of using the drug. 

Ten years later, and local treatment specialists, jail deputies and police officers are still citing methamphetamine as a much bigger issue than opioids in Clinton. 

"We saw people who were methamphetamine cooks or people using meth go away for 10 years," Mussmann said. "Fast-forward from that and now they're coming out, and they still have an addiction. They still want that drug and so we're starting to see that come back now."

That doesn't necessarily mean prescription opioid and heroin users will avoid jail entirely. The Clinton Police Department targets known drug houses. If there is an overdose called in to the 911 dispatch service, Raaymakers said, officers will collect any evidence of the overdose and will likely destroy paraphernalia.

Raaymakers estimates that 10 to 15 known drug houses saw people move out of town since the targeted enforcement began. If the police are aware of a drug house, they will sit out front and talk to everybody that comes and goes.  

"We want to make it clear that if you're not a productive member of the community, we don't went them in the community," Raaymakers said.

Raaymakers stressed, though, that officers aren't going into every situation with the mindset of arresting everyone.  

"We're not wanting to throw everybody in jail," Raaymakers said. "It's a medical problem. We may collect paraphernalia and destroy it. But we don't throw everybody in jail. We want people to call when there's been an overdose."

Those who do set up quarters in jail will soon have more options available for treatment. Clinton County voters in May 2016 approved the construction of a $22 million jail and law center, which is under construction. Included in the construction are more options for those who need access to better treatment options, Clinton County Jail Administrator Paul Hammond said. 

Currently, those who are high on a drug are placed in a holding cell with everybody else, Hammond said, because of the lack of availability of other holding cells.

"We don't have the extra room to put somebody high on opioids in a separate cell," Hammond said. "We'll have additional holding cells with the new facility. The current facility has just four holding cells and they're pretty much full on a daily basis."

The new law center will feature classrooms, where groups can come in and provide treatment options. The Area Substance Abuse Council cannot use the current site for assessments because of confidentiality concerns. Mussmann said the group sat down with planners for the new law center, and told them how the new law center can meet the organization's criteria.

"They've included us in every step of the way, that's been really beneficial," Mussmann said. "We're really excited about the opportunities the new jail will offer for services."

To Mussmann, that's the beauty of Clinton. Agencies, from across all disciplines, work together to ensure treatment and prevention are addressed, while also keeping the community safe. 

"There's a unique relationship, especially in Clinton," Mussmann said. "We're able to work more closely as a community."

Scott Levine can be reached at or on Twitter @ScottLevineCH