A Duluth treatment center has quietly expanded its hours while serving hundreds of individuals on opioid withdrawal during its first two years of operation.

The Pathfinder Unit within the Center for Alcohol and Drug Treatment, 1402 E. Superior St., opened with “very limited hours” and a limited nursing staff in November 2017, said Tina Silverness, executive director of CADT. “Everybody had to be referred,” she said. “They couldn’t just walk in.”

Tina Silverness is the CEO at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)
Tina Silverness is the CEO at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)

About a year ago, Pathfinder expanded to a 24/7 operation, she said. Medical staff is always on duty. Although it still has the original six beds — divided into a room of three beds for women and another room of three beds for men — a new option has been added if those beds are full. Eight “flex beds” within the larger detoxification unit can be used when needed for clients waiting for Pathfinder treatment.

No referrals required.

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One of the rooms used in the Pathfinder clinic for opioid withdrawal at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)
One of the rooms used in the Pathfinder clinic for opioid withdrawal at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)

“We have a no-barrier, no-wrong door, rapid immediate access philosophy here,” Silverness said. “Because we know they die if we don’t get them immediate help.”

People are dying. Duluth police reported that 22 people died because of drug overdoses in St. Louis County last year, 15 of them in Duluth. That’s why police are on board with the work of Pathfinder.

“We’re very happy to be partners with them,” said Duluth police Lt. Jeff Kazel, who commands the regional Lake Superior Drug and Violent Crime Task Force.

Duluth police worked with Pathfinder last year to obtain a Department of Justice grant that’s helping to pay for its work, he said.

It’s a service that’s being used. From its opening on a small scale in November 2017 through Dec. 17 of last year, Pathfinder admitted 460 patients, said Jadrianne “Annie” LaTulip, a provider at the treatment center. Because some patients made repeat visits, that represents roughly 390 individual clients, she said.

After clients check in to Pathfinder, they are placed on the medication assisted therapy drug Subutex, Silverness said.

That proves to be a game-changer in a short amount of time, said Tim Innis, CADT’s director of nursing.

Tim Innis is the Director of Nursing at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)
Tim Innis is the Director of Nursing at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)

“They come in and they’re sick and they’re hurting,” he said. “We start them on that and you come back the next day, and it’s such a profound difference. They start making clearheaded decisions and actually look at themselves in a different way.”

Clients can leave whenever they wish, Innis said, but that seldom happens. When they’re discharged, typically within three to seven days, it’s with a treatment plan and a prescription for Suboxone. That’s similar to Subutex but is ordinarily covered by insurance and includes the overdose reversal drug naloxone.

If the individual faithfully takes Suboxone, there’s a strong disincentive to resume previous behaviors, Innis said.

An overdose rescue kit containing three doses of naloxone from the Center for Alcohol & Drug Treatment in Duluth. Clients in the Pathfinder program receive one of these kits.  (Clint Austin / caustin@duluthnews.com)
An overdose rescue kit containing three doses of naloxone from the Center for Alcohol & Drug Treatment in Duluth. Clients in the Pathfinder program receive one of these kits. (Clint Austin / caustin@duluthnews.com)

“If you’re taking Suboxone, and then you try to shoot up with heroin, it’s going to put you into withdrawal right away,” he said. “So it’s another safety net for you.”

Studies say individuals remain on medically assisted therapies for two years, on average, Silverness said. “Some need it for the rest of their lives. That’s OK, too. At least they’re not dying and their level of functioning has improved.”

Those treated at Pathfinder also leave with a naloxone kit that someone can use for them or they can use on someone else in the event of an overdose. As the News Tribune reported previously, CADT has a more ready supply of the kits this year through the Steve Rummler Hope Network.

“Before, there was a limited number of them,” Innis said. “We’d get kits, but we’d only get so many at a time. And then it’s, of course, who’s the neediest at this point?”

Roughly three out of four clients are from St. Louis County, but people come to Pathfinder from throughout the state, Innis said. Currently, Pathfinder is one of only three licensed withdrawal management facilities in Minnesota.

The people who work there do so with the conviction that they are saving lives. They know that, nursing supervisor Shawna Rae Fisk said, because clients return to tell them so.

Shawna Fisk is a nursing supervisor at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)
Shawna Fisk is a nursing supervisor at the Center for Alcohol & Drug Treatment in Duluth. (Clint Austin / caustin@duluthnews.com)

“Those are my best moments,” Fisk said. “I love those. I always cry.”

But Pathfinder is doing more than just saving lives, she said. It’s giving lives back.

“You see people at their absolute worst,” Fisk said. “You just see their heartbreak. And then they come back in a month or after they’ve had long-term treatment or in a year. (They say) ‘Hey, I’m doing good. I’ve got my kids back. I’ve got my first apartment.’ We’ve seen all those successes. That is what really keeps me motivated.”

It starts, Innis said, with Pathfinder treating people, not nameless “cases.”

“It’s such a simple concept to treat somebody like a human being and … help them get through some rough times,” he said. “You’re saving lives. You really, really know where you’re saving lives.”

To get help

  • Call the help line at the Center for Alcohol and Drug Treatment, 218-723-8444
  • Call the Duluth Police Department opioid hotline, 218-730-4009