‘Uphill in a blizzard’: How one village in Oklahoma is fighting the opioid epidemic

Alicia Wagnon’s job as Lincoln County Clerk remains busy. Along with managing payroll and benefits for county employees, the office in Chandler is responsible for filing records that go back home.

But when Wagnon learned the attorney general accepted the offer for the state’s share of the opioid settlement fundHe thinks it can’t hurt to add a grant applicant to his plate.

“The need is so great in Lincoln County,” she said. “We have to do something.”

Local governments in Oklahoma are taking an active role in funding mental health care and opioid settlement funds, but some are struggling to manage the new responsibilities while existing services are cut.

“It’s difficult in some districts to know what to do with that fund,” Wagnon said. “What do we do with that? Where can we go?”

Oklahoma’s opioid settlement fund designed to prevent overdose deaths and expand access to treatment. Funds are distributed by the board of directors to ensure that the money is spent in evidence-based best practices and in accordance with the provisions of lawsuits that bring money to the country.

Cities and counties, such as Lincoln County, can apply for Oklahoma opioid settlement funding, but many do not have experience providing mental and substance abuse services to their residents.

“If I had to do this alone, it wouldn’t be where it is today,” Wagnon said.

He knows opioids and addiction are hurting his community, but he needs help. Wagnon recruited Judy Smith, who had previously helped the county secure funding for its fairgrounds. Smith spent the better part of a decade as director of equine therapy at Utah State University, and he quickly recognized a gap in care locally.

“We have a need for mental health services in the county,” Smith said. “Our disparity is enormous.”

District officials created a task force

Before applying for a state opioid settlement grant, Wagnon and Smith set up a local task force to identify the county’s most pressing needs. Weekly meetings bring together local law enforcement officials, health care workers, community leaders and care providers.

Smith said it was the first time many of them had been in the same room.

Together, the group identified some of the community’s most pressing needs. The county reports more than 95% of prison incarcerations in 2024 are linked to substance use or mental health. Care tends to be piecemeal, and there are not enough resources to support people struggling with addiction, Smith said. Some behavioral health providers in the area are stretched thin.

“We all have a shortage of employees,” he said. “It’s hard to find professionals to stay and pay enough to stay here.”

Josh Maxey is a peer intern at the nonprofit gateChandler’s primary substance abuse service provider. Before working at Gateway, Maxey used to be a client. He said relapse prevention classes and therapy helped him stay sober after prison, and he wants to be a part of that process for others.

“This is a small town. I know many of these people,” said Maxey.

But like Smith, Maxey said resources for addiction are slim. For example, there are no Narcotics Anonymous meetings in town, and he hopes to start one.

“I just want to see more resources and focus on getting addicts into recovery and breaking the cycle of addiction instead of sending them through a system that isn’t really going to address the root cause,” he said.

Lincoln County officials decided to partner with Gateway for an opioid settlement grant. Gateway has an office in Chandler and agreements with local treatment court so people can complete court-ordered treatment that keeps them out of prison and jail. Smith said having a non-profit on the app makes it powerful.

“Because the last thing we want to do is do something and as soon as the grant is over, it’s all gone,” Smith said. “We will cause more harm than good.”

Budget cuts threaten progress

Smith worked with the county and gateway to build an application to expand services and bring new resources to the community, including a case manager for families involved in court. The Oklahoma Opioid Abatement Board awarded the county a $ 150,000 two year grant.

But last year state sweeping cuts to mental health Providers threatened Lincoln County’s progress.

“Gateway had to close the Chandler office,” Smith said.

The Department of Mental Health and Substance Abuse Services, which funds many local providers through state contracts, put hundreds of programs on the chopping block last year after extreme financial mismanagement in the agency came to light.

Officials said the decision was not taken lightly, and only “non-essential” or “redundant” services were cut. But Smith says it goes deeper than that.

“Because we know that relapse can mean death,” he said.

“Monthly, there are almost 90 active clients that we think all services have to go outside the district, which is in the middle of the recovery stage.”

Many of those people don’t have reliable access to transportation, Smith said. He had a hard time talking about the piece because of how much stress he had to make things happen. He was brought in to strengthen society’s approach to mental health, not keep it afloat.

At Gateway, opioid settlement grants from the state fund medication-assisted treatment for opioid use disorder and case management. Smith leveraged that responsibility to convince the county to pay nearly $41,000 to cover the nonprofit’s operating costs and rent for three months, until the provider could get the funding returned.

“What started as a grant application has become so much more,” Wagnon said.

Without the grant, Gateway would not be able to support its staff in Chandler or pay the building’s rent. Maxey said seeing Smith’s dedication made him want to return to the nonprofit as an employee.

“Seeing how important it is that we have this service, it played a big part in me dedicating my life to this stuff,” he said. “They have helped me on my journey.”

‘It’s hard to walk uphill in a snowstorm’

Other localities are struggling to spend a lot of settlement money. Local officials focused on running roads and balancing budgets are now navigating complex behavioral health systems — often with limited staff.

This month, the attorney general’s office canceled ten grants awarded in 2024 because the grantees still haven’t used the money awarded. Members of the Opioid Abatement Board said they reached out several times to provide technical support, but saw little movement.

“They just get confused. They get someone to do the grant, but no one brings it forward,” said Terry Simonson, who is responsible for outreach and collaborations for the board. “They need someone at home to carry the ball.”

Wagnon said Lincoln County is focused on setting up a sustainable path to continuing care when the attorney general’s cash infusion runs out. They have just been approved for a second round of funding from the council and are looking for a federal grant.

“This is how we got to where we are,” he said. “And just seeing the need and being able to solve it. Now, we certainly don’t want to lose that.”