PITTSBURG — While drug overdose deaths appear to be declining nationwide for the first time in decades, they are continuing to rise in Kansas and Missouri, according to recent media reports.

Drug-related deaths dropped by about 5 percent across the US in 2018, but in Kansas they appear to have continued to increase at nearly that same rate, according to the Kansas City Star. In Missouri, the problem is even worse, with overdose deaths increasing at the second highest rate in the country.

County and local level statistics are less consistently tracked, but some available numbers seem to indicate the problem is particularly serious in Southeast Kansas. From 2009 to 2013, when adjusted for population, the region had the highest rate of acute drug poisoning deaths in the state, according to the Kansas Department of Health and Environment (KDHE). Comparing the periods between 2005 and 2009 and between 2012 and 2016, overdose deaths in Crawford County appear to have increased significantly.

Other indicators appear less dire. From 2005 to 2014, drug-related poisoning hospital discharges decreased in Crawford County and most surrounding counties, though they increased in Cherokee County, according to KDHE. And while drug overdose deaths increased from 2016 to 2017 in Kansas, the total number adjusted for population was significantly lower than the US average. A 2017 report by the Southeast Kansas Health Committee notes, however, that there were more than 200 drug arrests in Crawford County in 2015, or more than half the total for the entire 6-county region.

To help combat the apparent drug problems in the area, the Crawford County Health Department is working on plans for a new Addiction Treatment Center. On Tuesday, Health Department Executive Administrator Rick Pfeiffer and Dwight Brennfoerder, the architect for the new facility, along with several other interested stakeholders, attended the Crawford County Commission to discuss the project.

The Crawford County Health Department currently has an Addiction Treatment Center (ATC) in Girard, but there are a variety of problems with the facility, including its capacity, which is 24 beds. Pfeiffer and Brennfoerder presented plans Tuesday for a new center in Pittsburg near the County Health Department’s office and the Community Health Center of Southeast Kansas (CHC/SEK). One version of the plan would offer 52 beds, while a less ambitious version would have 28 beds — still a slight improvement over the current ATC.

The proposed facility would also include a kitchen and dining area, areas for visitors to meet with ATC clients and for staff conferences, and an activity room that could double as a storm shelter. There would also be secure outdoor area with a patio and gazebo, and a fenced yard where clients could have the opportunity to visit with support animals such as dogs.

Brennfoerder estimated the cost for the smaller capacity version of the ATC at $2.1 to 2.5 million, while the larger facility, complete with the storm shelter, could cost closer to $3 million, although he noted that all of these figures are very rough estimates. “Really without bids we don’t know for sure,” Brennfoerder said.

Pfeiffer noted that the current ATC serves a wide range of clients.

“We take people from all over the state, but it’s primarily Southeast Kansas,” he said, adding that many are from Pittsburg.

“I think that this whole process and project is a very deep and long-term responsibility,” Pfeiffer said. “I think that you and your process here not only are making history but you’re looking at a 50 to 100 year issue of community health and community well-being,” referring to the county’s decision-making process regarding the ATC. County Clerk Don Pyle pointed out that the county also has addiction treatment responsibilities that are required by law.

Pfeiffer noted, however, that there is a “spiritual component of recovery from addiction” that he said is a very important part of treating drug abuse problems.

The Addiction Treatment Center will be able to work with 12-step groups such as Alcoholics Anonymous, Narcotics Anonymous, or local church groups — while not violating the separation of church and state — by partnering with FACT, Inc., Pfeiffer said. FACT, Inc. is a nonprofit that “exists to provide philanthropic support for mental health and substance use disorder treatment programs to the citizens of Crawford County, Kansas.” according to the Crawford County Mental Health Center website.

Commissioner Jeremy Johnson also asked Pfeiffer about possible collaboration with CHC/SEK.

Pfeiffer said CHC/SEK offers some kinds of outpatient treatments not available through the County Health Department, and that ATC patients might be able to walk between the two facilities to be treated at CHC/SEK while still staying at the ATC at some point during their recovery.

Several of those attending Tuesday’s work session with the county commission pointed out, however, that while the ATC may offer some opportunities to leave its premises for some clients who are doing well in their recovery process, it will also be a secure facility.

“These are not criminals, these are not dangerous people, these are sick people — but their behavior might be a problem,” Pfeiffer said.

Tom Ragonese, a consultant with FACT Inc., pointed out some problems with the current ATC in Girard, saying that “when it was built was a very nice facility” but he didn’t feel “that it was designed for the type of clientele that’s out there.”

Instead it was designed like “more of a business building or a hotel rather than a prison, and a lot of the people that are out there are people that don’t want to be there, and the current facility there’s always maintenance because there’s always somebody out there trying to tear stuff up,” Ragonese said. “So this one, we’ve looked into it and we’ve kind of designed it with maintenance in mind, putting the proper type of stuff in there that’s not easily tore up.”

Brennfoerder noted that “the bathrooms will be prison-quality, stainless steel, things that can’t be destroyed.”

The plan for the new ATC includes a secure admission area. It also features a central control area offering staff direct visual access to all of the building’s major hallways, including those adjacent to the clients’ bedroom areas. Though no one at the county work session referenced it, the idea is similar to the “panopticon” prison design first envisioned by the English philosopher Jeremy Bentham in the 18th century. Brennfoerder noted that giving ATC staff direct visual access to virtually the whole facility from a central location eliminates the need for an elaborate surveillance camera system that ATC staff would have to monitor using a roomful of TV screens.

“Yes, people are there because they don’t want to be,” Pfeiffer said, adding that the ATC staff try to work with clients to get them to accept the center’s rules within about two weeks of their arrival. “They’ll definitely be going someplace else if they don’t follow the rules,” he said.

Commissioner Tom Moody asked Pfeiffer what the next step in the process of planning the new ATC would be.

“I think (to) authorize the architects to do the final drawings, start to cautiously stick our toe in the water in regard to how we think we’re actually going to bid the construction, and then bid it,” Pfeiffer said.

Moody said Pfeiffer and Brennfoerder should move forward with work on the architectural drawings and then set up another meeting with the commission, and then the county could move forward with the bidding process for construction of the ATC.

Pfeiffer thanked the commissioners and Moody said he appreciated Pfeiffer, Brennfoerder and others for meeting with the commission.