Illustration by Nik Garvoille.

This story is part of a series on opioid and methamphetamine addiction in Door County.

This story contains descriptions of a suicidal situation. If you or someone you know is in crisis, call or text 988 for the Suicide and Crisis Lifeline, or contact the Crisis Text Line by texting TALK to 741741. To contact Door County Health and Human Services about mental health or substance abuse services, call 920-746-7155 during business hours.

Jennifer Singer is a recovering heroin addict who lives in Sturgeon Bay. She is six months sober. She has had several relapses since she moved here eight years ago. In October 2021 one of those culminated in Singer being talked off a roof by a hostage negotiator.

“I was homicidal. I was suicidal,” she said. She went to jail after the incident, and when she got out on bond, Singer started recovery for what she thinks is at least the 15th time since she first became addicted to opioids in 2004.

For those who think drug abuse and addiction are not a problem in Door County, Singer wants them to open their eyes. From her perspective, local use and availability of drugs like fentanyl and methamphetamine has gotten drastically worse since she was away for treatment in 2021 and 2022.

Door County deviates from a national timeline of what the Centers for Disease Control and Prevention has deemed an epidemic of opioid and methamphetamine use in other areas of the state and country. However, the county has caught up with national trends, according to local public health officials. 

The CDC identifies three waves of opioid use by tracking fatal overdose statistics from 1999 to 2021. Starting in the late 1990s, it began with prescription opioids, and overdose deaths involving them increased significantly.  2010 ushered in a next wave, with rapid increases in deaths involving heroin, followed in 2013 by a third wave of synthetic opioid overdose fatalities. 

Methamphetamine use, which follows a different timeline, has converged with the opioid epidemic recently, in an evolving drug landscape. In Door County, law enforcement and treatment workers did not see significant opioid and meth use until after 2010; local drugs of abuse had predominantly been alcohol, cocaine and THC.

Not a lot scares Singer when it comes to drugs, but what she is seeing in the local addict community, “terrifies” her, she said, referring to the influx of fentanyl and the rise in polysubstance use, or combining more than one psychoactive substance. Singer runs a recovery fellowship support group and is a board member of The 115 Club, a recovery organization in Sturgeon Bay. (Disclosure: Knock board member Peter Mannoja is The 115 Club’s president.)

Door County differences

According to substance use and treatment data provided by the county Health and Human Services Department, out of 174 clients seeking Alcohol and Other Drug Abuse treatment in 2003, 2.2 percent—or 4 clients—reported opioid use. In 2022 it rose to 12.8 percent: 20 out of 156 clients seeking treatment reported opioid use.

HHS director Joe Krebsbach has been in the addiction field since 1988. Alcohol has always been, and remains, one of the biggest problems in terms of substance abuse for Door County, according to Krebsbach. Inhalants, THC and cocaine were also commonly abused drugs before 2000, he reported. 

Some of his clients were addicted to prescription opioids, heroin, and meth in the early 2000s, he said, but they were typically people from other places who came to Door County, because those drugs were not as readily available here. 

He’s not the only official who has seen the uptick in fentanyl, heroin, and meth. Since being elected in 2016, District Attorney Colleen Nordin has seen drug use change drastically here. Before 2016, cocaine and marijuana comprised many of Door County’s drug arrests, while heroin and meth were happening elsewhere, she reported. 

However, Door County is trending with everywhere else, especially when it comes to fentanyl use, said Nordin. 

Jon Gilson, an investigator with the Door County Sheriff’s Office, also addressed the peninsula’s deviation from the national timeline. Gilson has been in law enforcement for 22 years, 19 of them in Door County as a patrol officer and drug investigator. He testifies in court regularly as an expert witness in drug cases. 

Gilson agreed with Krebsbach and Nordin that in the early 2000s, marijuana and some cocaine were the county’s biggest substance use issues, besides alcohol. Controlled drug buys in 2009 through 2011 were mostly prescription opioids like OxyContin, he reported.  A controlled drug buy is a type of investigation where police use an informant to monitor an illegal drug purchase in order to collect evidence against a suspect. It took until 2016 for the Door County drug task force to actually obtain heroin in a controlled purchase, he added, but the jump was different here.

Gilson said the national media reported a lot of situations where someone became addicted after being over-prescribed opioids by a doctor.

“I can recall one case like that,” Gilson said. “For the most part it was already people who were known to drug investigators that were using other controlled substances and then switched to heroin.”

“It took a long time to move here…the heroin, meth, fentanyl now, I always feel like we are a little bit behind, but we are now there.”

Joe Krebsbach, director, Door County Health and HUman Services

Cheaper than heroin, meth is relatively easy to manufacture. OxyContin, heroin, and fentanyl are opioids. Meth acts differently, as a psychostimulant. Cocaine is also a stimulant, but meth is much stronger, more addictive, and has higher risks of psychosis with use, according to the CDC.

Meth has been widely available in Door County since 2014 or so and is popular here because it is cheap, according to local law enforcement officials and county court services coordinator Kelsey Christensen. Christensen manages clients in the county’s Treatment Court, a diversion program launched in 2020. 

Christensen added that all her opioid-addicted clients are polysubstance users, and meth is often involved. “They use whatever they can get,” she said, which makes treatment more complicated.

As for Door County’s deviation from national trends, that is partly a result of geography, explained Nordin. The peninsula is a dead end for traffickers running drugs north, she said. 

When traveling around the state for HHS between 2008 and 2014, Krebsbach was surprised at the impacts of opioid and meth use in the western and southern counties. Child foster care placements and drug cases were increasing significantly, he said. 

“I don’t know if I can quantify this, but it felt like it was moving from the south and west of the state to our direction. It took a long time to move here…the heroin, meth, fentanyl now, I always feel like we are a little bit behind, but we are now there,” said Krebsbach. “Our foster care and out-of-home placements are going up in recent years. We’re seeing that tied more and more to drug use and dependency.”

According to Gilson, local drug use also depends on factors like what the cost is out of town, what people are willing to pay locally, and the number of people using. 

“It’s supply and demand,” he said.

Jennifer Singer in Sturgeon Bay on Saturday, June 24, 2023. Photo by Heidi Hodges.

Addiction demographics

“People still say to me all the time, you don’t look like a heroin addict,” said Singer, who is 40 years old, white, Jewish, middle class, and raised mainly on the East Coast by parents she describes as well-educated and well-traveled. They were also heroin addicts. 

“Kind of wild” when she was younger, Singer said she started drinking at 12, and experimenting with marijuana, psychedelics, and cocaine throughout her teens and young adulthood. She tried to straighten up when she met her first husband in college, but continued to have a problem with alcohol, she said. 

It was not until she was in her early 20’s that Singer started using prescription opioids and became addicted to them.

A drop in the wave: One woman’s story of addiction and recovery

Jennifer Singer’s experience with addiction over the past two decades reflects what was happening throughout the country, in what the Centers for Disease Control and Prevention calls an opioid epidemic. Read more.

When asked about the role of mental health in her addiction, Singer expressed certainty that the trauma of an erratic childhood with parents who were actively using played a big part in her own substance use. That trauma was further compounded when she lost custody of three of her five children after a law enforcement raid on her home in North Carolina in 2015, she said. 

Singer described her mental state during the relapse that ended on a roof.

“When I went off the rails that time, there was just no coming back,” she said. “It wasn’t even so much about using, it was a suicide mission, but I was too afraid to just end it. … I lost my mind. And at that point, why not use drugs?”

When people experience overwhelming stress or events that override their ability to cope and integrate the experience, it can cause long term psychological consequences.

“The gateway drug is trauma,” said Lisa Barnaby, an addiction and substance abuse therapist working with HHS AODA clients and Treatment Court participants. People become addicted to substances when they gravitate to putting something in their body to avoid pain caused by trauma, she explained. 

Substance use starts as early as six or seven years old in some of her cases. By the time young people from a dysfunctional home come to Barnaby with addiction issues, “it can be very hard to unwind that,” she said. 

In Door County, there is one mental healthcare provider to every 720 people living here, more than double the national gap, according to United Way of Door County.

“Psychopathology always precedes behavior,” said Timmie Sinclair. She is United Way of Door County’s community impact coordinator, and assists in managing programs for health and basic needs, the AOD Coalition, and the food pantry the organization runs. The United Way tracks and reports mental health issues in the county as part of their programming. 

Mental health problems are on the rise, exacerbated by the pandemic and lack of access to behavioral or mental health care. Nationally, the ratio of mental healthcare providers to population is 1:350. Statewide it is 1:440, according to United Way data.

In Door County? There is one mental healthcare provider to every 720 people living here, more than double the national gap, Sinclair reported.

Financial insecurity is a major stressor, and those struggling financially are less likely to have access to mental healthcare. When you are trying to put food on the table, or find a place to live, finding and paying for therapy is not a priority, according to Sinclair.  Insurance often does not cover treatment, or people are uninsured, she said.

According to 2023 Asset Limited Income Constrained Employed data compiled by United Way, 24 percent of Door County qualifies for the distinction. ALICE individuals make just enough money to be above the federal poverty level, but not to make ends meet; the working poor. An additional 9 percent of county households fall below the national poverty line. 

Drug users in Door County are often “bread and butter workers,” said HHS behavioral health manager Donna Altepeter.

“These are people who are in the entertainment industry, bartenders, waitresses, resort workers, housekeepers, people working two or three jobs,” Altepeter said. People with addiction issues are not just a drain on county resources, but they contribute to the community until their addiction gets in the way of functioning, she said. 

Gilson said addiction demographics are hard to pinpoint. Drug cases in his career have run the gamut of financial status and age but have one commonality.

“If you have someone who is addicted to drugs, you have someone with an underlying mental health condition that needs to be addressed,” he said. 

In the last five years, local law enforcement has begun looking at drug cases through a mental health lens and works more closely with mental healthcare providers and diversion programs, according to Gilson.

Unclear data on a growing problem

The demographics of addiction are not the only moving statistical target. The latest preliminary statistics from the CDC show the number of drug overdose deaths involving synthetic opioids and stimulants like meth continued to increase in 2022, with an estimated total of almost 110,000 fatalities nationally.

Addiction and overdose statistics specific to Door County are hard to pinpoint, according to the people who are on the front lines of addiction here. That is partially due to a lack of detox or treatment centers on the peninsula, so treatment data is not captured locally, according to United Way’s Sinclair. 

Gilson explained it is more than just people going elsewhere for treatment; the increased availability of Narcan means many overdoses are treated privately and go unreported. Narcan is the brand name of naloxone, a medication used to reduce or reverse the effects of opioids. Gilson added he thinks there would be a much higher rate of overdose deaths in the current fentanyl landscape, if it weren’t for Narcan. 

“Statewide and nationwide, those numbers, knowing what I know now,” Gilson added, “they’re irrelevant. I know it’s frustrating, but we have no way of knowing for sure.”

Illustration by Nik Garvoille.

Coming out of the woodwork

When asked if drugs like heroin, fentanyl and meth have been introduced to the county by visitors, DA Nordin is clear that they have not.

“We wouldn’t see overdoses in the winter months if that was the case. And we do,” she said. “It is absolutely a local problem our local Door County residents are suffering from. … Are there tourists who bring drugs into our county to use them? Sure. Are tourists responsible for bringing fentanyl to Door County? Absolutely not.”

When asked if the county is equipped for cases like Singer’s, and what is a growing problem here, Nordin said, unequivocally, no.

“We have a great HHS, great service providers, but they are stretched thin. There are no inpatient facilities, and we try to find them elsewhere,” she said, which makes diversion programs harder to administer. 

Door County also does not have adequate sober living and affordable housing options for recovering addicts, according to Nordin.

But Gilson said he is hopeful, when looking at the magnitude of Door County’s opioid and meth problem, especially compared to other communities. 

“We don’t have a huge drug problem in Door County. We really don’t … We don’t have people in the street using,” he said.  He called the county a good community full of good people who are willing to help when others have a problem like addiction.

Door County has an issue that needs to be dealt with, and is leading the rest of the state with diversion programs already in place, according to Gilson.

“A lot of people in the community don’t know we have fentanyl use, and it is a problem,” Gilson said. “It is. But we don’t have the problems a lot of other communities have.”

“It’s really kind of miraculous how many programs we have for such a small place,” he added.

“We honestly can’t keep up. There’s a lot of people who need services. I know we’re only seeing a tip of the iceberg.”

Donna Altepeter, behavioral health manager, Door County Health and Human Services

There is a lack of data, and the perception that opioid and stimulant addiction is not a big issue in Door County is one that may have been maintained for a while, according to HHS’s Altepeter.

“Now it’s just coming out of the woodwork … I understand what kind of utopia Door (County) is. I would understand the resistance there might be to identifying use as a problem for the county, but I don’t think there’s anybody now who would deny that,” she said.

Altepeter described  “a pattern” in Door County, a desire to minimize the difficult issues like opioid and meth use, poverty, and mental health.

Sinclair addressed this attitude as well.

“Door County has the same issues as everyone else, but we just have that extra wholesome, white bread, Mayberry facade that we have to keep up,” she said. 

A desire not to know about or want to address difficult issues is coupled with a treatment and resource community that is spread thin. 

“We honestly can’t keep up. There’s a lot of people who need services. I know we’re only seeing a tip of the iceberg … We get those clients when they get really bad, threats to self and others. There’s a lot that’s hidden,” said Altepeter.

As far as treatment, HHS is the only game in town, according to Altepeter. The county has the funding to provide resources, but its biggest challenge is staffing. Barnaby is the only AODA therapist with HHS, and there are only a handful of others in private practice, she said. 

“I could go into the street and buy heroin right now,” Singer said during an interview in Sturgeon Bay. Meth and fentanyl are also cheap and readily available in Door County, according to Singer, who has regular contact with active and recovering users in her sobriety work. 

“It’s just everywhere,” she added.

Correction: A previous version of this story stated that Jennifer Singer lived in South Carolina before moving to Door County; she in fact lived in North Carolina.