Addiction is not unique to North Dakota, it’s an issue that spans the country. But, treatment is scarce in rural communities, which make up much of our state.

KX News visited a rural health care center that is one of a kind, in its efforts in responding to the vast need for addiction treatment.

Coal Country Community Health Center Medical Director Aaron Garman says, “Substance use is pervasive in family physicians’ practices. We see this everyday, and so in order to try and fill that gap, that it was important to try and offer those services here in our hometown.”

Rural parts of North Dakota have been hit hard by the opioid epidemic. Beulah’s Coal Country Community Health Center made addiction services a part of their medical care in 2009, and these services are unique to rural areas.

Licensed Addiction Counselor Melissa Herman adds, “The closest substance use services that we had prior to this is in Bismarck or Minot, or Dickinson.”

The Center offers rural North Dakota’s first drug and addiction counseling as well as medication-assisted-treatment. 

Herman explains, “It’s not something that you have to be embarrassed about, it’s a disease. And fight the stigma that these people feel like they have to do this by themselves.”

Dr. Garman is certified to administer Suboxone.

Dr. Garman explains, “Minimizing your withdrawal so that people can regain a functional life without having the devastating effects of withdrawal.”

Dr. Garman says the drug is made of two major ingredients.

One fills the cravings for opioids without the euphoric high that comes from opioids. The other blocks the effects of opioids, which protects against the misuse of suboxone. 

Dr. Garman shares, “A perfect story I can tell you about a young gentleman I was taking care of with opioid addiction: I asked him what his life would be like if he wasn’t on Suboxone. And he said, ‘I’m married and I have kids; I would be in an alley shooting up drugs right now and not know my family. But now I go home every night after work, I have an apartment, I have a good family life, I take care of and play with my kids.’ That’s the difference between what our program provides and not being in the program.”

Dr. Garman says methamphetamines and prescribed opioids are the drugs he sees people struggle with the most, in rural North Dakota.


Coal Country Community Health has also been working alongside schools in Beulah to prevent substance use and addiction before it develops.

The counselor at the high school says they started a conversation with the healthcare center a couple of years ago.

They began a partnership to create a behavioral health program to help students facing financial barriers. 

The high school is now equipped with a visiting psychologist, clinical counselor, and a full-time social worker.

Beulah High School Counselor Colleen Kalvoda explains, “The more we get into the classroom, the more conversations that we’re having with students in increasing their awareness about their own emotional and behavioral health wellness: ‘Where am I at on that continuum? Am I healthy? And if I’m not, where can I go for some of those supportive resources that we have in our community?'”

Together the new additions make up Beulah High School’s Impact team. They have a screening tool which helps determine which students are in need.