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Community Response to Heroin and Opiate Usage in Northern Rice County Minnesota Rural Health Conference June 28th and 29th 2010 Presented By Kathleen Meier Andrew Yurek Northfield Hospital and Clinics 37 licensed bed hospital 40 bed Long Term Care Center 4 FamilyHealth Medical Clinics 1 Women’s Health Center 2 Center for Sport Medicine and Rehabilitation 1 Orthopedic Fracture Clinic 1 Ophthalmology Clinic Ambulance Service Overview Background Historical Information Grant Application Goals Outcomes Background From 2006 - 2008 there were 7 deaths attributed to opiate overdose in Rice County Twice the rate of Hennepin County Law enforcement estimate of 250 young adults are abusing heroin and other opiates 6.1% of persons seeking treatment in Rice County claim heroin as their drug of choice compared to 3.5 statewide Historical Information Rice County Chemical Health Coalition Provider Team Healthy Community Initiative Mayor’s Task Force on Drug and Alcohol Local law enforcement drug task force Historical Information Survey of High School Students 27% of students report that it is easy to obtain prescription medications not prescribed to them 5% of student report they have taken medications prescribed to another Issues No local provider trained for the treatment of opioid/opiate addiction Persons seeking treatment must travel to the Twin Cities (46 miles). In a community of individuals with reduced income this is difficult Poor community understanding of opiate addiction No safe disposal options for prescription medications MN Rural Hospital Flex Grant Application February 2009 we became aware of the grant Gained Administrative approval to further collaborate with those Rice County planners Meetings scheduled and the grant application completed and submitted MN Rural Hospital Flex Grant Application Received the 2009 Rural Flex Grant Increase meeting frequency with those already responding Use our electronic medical record to obtain monthly data on persons seeking medical care while receiving treatment for opiate/opioid treatment with buprenorphine MN Rural Hospital Flex Grant Application Use of the electronic patient care report generated from EMS to track narcan administration Duplication of the Isanti County medication collection by law enforcement Goals Hospital provided MD expert in opioid treatment in its Out Patient Clinic (not grant related) Community Education Medical Community Education on treatment of Opiate/Opioid addiction with Buprenorphine Provide a means of safe disposal for prescription medications as most heroin addiction begins with miss use of prescription medication Goals Promote regionalization of medical treatment to allow for persons seeking/receiving care to obtain it locally Policy development for medical staff that treat pain in persons during the recovery process Train EMS personnel on the treatment of pain of those persons in opioid agonist treatment Goals Public Access Television educational segment on heroin/opiate use in the community Conversations with pharmacists in Rice County addressing medication misuse issues Finally to make our response available for duplication in other areas being impacted by heroin and opiate abuse Outcome Trainings offered to the community (number = attendees) High School and middle School Staff 230+ High and middle School Students1000+ Community Forums 550+ Quote from a forum speaker Outcomes Physician training offered at two locations in Rice County Northfield medical community including Northfield Hospital, District One Hospital, Allina Clinics of Northfield, Faribault,and Farmington, Cannon Valley Clinic, and the FamilyHealth Medical Clinics of Lonsdale, Lakeville, Farmington, and Northfield. District One Hospital Outcome Trainings offered to Northfield Hospital staff Pain management protocols developed and implemented Electronic and instructor present trainings on Chronic and Acute pain treatment for Ambulance Emergency Department Surgery Medical/Surgical Clinic Outcome Address Prescription Drug Diversion from home medicine cabinets Coordination of multiple groups around the collection of medications from the community Financed the construction and installation of 2 medication receiving boxes one for Northfield Police and one for Faribault Police stations Had an article of this effort published in the MHD Rural Health Spring 2010 Quarterly http://www.health.state.mn.us/divs/orhpc/pubs/quarterly/2010/spring.html Outcomes Meetings were conducted with pharmacists in Rice County Information provided on the grant work Pharmacists provided input regarding suggestions related to medication misuse Opiate Agonist Treatment Available at Northfield Hospital as an outpatient clinic utilizing an addiction specialist from Hennepin Faculty Associates (not part of our grant) Outcome Local television production Take It to the Box Community education campaign Project initiation Sept 17th 2009 300 pounds of medication in the first month The oldest from 1957 1850 pounds collected to date Use of the grant to pay for a contracted company to sort and haul the collected medication for appropriate disposal Over 70 pounds of controlled substances Take It To The Box program presentation to other counties and municipalities Municipalities Invited to an informational meeting Join us for a Medication Disposal Information Meeting Disposal of unneeded medication is a growing community concern affecting health, law enforcement, drug abuse prevention, and environmental safety. Rice County’s Take It To The Box medication disposal program was successfully launched last fall and has received a tremendous, positive response from our community. We invite you, and others who are interested, to an information exchange meeting to share what we, and others, have learned in a step-by-step, who/what/where/why type of a format. Medication Disposal Information Meeting • Open exchange of experience, information, and questions • Copies of articles, communication plans, costs/funding, resources, data, process steps, and more. • Optional tour of drop-off site to see drop box, storage containers, and medication storage and processing area. When: Wednesday, April 21, 2010 Safe Use • Safe Storage • Safe Disposal Take It To THE BOX Rx Rice County MEDICATION Safety Program www.ricecountychc.com • 507-664-3524 • 507-210-5151 (30 + municipality/county representatives attended) Going Forward Flex Grant Final Report to MDH Present at the MN Rural Health Conference in June http://www.health.state.mn.us/divs/orhpc/conf/2010/presentations.html Continue to monitor numbers of patients entering our care using the EMR Expand Opioid Agonist Therapy through Outpatient Clinic Continue collaboration Take It To The Box