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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