Non-narcotic Pain Management Mapping and Demonstration Projects
The 2019 Minnesota legislative session included several primary prevention strategies as part of a comprehensive approach to addressing the opioid epidemic in the state. One of these strategies allocated $1.25 million to fund studies evaluating non-narcotic pain management treatment in Minnesota. Of the total, $250,000 is funding one statewide mapping study to better understand where non-narcotic pain management is available and what barriers exist to accessing this type of care. The other $1 million dollars was awarded to five demonstration projects across the state to better understand what non-narcotic pain management and wellness services are being used, for and among whom, and their effectiveness.
The grantees who received funding are:
- HealthPartners Institute
- Hennepin Healthcare
- Innovations for Aging's Juniper Program
- Native American Community Clinic
- Nura Pain Clinic
Statewide mapping study
Hennepin Healthcare was awarded $250,000 to develop the Non-Opioid Pain Alleviation Information Network (NO PAIN). To accomplish this, Hennepin Healthcare will collect data and complete surveys in the regions utilized by the statewide Emergency Communication Network (ECN) to: 1) map the location and availability of both inpatient and outpatient evidence-based non-narcotic pain management services and modalities in Minnesota, 2) develop a NO PAIN-Minnesota services and modalities network website to display the map, and 3) highlight existing facilitators and barriers to non-narcotic pain management care to Minnesotans with chronic pain.
"...Our mapping work will provide an information resource for Minnesotans in pain. Specifically, we will provide statewide mapping of the comprehensive resources for non-narcotic pain management to equally empower patients and providers towards a path of “do no harm” pain alleviation..."
The Non-Narcotic Pain Management (NNPM) Demonstration and Mapping projects were funded through a one-time allocation of funds from the Minnesota State Legislature and managed by the Minnesota Department of Health to develop, pilot, and evaluate programs that could improve patient access to chronic pain management care between June 2020 and June 2022. Positive outcomes experienced among the majority of NNPM patients include a reduction in pain symptoms, an increase in connection to others experiencing pain, and feelings of hope for continued maintenance of pain.
This demonstration project will expand access of a HealthPartners
yoga program for management of chronic pain (offered since 2017) through development, implementation, and evaluation of an online curriculum called "Manage My Pain with Yoga" - a yoga program specifically geared towards people living with chronic pain.
The curriculum weaves mindfulness-based stress reduction into yoga practice and encourages participants to use these skills both on and off their yoga mats to improve their overall quality of life. By learning yoga, relaxation and body awareness, patients will be able to incorporate these techniques into their daily routine to help reduce pain as an alternative to opioid medications leading to reduced health care utilization. Class content includes meditation and mindfulness training, yoga didactics, breathing exercises, and yoga poses appropriately adapted for participants diagnosed with chronic pain.
The program aims to expand the yoga pain program availability to a broader population through the development of an online yoga program, “Manage My Pain with Yoga,” specifically adapted to those living with chronic pain, and make it available to everyone in Minnesota. We aim to create durable online curriculum and place it on the www.myneurosciencecenter.com website.
Phone Number: 651-495-6363
E-mail Address: MyYoga@Healthpartners.com
“Since 2017, the HealthPartners Institute has offered a unique yoga program for people living with chronic pain, taught by an advanced practice nurse certified in pain management, as well as registered yoga instructors. It has bridged the gap between the fitness focused classes commonly offered in the community and those needing more modifications or support with developing a self-paced yoga program that is targeted for their chronic pain. With expansion of our program, we will increase accessibility and reduce barriers while addressing common symptoms related to chronic pain including poor sleep, fatigue and anxiety or depression. This will lead to enhanced self-care and less healthcare utilization in people with chronic pain.”
The Growing Resilience in Chronic Pain Project will demonstrate the efficacy of a cohort-based group medical visit model for non-narcotic pain management. Group Medical Visits (GMVs) involve a group, or cohort, of patients being seen at the same time in a visit. Hennepin Healthcare's model will deliver care onsite at the Interventional Pain Clinic through a series of ten cohorts who will meet together weekly for 8 weeks over a two-year period. Several strategies employed in this project are unique to this effort. Strategies will include: addressing pain during didactic learning through weekly themed topics, active learning in mind-body integration including breathing techniques, mindful meditation, and guided imagery, movement-practice such as yoga and tai-chi, group socialization to grow community (e.g. shared experience in pain management), and a food or snack example each week to illustrate simple, affordable, anti-inflammatory food options. Patients with chronic pain will participate in these cohort sessions and provide valuable feedback on the effectiveness of the intervention. This project is not an add-on to existing services of the Interventional Pain Clinic at Hennepin Healthcare, but rather a pilot program that will be led by a clinician and an RN/wellness health coach who are passionate about integrative pain management strategies.
Phone Number: 612-873-3066
Email Address: NoPainMN@hhrinstitute.org
"Our demonstration project will show that pain management and healing are possible without narcotics...We will use proven strategies – including group visits, active learning in mind-body integration, and community building - to grow resilience and provide non-narcotic pain management to patients."
Innovations for Aging's Juniper Program
Participants in the six-session Living Well with Chronic Pain class will learn non-pharmacological, self-management skills for lessening chronic pain. Topics in the class include dealing with frustration, fatigue and isolation; appropriate exercise for maintaining and improving strength, flexibility and endurance; appropriate use of medications; and communicating effectively with family, friends, and health professionals. Participants benefit from connecting and socializing with others with similar experiences.
Recognizing the correlation between a referral from a trusted healthcare provider and an individual’s success in the class, Juniper will cultivate relationships with chronic pain clinics and other providers. Juniper will also employ a community health worker to build connections and increase accessibility of the classes in targeted communities.
The project plans to engage 442 participants in the Living Well with Chronic Pain class over the next two years. Through this project, Juniper will demonstrate a pathway for integrating healthcare and social service systems while helping more individuals improve their quality of life.
Find more information about this class and all Juniper classes at yourjuniper.org.
Sarah Blonigan, JD, MPH firstname.lastname@example.org
“Juniper’s Living Well with Chronic Pain class provides the support system that people need to move away from dependence on prescription solutions. One of the most valuable outcomes of the class is that participants no longer feel so alone in their pain. By strengthening referral pathways between healthcare providers and individuals experiencing pain, this project will make classes available to those who would most benefit from them to reduce their chronic pain and increase their quality of life.”
-Innovations for Aging's Juniper Program
Native American Community Clinic (NACC)
NACC will develop and evaluate a culturally-centered non-narcotic pain management program to help prevent and treat the opioid epidemic, which has significantly and disparately impacted American Indians in Minnesota over the last several years. NACC is in partnership with the Johns Hopkins Center for American Indian Health-Great Lakes Hub, which will be the evaluators of the project. NACC serves one of the densest urban American Indian communities in the country, and provides culturally-centered and responsive services in a fully-integrated primary care Community Health Center (CHC) setting. Increasing access to traditional and culturally-anchored medicine has always been at the forefront of their mission. JHU will be responsible for collecting data, working closely with the NACC Elders Advisory Council to ensure the process is culturally safe throughout. Resiliency training will be administered to staff and community members, as well as focused training in a variety of alternative pain management methods, including but not limited to, equine therapy, yoga, and somatic healing. The Non-Narcotic Pain Management Grant will help support these training efforts and eventually implement them as programs, which had previously been financially out of reach. Through these development and research efforts, NACC will successfully establish a comprehensive pain management practice, evaluate existing cultural healing programs and other non-narcotic interventions, and increase availability and access to resiliency strategies in alternative non-narcotic pain management.
Dr. Laurelle Myhra LMyhra@nacc-healthcare.org
Dr. Antony Stately email@example.com
“Native American Community Clinic (NACC) is honored to have the support of the State in assisting us to develop and evaluate a culturally-centered non-narcotic pain management program that will serve the urban American Indian community in the Twin Cities. Our community has been among the hardest hit by the opioid epidemic in Minnesota. This project will help us to develop and implement a prevention tool that is grounded in cultural healing and alternative treatment methods, and will promote health and wellbeing in our community. We are deeply grateful for the support!”
-Native American Community Clinic
Nura Pain Clinic
The Nura Chronic Pain Program is a month-long multidisciplinary program for pain patients with the goal of optimizing function and restoring quality of life while minimizing or eliminating the use of opioids. This program provides education, guidance, and counseling to improve physical strength, increase function, and help individuals manage the emotional components of the “chronic pain syndrome”. It includes medication management with the goal of reducing opioids, physical therapy to assist with physical conditioning, and wellness coaching to reduce stress, depression and anxiety, all of which influence chronic pain. The program is four weeks, Monday through Friday, for four hours per day which helps patients activate from an isolated, sedentary existence to a more engaged, active and productive way of living. Nura also offers a long-term follow up After Care program that helps patients living with chronic pain to stay on track and sustain the gains they have made during the initial four weeks.
Diane Budnick, CNP firstname.lastname@example.org
Dr. Peter Schultz email@example.com
“A multidisciplinary approach to the management of chronic pain has been shown to be one of the most effective treatment approaches for pain management. The chronic pain program at Nura Pain Clinics focuses on a patient’s medical, physical therapy, and behavioral health needs to help them make lifestyle changes and better manage their pain."
-Nura Pain Clinics
Contact Dana Farley at firstname.lastname@example.org for further questions about the grant.