March 26, 2019
Minnesota looking to expand on successful local strategy for fighting opioid crisis
Opioids remain a major public health challenge in Minnesota and nationwide, but Little Falls and several Greater Minnesota communities are showing that real progress is possible.
The Minnesota Department of Health (MDH) Opioid Prevention Pilot Project involves eight communities across the state. Based on six months of data, these communities are expected to cut patient pill use by nearly 765,000 pills per year. In addition, 147 patients are receiving care for opioid use disorder, and Greater Minnesota now has 21 new providers of medication-assisted treatment, which uses medicines that help prevent withdrawal symptoms.
The pioneer of the approach and leader of the initiative is CHI St. Gabriel’s Family Medical Center in Little Falls. The clinic estimates it has reduced patient pill use by 724,000 pills per year, tapered about 670 patients off of controlled substance prescriptions, and currently provides about 90 patients medication-assisted treatment.
“The impact our legislative pilot program has had on these eight communities is substantial,” said Dr. Kurt DeVine, CHI St. Gabriel’s. “Prescription opioids dispensed have markedly decreased. This will impact and lessen the number of patients exposed to opioids and hopefully reduce the chronic dependence and subsequent opioid use disorder. Additionally, these communities have significantly increased access to medication-assisted treatment.”
Gov. Tim Walz’s proposed budget includes funds to offer grants to up to 20 additional communities. The proposal also includes support for fatality review teams in local communities, culturally competent services incorporating traditional American Indian healing, resources to connect patients to treatment through increased screening, access to life-saving naloxone, expanded treatment access for those in correctional facilities, and funding for medication-assisted treatment.
“The early success and proven track record of these pilot projects is encouraging,” said Minnesota Health Commissioner Jan Malcolm. “By scaling up the effort, we hope to bring the positive impact to many more communities across the state.”
The pilot projects focus on reducing the numbers of prescribed opioids in their communities by working locally to help patients rebuild lives and overcome opioid use disorder.
One life changed is that of Monica Rudolph, one of the first patients in the Little Falls program. “This program helped rebuild my life by allowing me to live normally while taking Suboxone [a drug that blocks the effects of opioids],” she said. “This unique team of providers contributed greatly to my success, and I am so pleased that now I have joined them in their effort to help other Minnesotans.”
Each community-led project includes controlled substance care teams that can consist of pharmacists, physicians, social workers, nurse care coordinators, mental health professionals and others. The teams implement evidence-based strategies developed by CHI St. Gabriel’s over the past three years to reduce inappropriate use of opioids through care coordination, addressing unmet social service needs, prescriber education and assistance, proper opioid disposal, and engaging partners outside the health care system.
“The collaboration of these pilot sites with their communities has helped facilitate a comprehensive network of stigma-free patient care,” Dr. Heather Bell of CHI St. Gabriel’s said. “Combining this legislative pilot program with our weekly Project ECHO telehealth program would enable us to affect dozens more communities if funding is available.”
Project ECHO (Extension for Community Healthcare Outcomes) offers providers training on best practices in addressing opioid use disorder in the family practice setting. The CHI St. Gabriel’s Health ECHO telehealth program is one of three such programs funded by an opioid crisis grant from the Minnesota Department of Human Services.
In 2017, Minnesota has had more people die from drug overdoses than from car crashes. According to MDH’s data, in 2017, Minnesota recorded 422 opioid-involved deaths and 733 drug-overdose deaths. The opioid death rate in Minnesota has increased dramatically, seven times, since 2000 from 1.1 deaths per 100,000 residents to 7.8 deaths per 100,000 residents in 2017. Minnesota had 358 traffic fatalities in 2017, according to the Minnesota Department of Public Safety.
The Minnesota Legislature approved about $1 million in funding to establish the eight pilot projects in 2017. The initiative was modeled on the successful program initiated by CHI St. Gabriel’s Health that grappled with opioid abuse and addiction problem in Little Falls and the surrounding rural towns of Morrison County. The pilot projects included the following providers:
- Alexandria Clinic, A Service of Douglas County Hospital
- Carris Health Redwood Falls Clinic
- Chippewa County Montevideo Hospital
- Fairview Mesaba Clinics – Hibbing
- FirstLight Health System - Mora
- Lake Region Healthcare- Fergus Falls
- Mille Lacs Band of Ojibwe
- Riverwood Healthcare Center - Aitkin/McGregor