IN THE KNOW: How to curb the opioid crisis
For too many years, physicians, nurse practitioners, physician assistants and dentists have prescribed opioids to help relieve any and all pain. The plan was to be "pain-free" and this was encouraged by big pharma and an unofficial national policy. Yes, opioids are an effective tool to relieve pain — but opioids can be and are misused. Innocent patients can become quickly dependent or addicted to opioids, and any misuse of opioids can lead to dangerous and potentially deadly overdoses.
The dramatic increase in deaths associated with opioid abuse in recent years is a public health crisis. From 1999 to 2015, the number of deaths from opioid drugs quadrupled in the U.S. to over 30,000 in 2015. Opioids are a significant problem right here Minnesota. In 2016 more Minnesotans died from opioid overdoses (395) than in motor vehicle crashes (388)
The Minnesota Department of Health (MDH) encourages the use of a prevention parable to educate on how we will solve this public health crisis: The story of three sisters who were taking a walk along a river. As they turned a corner, they saw babies in the river. One sister swooped the babies out of the water. The second sister jumped into the river and showed the babies how to swim. The third sister ran upstream to see why the babies were falling into the river.
We need all three sisters to address this crisis. If we only respond to emergencies, we never address the root causes of the problem. If we only address the root causes, we are missing the emergencies. All the sisters must work together, simultaneously.
• The first sister is emergency response (tertiary prevention) — she saves lives.
• The second sister is intervention and treatment (secondary prevention) — she addresses harms that have already happened.
• The third sister is prevention and public health (primary prevention) — she looks at the conditions that create health and wellness.
Horizon Public Health and Alomere Health have teamed up locally to organize against the opioid crisis locally using all three approaches. To further the cause, an Opioid Use and Abuse Reduction Task Force is now meeting regularly with over 40 diverse members attending. The task force includes physicians, nurse practitioners, public health nurses, pharmacists, social workers, educators, law enforcement, mental health professionals and patient representatives. It is an ideal opportunity to share resources and opportunities.
With community teamwork, we will eventually reverse this public health crisis. Here are some points of education to help every individual in our community become a part of our team:
• Opioids are for temporary relief of severe episodic pain or at the end of life for comfort (hospice). They should not be used chronically.
• If you have an acute injury or medical procedure you should receive a short-term prescription of opioids for pain relief (3-7 days depending on procedure) from your healthcare provider.
• Work together to create a plan on how to manage your pain.
• Talk about ways to help manage your pain that don't involve prescription opioids.
• Talk about any and all concerns and side effects.
3. Store prescription opioids in a secure place and out of reach of others (this may include visitors, children, friends and family).
4. Help prevent misuse and abuse: Never sell or share prescription opioids. Never use another person's prescription opioids.
5. Safely dispose of unused prescription opioids. Use the DisposeRx powder that you may have received from your pharmacist and throw into garbage or take opioids to the disposal bins at the Douglas County Sheriff's Office or Alexandria Police Department.
6. If you are requiring chronic, daily opioids or believe you may be struggling with addiction, tell your health care provider and ask for guidance.
Thanks for your efforts to curb the opioid crisis. Strive to be well.
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Dr. Deb Dittberner is the chief medical officer for Alomere Health (Douglas County Hospital). In the Know is a rotating column written by community leaders from the Douglas County area.