Killer Crisis: ND health professionals take various tactics to address opioid abuse, treatment
Across North Dakota, hospitals and health professionals are doing what they can to help combat the ongoing opioid crisis.
Here is a look at what some public health units and hospitals across the state are working on.
Grand Forks-based Altru Health Systems reported 345 overdoses from January through September 2017. The hospital has various committees working on the topic and several stakeholders — including the University of North Dakota, Grand Forks Public Schools, Grand Forks Police Department and Grand Forks Public Health department — formed a coalition to address it.
Michael Dulitz, the Public Health opiate response project coordinator, said they are working on ways to increase access to naloxone, including making it available at public facilities helping it get in the hands of those who are most at risk for an overdose.
The health unit is also working on providing medication-assisted therapy in the Grand Forks-area. The therapy uses one of three medications, such as methadone, to help curb the cravings an individual may have with an opioid addiction.
Fargo Cass Public Health
The Fargo Cass Public Health department received a state targeted response grant to the opioid crisis earlier this year. As a part of the grant, the department is distributing narcan and giving training on narcan, which includes middle schools and high schools in Cass County, Robyn Litke Sall, the department's substance abuse prevention coordinator said. So far, more than 220 people have received the training.
Additionally the department has used the grant to help 53 individuals pay for an opioid treatment program, including three pregnant women, Sall said.
The number of opioid-related deaths has appeared to trend downward from 2016 (31 overdose deaths) compared to 2017, which has had 12 reported overdose deaths through September, Sall said.
"I think we're definitely doing well on that front," she said.
David Bradley, a pain management doctor for Essentia Health in Fargo, said pain medication prescriptions increased in the late 1990s and early 2000s and continued for many more years.
"Now we've kind of gotten into the dilemma where were providing too much pain medication and we're giving it out too freely to our patients," Bradley said. "We really need to find other ways to battle people that have pain symptoms."
Bradley noted that, for him, one of the most important things to consider is physical therapy, which can help relieve pain for some individuals and can include some pain medication in adjunct. However, he noted that the pain medication is not always narcotics.
"Dietary is something that's not hit on very heavily from a physician's standpoint but can affect a patient's pain symptoms dramatically," he said.
Depending on the person, some foods can influence pain. If the foods are slowly eliminated, it could also help bring pain relief to a patient, Bradley said. Additionally, tobacco use and heavy alcohol use can have an impact on pain and one's perception of pain.
Activities like tai chi, music and art therapy, acupuncture and visiting a pain psychologist can be helpful tools for dealing with pain, Bradley said.
Chris Meeker, vice president of medicine with Sanford Health in Bismarck, said the hospital evaluates all opioid prescriptions through a program called EPIC. The program allows doctors to watch prescribing patterns and make sure that opioids are being prescribed appropriately.
"We often look at the total opioids prescribed, total prescription numbers, some combinations of medicines, essentially we want to make sure that our opioids are being prescribed appropriately and safely," he said.
Opioid usage started going up around the same time the oil boom began, Meeker said, adding there has been an uptick more recently in heroin-related overdoses in the emergency room.
"It's happening because prescription opioids are tougher to come by than they used to be and that's a combination of doctors are prescribing less, there's also less of a pipeline from certain areas in the south," he said. "You're seeing it switch to heroin because it's cheaper and easier to obtain."
Syringe exchange to be available in Mandan
Beginning next year, Custer Health, which encompasses Morton, Grant, Mercer, Oliver and Sioux counties, will be conducting a syringe exchange program. The program will launch at its Mandan location on Jan. 2. The Mandan Good Neighbor Project is the first syringe exchange program in North Dakota.
The Good Neighbor Project is a syringe exchange program that hopes to prevent the spread of Hepatitis C and HIV by providing safe disposal of dirty syringes to prevent needle stick injuries and clean syringes to IV drug users. Injectable naloxone will also be available, along with administration education to prevent overdose death, said Jodie Fetsch, director of nursing.
"People have to bring us dirty syringes before we give them clean syringes," she said.
The state has provided some money for the program, but will not pay for the syringes themselves.
The program will expand to Mercer County next, followed by Grant and Sioux Counties.