Minnesota Hospital Association

Policy & Advocacy

Opioids

In Minnesota and across the nation, the opioid epidemic affects more families and communities every year than homicides and car crashes. According to the Minnesota Department of Health (MDH), 572 Minnesotans died in 2015 as a result of drug overdoses, with 216 deaths related to prescription opioid medications and 114 related to heroin.   

MHA members are implementing new prescriber protocols in their Emergency Departments, for inpatient hospital patients and in primary care clinics. In addition, MHA members are working to track reductions in opioid prescriptions; review patients on long-term opioids and to develop alternative programs for pain management; use medication assisted therapy as a treatment; and to integrate the prescription monitoring program information into their electronic health record.   

MHA has received a grant from the Minnesota Department of Human Services to develop a roadmap to better identify, screen and treat Neonatal Abstinence Syndrome (NAS). NAS is drug withdrawal that occurs in newborns who were exposed to opioids prior to birth. The roadmap will allow MHA to work with experts to develop tools for better identification, screening and treatment of NAS, supporting mothers and babies. 

Following are several examples of what Minnesota’s hospitals and health systems are doing. Member spotlights include CHI St. Gabriel's Health, Little Falls; Sanford Bemidji Medical Center; Lakeview Hospital, Stillwater; and Winona Health. 

Member spotlights

CHI St. Gabriel's Health, Little Falls

To respond to the opioid crisis, CHI St. Gabriel’s Health brought together law enforcement, medical professionals, public health advocates and other community leaders to create the Morrison County Drug Task Force. Led by two physicians in their clinic, CHI St. Gabriel’s created a Controlled Substance Care Team to monitor patients on chronic pain medications and decide when narcotics are appropriate or when they are being misused, abused or diverted. If the team determines a patient may be misusing medication, they treat his or her substance use disorder. In the first eight months of their program, pain dropped from being the number one reason patients entered the emergency room to not even being in the top 20. In the program’s first year, one of the community’s four pharmacies reported a 23 percent decrease in controlled substance prescriptions. St. Gabriel’s has helped 324 patients taper off controlled substances completely. In a year, that translates to more than 370,000 fewer controlled substance doses entering the community. Learn more by viewing this video.

Sanford Bemidji Medical Center

Convinced they could help moms break cycles of addiction and build strong, healthy families, Sanford Bemidji Medical Center, Red Lake Nation and Beltrami County came together to create the First Steps to Healthy Babies program in 2014, funded by a grant from PrimeWest Health. The hospital screens all women for opioid use during prenatal care. Women who test positive for opioids are invited to participate in the voluntary program. Learn more here

Lakeview Hospital, Stillwater

Lakeview Hospital in Stillwater and the Washington County Sheriff’s Office have worked together to reduce accidental opioid overdoses by expanding the use of naloxone. To make naloxone more widely available in their community, Lakeview emergency medical services (EMS) staff supply naloxone to Washington County licensed deputies and train them on how to administer the medication to patients in the event they are on the scene of an opioid overdose prior to the EMS team arriving. Read more about the community partnership here

Winona Health

Seeing an alarming number of prescription opioids flow into the community, Winona Health took steps to provide stronger monitoring of patients who are prescribed opioids. The hospital ended the practice of allowing over-the-phone opioid refills and requires patients receiving opioid prescriptions to see a doctor face-to-face every three months. In addition, Winona Health opened the Conservative Management Clinic (CMC), a dedicated pain management clinic aimed at helping patients find the safest, most effective treatment options to lessen their pain. Learn more about these efforts here.

Resources

Minnesota hospitals are taking steps to address the opioid crisis in their communities, but this work cannot be done alone. MHA and its members are involved with a number of stakeholder groups and coalitions to help turn the tide:   

Minnesota State Targeted Response to the Opioid Crisis (MN Opioid STR)
This is a collaborative effort between the Minnesota Department of Human Services (DHS) Alcohol and Drug Abuse Division, Health Care Administration and Office of Indian Policy and the Minnesota Department of Health (MDH). MN Opioid STR aims to expedite opioid treatment and recovery resources and supports integration of services at each point in the health care continuum. This collaboration aims to provide immediate response to American Indian, African American, women/pregnant mothers and infants with neonatal abstinence syndrome (NAS).   

DHS Opioid Prescribing Work Group
This advisory body of experts convened to advance the DHS Opioid Prescribing Improvement Program (OPIP). The program’s goal is to address inappropriate prescribing behavior among Minnesota health care providers, develop educational resources and messages for providers to use in communicating with patients about pain and develop quality improvement measures to assess variation and support improvement in clinical practice. The workgroup will recommend statewide protocols for all phases of the opioid prescribing cycle. The workgroup was created in 2015 and will convene through 2017. This advisory body is comprised of consumers, health care and mental health professionals, law enforcement and managed care organizations, including representatives from many MHA member organizations. Recommendations for acute pain prescribing and post-acute pain prescribing and a post-acute pain prescribing and assessment guide have been drafted.   

Minnesota E-health Advisory Committee
This multistakeholder group includes MHA, MDH and its Office of Health Information Technology. This group is responsible for drafting recommendations for using e-health to prevent and respond to opioid misuse and overdose. These recommendations cover the areas of: 

  • Overdose and misuse alerts to providers for improved treatment and outcomes 
  • Telehealth for access to tapering off of opioids and other treatment options 
  • Clinical decision support for improved provider and patient joint decision-making 
  • Prior authorization to decrease administrative burden 
  • E-health tools, such as patient portals and personal health records, to provide additional patient resources    

The committee will be reviewing and prioritizing the draft recommendations with final recommendations due in December 2017.   

MDH provides opioid overdose information with specific information on naloxone, a drug that can help stop an opioid overdose. Naloxone is commonly known as Narcan. Learn how to obtain and administer naloxone and signs to look for in a person experiencing an overdose.   

Steve’s Law was passed by the Minnesota Legislature in 2014. It allows first responders, police officers and prevention program staffers to carry and administer naloxone. It also provides immunity from civil or criminal charges for people who call 911 to report an overdose, even if they may be users themselves.    

The American Hospital Association (AHA) released an opioid toolkit to provide guidance and information to hospitals and health systems on how they can work with patients, clinicians and communities to stem the opioid epidemic. The opioid toolkit reviews the multifaceted role of hospitals and health systems in fighting the epidemic; reiterates the key activities that every hospital should be undertaking; and offers sources of expertise, ideas and resources to assist hospitals in fulfilling their roles. 

The U.S. Drug Enforcement Administration (DEA) Diversion Control Division hosts two annual National Prescription Drug Take-Back Days in the spring and fall. These events provide a safe, convenient and responsible means of disposing prescription drugs.   

The Minnesota Poison Control System at 1-800-222-1222 will provide immediate professional assistance for drug overdose to the public and health care providers. The service is available 24/7.