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), opioid-involved deaths continued to increase for Minnesotans in 2017. There were 422 opioid-involved deaths in Minnesota in 20157, a 7% increase from 2016. This included 195 deaths related to prescription opioid medications, 111 related to heroin and 184 from synthetics. While prescription opioid and heroin deaths have decreased from 2016, deaths from synthetics have increased 86% from 2016.

In 2018, 1,946 Minnesotans were treated in emergency rooms for opioid-involved overdoses.

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 develop alternative programs for pain management; use medication assisted therapy as a treatment; and integrate the prescription monitoring program information into their electronic health record.   

A full 100% of MHA members are participating in an MHA road map to identify, screen and treat neonatal abstinence syndrome (NAS). NAS is drug withdrawal that occurs in newborns who were exposed to opioids prior to birth.

In 2018 and 2019, MHA supported state legislation to require opioid manufacturers to provide funding to help reverse some of the harm caused by the abuse of opioids. In 2019, Minnesota was the first in the nation to pass legislation that significantly increases licensing fees on opioid manufacturers, raising approximately $20 million a year. Money will be used to help offset county social service costs associated primarily with out-of-home placements; fund prevention, treatment and recovery services; and improve prescriber education.

Opioid prescribing guidelines

MHA has partnered with the Minnesota Department of Human Services (DHS) to implement new opioid prescribing guidelines. The state's Opioid Prescribing Improvement Program is designed 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 program aims to reduce opioid dependency and substance abuse related to the prescribing of opioid analgesics by health care providers. Program goals include:

• Prevent the progression from opioid use for acute pain to new chronic opioid use.
  
  • Prescribe the lowest effective dose and duration of opioid analgesia when an opioid is indicated for acute pain. Clinicians should reduce variation in opioid prescribing for acute pain.
  • The post-acute pain period is the critical time frame to halt the progression to chronic opioid use. Clinicians should increase assessment of the biopsychosocial factors associated with opioid-related harm and chronic opioid use during the post-acute period.
  • The evidence to support chronic opioid analgesic therapy for chronic pain is insufficient at this time, but the evidence of harm is clear. Providers should avoid initiating chronic opioid therapy and carefully manage any who remain on opioid medication.
• Reduce variation in opioid prescribing behavior.
• Provide prescribers with resources to communicate with their patients about pain and opioid use.

For additional opioid-related quality and patient safety resources, please see the quality and patient safety section of the MHA website.