One way to tackle the epidemic of opiate addiction that has swept America is to change doctor’s prescribing habits.
That tactic has worked well for doctors at CHI St. Gabriel’s Hospital in Little Falls, Minn., a town of about 9,000 residents, 100 miles north of the Twin Cities.
CHI St. Gabriel’s has partnered with law enforcement, public health advocates, a local pharmacy, and other community leaders to successfully reduce the flow of opioids into Morrison County. It is one of the first programs of its kind in the U.S.
Through heightened efforts to identify and treat addicted patients, and prescribe fewer opiate painkillers, the hospital has helped 324 patients taper off controlled substances completely. The number of controlled substance doses has been reduced by more than 370,000 since the program began, officials say.
On September 27, representatives from the hospital shared their story with U.S. Senate and House members at a bipartisan briefing in Washington, organized by members of the Senate Health Committee, including Minnesota Sen. Al Franken.
Doctors at St. Gabriel’s started their effort in 2014, after becoming aware of a rising number of opioid prescriptions, medication-related emergency room visits, and drug-related arrests.
“At the time, we had no idea how bad the heroin problem was in our town,” Dr. Kurt DeVine of St. Gabriel’s family practice clinic told the Minneapolis Star Tribune.
When the hospital launched the effort, pain medication management was the number one reason for ER visits. Now it is not among the top 20.
According to state officials, the number of opioid prescriptions in Minnesota declined from 2015 to 2016, but opioid-related deaths increased from 583 to 637, according to the Minnesota Department of Health.
When physicians reduce the number of opioid painkillers they prescribe, patients are less likely to take them long enough to develop addictions, DeVine says. Once people become addicted to opioid pain medications, they are forced to either obtain the pills illegally, or switch to using heroin.
When they looked more closely at prescription records, the doctors also discovered that addicts from other parts of the state were coming to St. Gabriel’s clinic and ER to obtain opioids. Addicts often share information about which clinics are most likely to prescribe them opiates, DeVine notes. “We had people driving from the Iron Range and all the way from south of the Twin Cities.”
Under St. Gabriel’s program, patients must sign contracts in order to to receive opioids from the clinic, that allows doctors to order drug tests and use electronic medical records to monitor patients’ prescription histories. Local law enforcement also notifies the doctors if opioids they prescribe are found in the possession of someone other than their patients.
Patients abusing or selling opioids aren’t punished, Dr. Heather Bell, a St. Gabriel’s family physician, told the Star Tribune. Instead, they can receive Suboxone and get help from to a support team that includes a nurse and mental health specialist.
“We don’t just ‘fire’ them from our clinic,” Bell said. “They … meet with our social worker, and if they are selling their meds to supplement their income, for instance, we try to hook them up with avenues that are a bit more positive to make money.”
Another part of the effort involves the Morrison County Sheriff’s Office in Little Falls. A pilot program started in early September provides Suboxone to jail inmates who are trying to kick opiates.
The hospital received a state grant to help finance the program. That grant has expired and St. Gabriel’s is seeking another source of funding help.