Editorial: Minnesota is taking opioid abuse seriously

Published 9:14 pm Thursday, December 28, 2017

glimmer of good news for Minnesota when it comes to opioid abuse turns out to be a grim testament to the toll taken by these powerful, addicting painkillers on the nation as a whole.

According to the latest national data, the North Star state rates fifth when it comes to an important metric on judicious use of these drugs — the number of prescriptions filled per 100 people per year. Only California; Washington, D.C.; Hawaii, and New York have a lower rate than Minnesota’s — 46.9.

And yet, at least one Minnesotan dies each day from opioid overdoses — a total of 376 people in 2016. If this is what fifth-best looks like, imagine the grief in other states where prescriptions flow more readily and the price in human life is even steeper. Nationally, more than 15,000 people die each year from opioid abuse.

A state that’s home to world-class medical providers has an obligation to jump into the trenches to combat this public health crisis. Minnesota, to its credit, recently took a leadership step with the draft release of new prescription guidelines for medical providers across the state.

States even harder hit by opioid deaths, which include a cluster of Appalachian and southern states, ought to give close scrutiny to this thoughtful new framework intended to educate medical providers about the drugs and reduce patients’ risks. It’s time to go from lamenting the problem to actually doing something about it.

The Minnesota plan, which strikes a reasonable balance between restraint and concern for pain treatment, is the result of two years of research by a state work group whose members included top medical experts and two legislators who lost children to drug overdoses. This group’s work stands in welcome contrast to the frustrating absence of leadership by the Trump administration, which has lacked follow-through after making big announcements about opioid dangers.

It’s commendable that the Minnesota work group took a deep dive into the data to understand opioid use in Minnesota and draw conclusions about how best to reduce the drugs’ risk. The analysis found that too many patients who began using the drugs over the short-term went on to become chronic users. Of those who received a 45-day supply, 80 percent went on to get a 90-day refill. Of those who received a 90-day refill, 65 percent continued opioid use at the three-year mark.

To stem this, the recommendations take a relatively novel focus — urging providers to do more to halt this transition from short-term to chronic use. Education is one of the strategies the report calls for to accomplish this, with recommendations crisply outlining time frames for usage after patient injuries.

But the report also calls for delivering confidential reports to medical providers on how their opioid prescribing practices compare to their peers, with further follow-up from state officials if prescribing practices do not change or have a reasonable explanation. Eventually, those who persist in prescribing outside the guidelines could be excluded from state medical assistance programs. That hopefully won’t be necessary, but it does give the recommendations some welcome teeth when opioid prescribing practices vary widely around the state.

Another noteworthy recommendation in the report — having legislators pass a “penny a pill” surcharge to fund treatment — merits support.

It is important to note that the work group’s recommendations are not meant to limit pain medication for patients in end-of-life situations or those who have serious conditions such as cancer. Members of the group are also admirably aware that they tackled only part of the problem. The vexing problem of how to effectively treat patients taking opioids for chronic pain remains. If not opioids, then what? As Minnesota patient pain advocate Jennifer Kane has argued on these pages, there’s not a confidence-inspiring “Plan B” for those whose pain causes them to seek out these drugs in the first place.

— Minneapolis Star Tribune, Dec. 18

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