A relatively new but persistent topic in the news is the opioid crisis and how it is impacting our country. There are devastating effects on individuals, communities and our country as a result of this crisis. As a small community we may think this is not an issue in Winona. Unfortunately, we are no exception.

Even before this topic was so prevalent in the news, our medical and clinical staff noticed the rapidly increasing number of people on chronic pain medications. A deep dive was done to look at this issue from a variety of perspectives and to help understand root causes. We also looked at
county data provided by the state regarding overdoses and related deaths. The data were startling.

  • From 2000 through 2015, there were 33 deaths in Winona County related to opioid use.
  • In 2016, there were 396 opioid-related overdose deaths in Minnesota, 195 were related to prescription opioids.
  • Nationwide, opiate overdoses became the leading cause of death in young adults, surpassing motor vehicle accidents.
  • State and regional trends in Southeast Minnesota indicated 4 percent of 8 th graders, 6 percent of 9th graders and 8 percent of 11th graders have used prescription opiates recreationally.

A team of physicians and clinical staff, led by Dr. Dan Parker and Dr. Al Beguin, looked at the risks of opioid use and what we could do about it. Their goals in addressing the issue were to increase safety and improve the quality of care related to controlled substance prescriptions; and to decrease the risk of accidental overdose; and prevent medications getting into the wrong hands. As a result, the Conservative Management Clinic (CMC) was created to help all patients get to the root cause of their pain and determine whether there were better, safer ways to manage their pain and pain medication.

In the Conservative Management Clinic, and now throughout our primary care clinics, if a medical professional determines opioids are needed, they use prescribing guidelines, giving patients the lowest dose for effective treatment. Clinical staff educate patients about the addictive risks associated with opioids and provide information about alternative pain management options like physical therapy, behavioral therapy and yoga among others. Healthcare providers have found that this approach allows them to put more focus on each person’s needs. And, in addition to improving safety, it can improve quality of life by helping people become less dependent on medications that may have negative side effects.

As part of a continuous system improvement process, the CMC has reintegrated the majority of patients back to primary care on safer doses or discontinued use of narcotics completely. The CMC care team continues to work with patients as needed to help them safely manage their pain and medications.

Whether you currently experience pain, or you someday develop pain due to an injury or chronic condition, it’s important to remember that we have processes in place to ensure safe and effective care. I hope you’ll also remember that the talented healthcare providers who have chosen to care for our community are proactive in finding new, safer and more effective ways to help improve your health and well-being.

The Conservative Management Clinic received a Minnesota Hospital Association Quality andPatient Safety Improvement Award.

Rachelle Schultz, EdD

Through this digital column, I hope to shine a light on what we’re working on both internally and beyond our walls in collaboration with other community-focused organizations.

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