Killer Crisis: ND looks to reduce number of opioid addictions, overdoses
The opioid crisis has made an impact across the nation and across the state of North Dakota, affecting people from all walks of life.
Combatting the crisis has proven to be a challenge for lawmakers, law enforcement, medical providers and everyone in between, but many are also working on preventing addiction through smart prescribing and making the life-saving drug naloxone readily available in communities across the state.
In 2015, there were 53 drug-related deaths, according to the North Dakota Department of Health's Vital Records decision. In 2016, that number rose to 68.
Laura Anderson, prevention administer for the state's department of human services, said opioid prevention efforts began to ramp up about two years ago with the creation of the state's Stop Overdose campaign, which is a statewide campaign supporting community efforts to address prescription drug and opioid abuse. The program worked to increase the availability of naloxone.
The state also has a "Lock. Monitor. Take Back." program, which is an evidence-based prevention effort with the primary goal of reducing access to prescription drugs, especially opioids. It encourages people to be safe with their medications, including promoting North Dakota Take Back locations, and promoting ways communities can support this effort at the local level.
"The goal is really to decrease access to prescription opioids," Anderson said.
Take Back program
The Take Back program was launched in December 2009 and North Dakota offers two free programs for residents to dispose of unwanted medications — the Take Back program at participating law enforcement agencies and the MedSafe program at participating pharmacies.
"North Dakota is very good at promoting it and helping get them off of the streets and out people's hands to decrease the abuse and misuse, the accidental ingestion," Dickinson pharmacist Brandi Ollerman said. "It gives them some place to go so they're not flushed down the toilet or in the hands of the wrong person."
Ollerman said the boxes are "locked and secure" and there's only one way to put the drugs in.
Items allowed in the boxes include unused or expired prescriptions and over-the-counter medications, such as pills, tablets and caplets and controlled substances like Vicodin, Hydrocodone, Demerol, oxycodone and fentanyl. However, items such as syringes are not allowed in the boxes. For a complete list of items allowed and a list of Take Back locations, visit the Attorney General's website.
"With the opioid crisis now there's so much news media and everything that we've gotten calls and people inquiring about how to get rid of it and what to do with it," Ollerman said. "We're trying to get out in the community more to let people know there's options to get it out the house."
North Dakota is the only state in the nation operating free, year-round, statewide prescription drug disposal programs at local law enforcement agencies and pharmacies, according to the North Dakota Attorney General's office.
As of Oct. 24, 2017, more than 10 tons, or 20,234 pounds, of unwanted and unused medications has been collected from the Take Back containers at local law enforcement agencies.
Mark Hardy, executive director of the state Board of Pharmacy, said North Dakota has "stood out" on a federal level when it comes to the number of disposal locations across the state, he said.
"The goal is to get the unused medicines out of the medicine cabinet and get them disposed of that would prevent that really high statistic of people that first get addicted from taking them free from a friend or relatives," he said.
The state's Board of Pharmacy is working with the state, universities and providers about what appropriate prescribing should look like, Hardy said.
Providers are also looking at how "order sets" can be changed for patients, he said.
For example, if a person leaves the hospital after a surgery, the hospital may decrease the amount the person is prescribed on their first visit, Hardy said.
Federal law has also allowed providers to partially fill a Schedule II medication, which allows the patient and provider to better control the amount of opioids being prescribed.
Hardy said there was around a 15 percent decrease in the number of opioid prescriptions from 2015 to 2016 and current numbers are showing that to be true from 2016 to 2017.
"There's definitely an increased awareness of the dangers of those products," Hardy said.
Earlier this year, North Dakota received a $2 million grant through the Substance Abuse and Mental Health Services Administration (SAMHSA).
Most of the grant goes to treatment and recovery services for people with an opioid use disorder, but part of it is also for supporting prevention of overdoses and trying to prevent addiction from happening in the first place.
"I think communities have really been working very closely with a lot of different partners and stakeholders to specifically increase access to naloxone," said Laura Anderson of the state's department of human services.
Placing naloxone in public places is similar to having an AED in public places and provides a life-saving tool that could be available at any time, she said.
Overdoses can happen to anyone, not just those who abuse drugs, so it is important for people to understand what an overdose looks like and what to do in the situation, Anderson said.
While some may believe increasing access to naloxone encourages drug abuse, Anderson said that is simply not the case. If a person overdoses, naloxone immediately puts the body into withdrawl, she said. Additionally, Anderson said there has been "a ton" of researching which shows there is not an increased use or abuse of opioids.
"It is not a pleasant experience," she said. "People who overdose do not want that feeling. It is not a something like 'Hey, yeah let's just overdose and then we'll have that experience.'"
Naloxone can also give people the chance of recovery and living a better life, Anderson said.
"If this was someone's son or daughter or mom or cousin, you would want to save them and give them a chance at recovery and at a full life," she said.