Group of officials applauds opioid efforts by local health departments

An opioid addiction program for incarcerated people in Hennepin County has started treatment for 203 people since January — a number that officials are expecting to rise as the opioid epidemic rages on.

Under the program, people being held in Hennepin County jail and workhouses receive Suboxone, what's known as medication-assisted treatment, a buprenorphine drug that can come in the form of a pill or a strip that patients dissolve under their tongues.

The program was launched after a study released in November found that nearly 30% of all opioid deaths among former inmates across Minnesota occurred within one year of release. The county Health Department brought the program idea to the Sheriff's Office and other emergency personnel, and they helped to launch it.

"We were not at all surprised that each month we've had more and more people start treatment while they're detained," said Julie Bauch, opioid response coordinator for the Hennepin County Public Health Department.

With programs like this one, local health departments' efforts on opioid response and partnerships with emergency personnel and nonprofits are driving policy and helping people access critically needed treatment and services, according to a report released this week by the National Association of County and City Health Officials.

The report surveyed 198 city and county health departments about programs they are implementing to curb opioid misuse and addiction.

Local health departments surveyed were more likely to directly provide community education, connections to treatment, medication take-back programs and outsourcing to partners for access to naloxone, prescriber education and stigma prevention. The departments and their partners were least likely to offer testing for fentanyl and other drugs, methadone-assisted treatment and detox programs.

A common challenge for local health departments in Minnesota is lack of dedicated funding for opioid misuse and overdose programs, says Deb Burns, deputy assistant commissioner for health improvement at the Minnesota Department of Health. She said local health departments are the "conveners in their communities."

The state health department helps with data and technical assistance, but the local health departments are the "boots on the ground."

"People tend to go right to health care when they talk about public health," Burns said. "Local public health departments have to understand the issues in their community and to pull together and try to find resources."

Last year, the St. Paul-Ramsey County Public Health Department launched its Clinic 555 syringe exchange program. Since then, the program has had 2,000 visits from people seeking fresh syringes and kits that include naloxone, cotton, ties to prepare the arm for a syringe, water and condoms. Approximately 58,754 syringes have been returned, and the department has distributed 121,000.

Hilary Zander, a health educator with Ramsey County Public Health who coordinates the syringe exchange program, said the department is hiring someone to work with libraries, homeless shelters, churches and other institutions to train them on the use of naloxone, an overdose reversal drug.

The department is also hoping to collaborate with police and sheriffs on preventing overdoses and bringing Narcan into correctional facilities.

Zander said workers often hear clients say how grateful they are for the syringe exchange service and the concern about how much stronger the drugs are getting. That's why he says the department is pushing clients to take their Narcan kits, avoid getting high alone, have a safety plan so someone could find them if they overdose, and take the dosages more slowly in case they're laced with fentanyl or other stronger opioids.

"It's important because it is the best thing that we have in terms of saving people's lives from this epidemic," Zander said.

More than 420 Minnesotans died from opioid overdoses in 2017, according to the latest data available from the state Department of Health.

One recommendation from Minneapolis Mayor Jacob Frey's Multijurisdictional Opioid Taskforce was a program that would connect overdose patients in emergency rooms to treatment and other supportive programs, such as housing and employment services. Heidi Ritchie, policy director for Frey's office, said the program would cost an estimated $200,000 to $500,000. Frey is slated to announce his budget priorities next week.

"I think in the long term that it's this program that we're going to see a break in the cycle of addiction and overdoses," Ritchie said. "Many of the people you see in the hospital for overdoses, it's not their first time."