Text Message to Send to Your Kids


If you’re concerned about your kid and drinking, use every opportunity to communicate your message – including via text. Here’s a helpful guide with suggestions for simple, effective text messages to send.

Click on picture to enlarge view. 










The Opioid Epidemic Is a Middle Class Problem, Too

Much of the conversation surrounding the opioid epidemic has, understandably, centered on poorer Americans, many of whom are insured under the Medicaid state-federal safety net program for low-income people. But a new analysis of more than 200 million private insurance claims finds that the crisis is also taking a massive toll on those with private insurance and employer-sponsored health coverage—typically members of the American middle class.

The report was drawn up by Amino, a company which compiles public health and medical pricing data in an effort to reveal more about about larger health trends while directing consumers to potentially cheaper care options. (I’ve covered Amino’s medical pricing tool and some of its earlier population health reports.)

The results were striking. “1.4 million privately insured patients were diagnosed with opioid use disorder in 2016—6 times more than in 2012,” according to the company, which dredged through 205 million insurance claims.

That volume of data also helped Amino identify location-specific trends, including areas with a disproportionate number of opioid use disorder diagnoses and prescriptions for addiction-fighting treatments like buprenorphine.

For instance, Kentucky contains “9 of the top 10 counties nationwide for doctors treating a high volume of patients for opioid use disorder,” according to the report. Areas known to be hit especially hard by the crisis, including Florida, New Mexico, and Appalachia, also saw high rates of treatment for the disease.

Amino’s research also homed in on the kinds of patients who receive addiction treatment. To be clear, this research doesn’t necessarily signal cause-and-effect, just a correlation. But mental health issues, back pain, and hepatitis C patients all appear more likely to be dealing with opioid painkiller addiction.

Source: Fortune Health

Potential penalties for Cowboy Jacks after string of drunken incidents

The city says five DWI arrests so far this year involved people who drank at Cowboy Jack’s.

After a string of drunken incidents, Plymouth city leaders are discussing whether to close bars earlier citywide and considering a $500 fine for one barin particular: Cowboy Jack’s.

The City Council discussed possible options Tuesday, but in the end tabled a decision on Cowboy Jack’s so the two sides can meet in an administrative hearing. Council members also talked about moving up bar closing times as another solution to curb alcohol-related incidents.

In January, city leaders warned Cowboy Jack’s that they would look at possible penalties if the popular bar had more than three “Place of Last Drink (http://partnership4change.org/projects/alcohol-enforcement-efforts/)” notifications within three months. They say that Cowboy Jack’s violated that license condition with nine reports from January to April, including five DWI arrests.

If the city levies the fine, it would be the first penalty imposed under its “Place of Last Drink” program. Plymouth was one of the first to sign on to the program a few years ago, as more suburban police departments started tracking where a person last consumed alcohol before an alcohol-related incident.

From Edina to Chaska, police now track receipts, witness details or voluntary information in an effort to clamp down on over-serving restaurants and bars. It’s illegal under state law for bars or restaurants to serve intoxicated people.“This is not the first year we’re discussing this,” Mayor Kelli Slavik said Tuesday. “It’s not getting fixed. It’s to the point where we need to do something.”

But attorney David Davenport, who represents Cowboy Jack’s owner, the After Midnight Group in Minneapolis, said that tying “often flawed” data to the bar’s liquor license is unfair. In one DWI case, he said, it’s unclear if the man had a drink at Cowboy Jack’s or was even in the restaurant before he was pulled over after picking up women outside the bar. “They’re being held accountable for behavior that they can’t control,” Davenport told council members. “They want to be a good member of this community.”

The company also owns Cowboy Jack’s bars in downtown Minneapolis, Bloomington, Otsego, the Mall of America, New Brighton, Woodbury, St. Cloud and Rochester. Plymouth officials discussed concerns about Cowboy Jack’s in 2014 and 2015. Then in January, the city attached “Place of Last Drink” conditions, making it the only restaurant or bar in Plymouth with that data tied to its liquor license.

Of the nine incidents from January to April, one case involved a driver arrested with a blood-alcohol concentration of 0.11, above the .08 legal limit. Although the man told police he had just “a couple of beers,” officers found a $90 receipt from Cowboy Jack’s. In another case, police responded to a report of a man at Cowboy Jack’s who fell off a bar stool and was unresponsive.“We truly do care about public safety and we look forward to working with the City Council to that end,” Davenport said.

Source: Star Tribune

*The Substance Abuse Coalition of Kanabec County offers Responsible Beverage Server Training several times each year. As a condition of holding a liquor license in Kanabec County establishments must show proof that their employees have had annual Responsible Beverage Server Training. 

Positivity in the Park – Update!


Positivity in the Park continued on Thursday, June 8th with an outdoor movie – “The Secret Life of Pets”. There was a great turn out and while it took a little longer than anticipated to get dark enough to view the movie, the weather was fantastic and our partners from B.A.D.G.E.S. and the Kanabec County Sheriff Office Reservist provided their equipment and technical expertise! 

Look for more Positivity in the Park events coming soon!


American’s Addition to Pain Pills

AMERICANS OVER 50 are using narcotic pain pills in surprisingly high numbers, and many are becoming addicted. While media attention has focused on younger people buying illegal opioids on the black market, dependence can also start with a legitimate prescription from a doctor: A well-meant treatment for knee surgery or chronic back troubles is often the path to a deadly outcome.

Consider these numbers:

  • Almost one-third of all Medicare patients — nearly 12 million people — were prescribed opioid painkillersby their physicians in 2015.
  • That same year, 2.7 million Americans over age 50 abused painkillers, meaning they took them for reasons or in amounts beyond what their doctors prescribed.
  • The hospitalization rate due to opioid abuse has quintupled for those 65 and older in the past two decades.

From pain to addiction

Behind the numbers are the shattered lives of many who never dreamed they’d become drug abusers.

Cindy Thoma, 63, who owns and operates a bookstore in Muskegon, Mich., became addicted to opioid pain pills after being injured in a car crash with a drunk driver who ran a red light. “I was running away from my pain,” she says. “I did well at first. But I began to take them sooner, which meant I needed more. I needed more because my body got used to the narcotics.”

The way opioids are often prescribed, dependence can set in after just a few days, experts say. “Within one week you’ve made that person physiologically dependent on the drug, meaning they feel some discomfort or side effects when they stop using,” says Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing.

“I was very, very sick. My mind was not right for a long, long time.”

—Cindy Thoma, 63, sober for five years following an eight-year opioid addiction

Thoma stopped abusing opioids after years of struggle. But for too many, their stories end badly.

Nearly 14,000 people age 45-plus died from an opioid overdose in 2015 — 42 percent of all such deaths in the U.S., according to the Centers for Disease Control and Prevention (CDC).

The actual number is likely much higher. Overdoses in older people are often mislabeled as heart failure or falls, Kolodny says.

“The deaths of older people are an untold part of it,” says Jeremiah Gardner, public affairs manager of the Hazelden Betty Ford Institute for Recovery Advocacy. Gardner speaks from personal experience: His mother died two years ago from an overdose after becoming dependent on painkillers prescribed for chronic pain and a surgery. She was 59.

So how did we get here?

The sin of overprescription

“We overestimated the benefits of opioids and underestimated the risks,” says Deborah Dowell, senior medical adviser at the CDC. “We assumed without adequate evidence that they would work as well long term as they did in the short term.”

Pharmaceutical companies have marketed opioids aggressively to physicians, especially after the Federal Drug Administration approved OxyContin in 1995. “The campaign that led to the increase in opioid prescriptions was multifaceted,” Kolodny says.

For example, Purdue Pharma, the maker of OxyContin, held pain management conferences in states like Florida that were attended by more than 5,000 doctors, nurses and pharmacists.

So beginning in the late ’90s, when older patients suffering from chronic conditions like arthritis or back issues asked for pain relief, their doctors innocently wrote prescriptions for OxyContin, Vicodin, Percocet and other opioid painkillers.

By 2012, addiction rates and the number of overdose deaths had soared. In that year, 259 million opioid prescriptions were written — enough for every adult in the U.S. to have one.

 “Many doctors still think seniors can’t get addicted.” 

Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing

The trade group representing most opioid manufacturers, PhRMA, did not return calls for comment. Purdue Pharma said in a statement, “The opioid crisis is among our nation’s top health challenges,” and the company is committed to being “part of the solution.”

The teaching in medical school used to be that opioid medication is not addictive as long as it is given to someone in legitimate pain — something we now know not to be true, says Vivek Murthy, who left the job of U.S. surgeon general in April.

It did not help that in 2009 the American Geriatric Society encouraged physicians to use opioids to treat moderate to severe pain in older patients, citing evidence that they were less susceptible to addiction. Though the society revised those guidelines, the myth persists. “Many doctors still think seniors can’t get addicted,” Kolodny says.

Last August, then-Surgeon General Murthy wrote a letter to every doctor in America. “Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely,” the letter said.

“This coincided with heavy marketing of opioids to doctors. Many of us were even taught — incorrectly — that opioids are not addictive when used as pain relief. The results have been devastating.”

The CDC issued guidelines last year recommending that doctors drug-test their patients before and during opioid therapy, to ensure that the medications are taken properly.

But doctors still overprescribe. A 2016 survey by the nonprofit National Safety Council found that 99 percent of physicians prescribe opioids beyond the dosage limit of three days recommended by the CDC.

Thoma had no trouble getting opioids. “I could get them from different doctors, and there was no communication between them about what they were prescribing,” she says. “You could get it fairly easily.” In eight years, she lost her job and home and went bankrupt. Finally, she forced herself to stop. “I was very, very sick. My mind was not right for a long, long time.”

A need for treatment options.

As people age, they can become more at risk for dependence or overdoses. To start, they are more likely to have serious pain. Kidney and liver function slows with age, increasing the time drugs remain in the system. And memory loss can make it harder to manage opioid medication effectively.

Solving the problem will require major changes, experts say. There is an urgent need for more treatment centers able to administer to older patients. That includes counseling tailored to older patients. It doesn’t work to have “a buttoned-up elderly person sitting next to a guy in his 20s who is pierced and tattooed,” says David Frenz, a Minneapolis physician certified in addiction medicine. And doctors need to be trained on medications used to treat opioid addiction, experts say.

There also needs to be a major attitude shift. “Some people still hold the mistaken belief that it’s a moral failing instead of a chronic medical condition that requires treatment,” says Melinda Campopiano, senior adviser for the federal Substance Abuse and Mental Health Services Administration.

But there are happy endings.

Thoma has been opioid-free for several years. She bought her bookstore in 2013, which helped refocus her life. She offers this advice for those who are dealing with drug issues: “Ask your provider to monitor your intake very closely. Consider trying nonaddictive options first. Be patient with yourself. Involve family members and friends to encourage you with your fight. And be prayerful.”


Source: AARP.org


Heroin’s use rising, costing society more than $51 billion

Heroin use in the United States was estimated to cost society more than $51 billion in 2015, according to new research at the University of Illinois at Chicago.

Made from morphine, heroin is an opiate commonly used as a recreational drug for its euphoric effects. According to the World Drug Report 2016 from the U.N. Office on Drugs and Crime, heroin use has reached the highest level in 20 years in the U.S. and is the deadliest drug worldwide.

UIC pharmacoeconomists led by Simon Pickard and Ruixuan Jiang created a cost-analytic model to determine how heroin impacts society using several variables: number of imprisoned heroin users and their crimes; treatment costs of heroin abuse; chronic infectious diseases contracted through heroin abuse (HIV, Hepatitis B and C, and tuberculosis), and cost of their treatments; cost of treating newborns with medical conditions associated with heroin; lost productivity at work; and heroin overdose deaths.

The study, published in the journal PLOS ONE, found that heroin users are less productive than others due to premature death; spend more time away from work due to seeking treatment for drug dependence and for drug-related hospitalizations, and have high rates of work absenteeism and unemployment.

On average, the societal cost per heroin user per year is $50,799. An estimated 1 million people are active heroin users in the United States, putting the total societal cost at approximately $51 billion, said Pickard, professor of pharmacy systems, outcomes and policy. The cost per user is significantly higher than for patients suffering from other chronic illnesses, such as chronic obstructive pulmonary disease ($2,567 per patient in 2015 dollars, or $38.5 billion for 15 million patients) and diabetes ($11,148 per patient in 2015 dollars, or $248.59 billion for 22.3 million patients).

“The opioid crisis didn’t happen overnight,” Jiang said. The number of heroin users doubled from 2000 to 2013, rising from one per 1,000 individuals in 2000 to two per 1,000 individuals in 2013, she said.

Pickard has monitored the rise in heroin use for several years, noting that users often start taking the illicit drug after becoming dependent on prescription opioid painkillers. Due to the high cost of opioids and difficulty in obtaining prescriptions, opioid abusers often turn to heroin, which is cheaper and easier to get.

As heroin use has increased, so have overdose deaths, according to the Centers for Disease Control and Prevention. Heroin-related overdose deaths have more than quadrupled since 2010. From 2014 to 2015, heroin overdose death rates increased about 21 percent, with almost 13,000 people dying in 2015. And today, research has shown that heroin use is not confined to urban areas, but has reached rural America as well.

Without meaningful public health efforts, the number of heroin users is likely to continue to grow, Pickard said.

“The downstream effects of heroin use, such as the spread of infectious diseases and increased incarceration due to actions associated with heroin use, compounded by their associated costs, would continue to increase the societal burden of heroin use disorder,” Pickard said.

Co-authors on the study were Inyoung Lee and Todd Lee of the UIC Center for Pharmacoepidemiology and Pharmacoeconomics Research.

Source: UIC News Center