30 August 2023
BAXTER, Minn. With overdose deaths increasing exponentially in Minnesota over the past few years, Essentia Health is continuing its work to ease some of the roadblocks to care.
The latest data from the Minnesota Department of Health show Minnesota went from 342 opioid-involved overdose deaths in 2018 to 978 in 2021. From 2020 to 2021, there was a 43% increase in the number of opioid-involved overdose deaths in the state.
“Even with all of the publicity, the media coverage and all of those things that have been done, we still continue to see overdose deaths increase every year, and so we’re bringing awareness to that,” said Jessica Schwartz, substance use disorder program manager for Essentia Health.
With September being National Recovery Month, Schwartz said it seemed fitting that Aug. 31 is International Overdose Awareness Day as she often hears about patients who wind up on the road to recovery after a non-fatal overdose.
“A lot of those in recovery will say something started or it was either themselves, a friend or a loved one, who had either a fatal or non-fatal overdose and it changed the trajectory of their life. And they went through recovery because of that,” she said.
Essentia Health is taking more of a harm-reduction approach to addiction, as most people are not perfect but they are looking for help and guidance, Schwartz said.
When someone is under the care of someone or in a place of recovery and they make a mistake, often rehab clinics and providers would drop that person from the program or clinic, leaving them without care and at a disproportionate risk of an overdose. That is not the plan at Essentia.
“What that means is, if you come to a clinic like ours, you don’t have to be perfect,” Schwartz said. “If you have a relapse, or you have something that happens or bumps come in the road, which are almost inevitable in recovery, we’re not going to kick you out of care.”
Another place Schwartz said she sees a disproportionate risk is with those who are getting out of incarceration.
“We know that those are two places where people have exponentially higher rates of fatal overdoses afterward because their tolerance has gone down,” she said. “Something happens, they have life stress, family stress, they can’t get connected to care like they thought they could, and they return to use, but that return to use can be fatal immediately after that abstinence.”
Knowing this, Essentia has increased efforts to connect people to care after treatment and after incarceration.
The clinic is reaching out to patients to make sure they have rides, talking with insurance companies, and adjusting the ways they see patients to make the system easier for those in difficult situations where they are vulnerable to relapses.
The system of “what can we do to make it so that you can still get your health care” has worked so well for those who are vulnerable, Essentia Health has implemented the use of a care facilitator or community health worker across other family medicine clinics to help people dealing with social determinants of health issues.
Schwartz said care providers need to remember all they did was enter a room where someone struggling with addiction may feel a lot of shame about where they are in life, yet they made a conscious effort to change.
“They were struggling with something that they probably felt a lot of shame about,” she said. “They made a phone call to a pretty large health care organization. Told a stranger on the phone something that’s probably deeply embarrassing to them. Made an appointment and probably got very anxious in the days leading up to that appointment.”
Along with changing how they interact with patients, Schwartz said she has seen the state and local communities come together to make changes to how they see and treat addiction.
“I think we’re really lucky in this area that we have some really amazing community leaders and people who are making big changes in our community,” she said.
On July 1, Minnesota law changed to require a school district or charter school to maintain a supply of two doses of opiate antagonists, Naloxone, in each school building.
Naloxone, when administered quickly and effectively, can immediately restore breathing to a victim experiencing an opioid overdose and prevent death.
“A really great friend of mine who I think says smart stuff all the time said, ‘We need to make getting care for substance use easier than getting drugs,’ ” Schwartz said.
“We can no longer judge people who use drugs, and say that they need to figure it out. We also know that health care systems can be really complicated to navigate for everyone. And if you’re coming at it from a place where you don’t have a phone, and you don’t have transportation, or you have these barriers to care, we have to do everything we can to eliminate those barriers, get people connected, then all of a sudden things start to fall into place and that’s going to help keep you on the path to success.”
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