Critics frustrated with progress of state drug strategy

GOLDEN VALLEY, Minn. – The Minnesota Department of Human Services released its first year report last week about the state's strategy to combat drug abuse and not everyone is pleased with the progress.

The most immediate priorities identified were prescription opiate and heroin addiction. While state officials say progress has been made, critics are frustrated that progress isn't moving fast enough.

"Nothing has changed in this year. The tide has not turned whatsoever," said Carol Falkowksi, drug abuse expert.

Falkowski is a retired state drug abuse strategy officer who helped put together the Minnesota State Substance Abuse Strategy, which was announced in September 2012.

Among the recommendations to help with the prescription painkiller and heroin addiction problem was to train doctors on how to recognize drug abuse and increase monitoring of potentially dangerous prescription drugs.

Falkowski isn't the only one frustrated. Lexi Reed Holtum is too.

"The fact that they haven't implemented so much of it is really frustrating," she said of the most immediate priorities.

Reed Holtum is with the Steve Rummler Hope Foundation, an organization named after her late fiancé. She says Rummler suffered from nerve pain and got addicted to painkillers his doctors prescribed.

And in 2011, the successful financial advisor died of a heroin overdose.

"Steve would be alive if not been for the prescribing practices," she said.

The state recommended requiring doctors to get more training on spotting drug abuse as a "condition of recertification".

And while officials claim more physicians are getting trained the state legislature has yet to make it mandatory.

"I think perhaps we're at the hand ringing stage of, 'oh isn't this horrible' and 'oh what a horrible problem'. But we have to move past that," said Falkowski.

But some doctors are skeptical.

"You can mandate them but I don't know if it's going to do anything," said Dr. Mark Eggen.

Eggen is an anesthesiologist and member of the Minnesota Board of Medical Practice. He admits sometimes doctors prescribe too much, but he also doesn't want to penalize patients with chronic pain.

"We need to be cognizant of the patients who need these medications and we can't prohibit them from accessing them," he said.

To cut down on doctor shopping the state put more emphasis on the Minnesota Prescription Monitoring Program, which officials started about four years ago. It's a website where prescribers and pharmacists can double check a patient's prescription history throughout the state. But checking the website is voluntary.

"We're coming up on 4 years now and we've seen an increase the number of users every year," said Wiberg.

Cody Wiberg is the executive director of the Minnesota Board of Pharmacy which runs the Prescription Monitoring Program or PMP. He contends a lot of work has been done to increase participation.

His office says the PMP established more than 3,000 new accounts for prescribers and dispensers in 2013.

But the most recent numbers show there are still not a lot of doctors using the system. About a third of them who are eligible to prescribe drugs like Vicodin are participating.

Eggen says many doctors complain the system is time consuming and not easy to use.

And both he and Wiberg are not as concerned with the lack of participation by doctors because not all of them prescribe painkillers.

"My view of it is, that's probably an alright number because about a third of doctors prescribe these prescriptions regularly," said Eggen.

But Falkowksi points to successes in other states that mandate the use of the PMP and believes checking the website should at least be required for the ones that do prescribe painkillers.

"I don't know what it takes to light a fire under policy makers to make this plan happen. In the meantime, kids are dying," said Falkowski.

Department of Human Services Commissioner Lucinda Jesson insists the state is making good progress but says the government can't do it alone.

"Addressing substance abuse is a problem for every individual and every family. You can't just leave this to state government or law enforcement." "I think this first year was a good start where we came together and identified priorities and started to work on them."

That said, for families who have lived through the pain, progress can't come fast enough.

"I miss being in his arms, I miss his laugh," said Reed Holtum about Rummler. "I miss the way he loved my kid."

The Minnesota Board of Pharmacy is pushing legislation this session that would strengthen the PMP but there is no plan to make it a requirement for health professionals to check it.

The legislation that Reed Holtum is pushing seems to have the best chance of passing this session. It's called "Steve's Law", which is named after Rummler.

Reed Holtum says it would give immunity to drug users who call 911 when someone else is suffering an overdose. It would also increase access to the drug naloxone, which can reverse the effects of an overdose.


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