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Community University Health Care Center, Minneapolis, MN 4 University of Kola Clinic, American Indian Community Development Corporation, Minneapolis, MN Page 2 Opioid Addiction in Hennepin County • Hennepin County medical

HENNEPIN COUNTY MEDICAL CENTER-NATIVE AMERICAN ADVOCATE HENNEPIN COUNTY AMERICAN INDIAN COMMUNITY DEVELOPMENT CORPORATION CITY OF 24 hour addiction help line: 1-866-675-4912 www rseden

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of Units Location - Administrator - Project Name Rehab/ Existing New Total American Indian Community Development Corporation – Pokegama North 3 3 3 3 Center for Energy and Environment – Brooklyn Center, Crystal, Richfield

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Short-term and critical access centers • Collaborative The County is currently transforming their 50-bed detoxification program at American Indian Community Development Corporation) and has developed a 16-bed Mental Health Crisis

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Mental Health in American Indian and Alaska Native Populations 1 Developed under the Substance Abuse and Mental Health Services Administration's Center for the Programs primarily focused on tribal youth (n=37), the whole tribal community American Indian Life Skills Development/Zuni Life Skills Development

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American Indian organizations, American Indian centers, Bureau of Indian Affairs and disability, career development, assessment, rehabilitation and American Indian Community House technology and lists of therapists and rehab

[PDF] Eliminating Health Disparities Initiative Report to the Legislature 2013

15 jan 2013 · American Indian communities, local public health officials, and others historical trauma on the development and maintenance of health homicide; obesity; mental illness; alcohol and other drug addiction, Department of Indian Work (lead agency), Ain Dah Yung (Our Home) Center, American Indian

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29 oct 2020 · NorthPoint Health Wellness Center Decrease in Detoxification spending American Indian Community Development Corporation

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National Indian Health Board, Tribal Epidemiology Centers, Native American Centers methamphetamine addiction; 2) providing intensive outpatient program Description: Lakota run grassroots Community Development Corporation that is

Naloxone Prescribing and

Distribution from Hennepin County

Community Clinics

Michael Tradewell

1 , Joseph Renier 1 , Nikki Giardina, RN 2 , CuongPham, MD 3,4 , RoliDwivedi, MD 3,5 , Kenneth McMillan, MD 6 , Ryan Kelly, MD, MS 3,4 1

University of Minnesota, Medical School

Native American Community Clinic, Minneapolis, MN

3 Community University Health Care Center, Minneapolis, MN 4 University of Minnesota, Division of General Internal Medicine 5 University of Minnesota, Department of Family Medicine and Community Health 6 Kola Clinic, American Indian Community Development Corporation, Minneapolis, MN

Opioid Addiction in Hennepin County

•Hennepin County medical examiner reports that in November 2017, 115 people died of an opioid overdose -

Compared with the 110 people who fatally

overdosed in all of 2015 1 •In 2017, Minneapolis firefighters administered

Narcan

, on 413 occasions

Nearly as many times as the previous two

years combined 1 •Feb 14, 2018 Gov. Dayton proposes a "penny-a-pill" paid for by drug companies to fund an opioid stewardship program for addiction prevention, treatment, and recovery efforts in Minnesota 2 •Feb. 24, 2018 Minneapolis Mayors office trained all staff, including the Mayor on naloxone use 3 (1)

Naloxone Distribution in Minnesota

•Steve's Law -2014, Amendments to Statutes 2012, section 151.37 -(1) Licensed providers (MD, DO, NP, PA) can authorize trained individuals to administer opiate antagonists -(2) Good Samaritan immunity for person who seeks medical assistance for an overdose and the person who has overdosed •Immunity also extends to the licensed healthcare professionals who prescribe or authorize distribution of the antagonists •Clinic and Community Based

Distribution

-Steve RummlerHope Network -Valhalla -Community Clinics

Our Project

•(1) Education / Naloxone Distribution -Inspired from volunteer experience at Kola •Quickly expanded to NACC and CUHCC -MAFP grant funded and SRHF matched -Did 100 individual or small-group trainings -Each kit contains: •Instructions for Administration •Rescue Breath Mask •Non-Latex Gloves •Alcohol Wipes •3 Naloxone Vials •3 Syringes •(2) Cross-Sectional Study, Survey -Outcome Questions •What is the state of naloxone distribution in this high need area? •Is clinic-based prescribing enough? Are scripts getting filled?

Methods

Training and Survey collection took place

between January 5, and February 22, 2018 •Naloxone Training -Individual or small group -Participants self-selected for training or were asked if they desired training based on history of opioid use disorder -Participants were offered a free

Naloxone kit at the completion of training

•Survey -Four Question Survey, with basic demographics collected -University of Minnesota IRB, exempt determination -Exclusion Criteria •Less than 18yo •Diminished capacity -Survey and training were uncoupled, but most often surveys were administered directly after training sessions •Race: -American Indian or Alaska Native 38 (47%) -White 26 (32%) -Black or African American 8 (10%) -Unspecified 6 (8%) -Native Hawaiian or Pacific Islander 2 (2%) -Asian 1 (1%)

Demographics

•94 Surveys Collected -Kola -27 -CUHCC -37 -NACC -30 -15 were excluded due to internal inconsistencies in the responses -79 surveys included in final analysis •Mean Age: -35.8 years (StDev12.4) -Minimum 19 years, Maximum 73 years •Gender: -37 (47%) Male, 35 (44%) Female,

0 (0%) Other, 7 (9%) Unspecified

•Ethnicity: -11 (14%) Hispanic, Latino, or Spanish Origin

How Were Survey Participants

Affected by Opioids?

•42 (53%) Current Use •13 (17%) Recovering from Opioid

Use Disorder (OUD)

•11 (14%) Friends or Family

Members Currently Use

•9 (11%) Report People in Their

Community are Affected by Opioids

•3 (4%) Unspecified •1 (1%) Not Affected

Naloxone

Distribution & Prescribing

•53 (67%) of participants had received physical naloxone syringe/vial, nasal s pray, or auto -injector kits before -Reported 70 incidences of receiving naloxone •27 (39%) from Community Distribution •15 (21%) from Pharmacy •15 (21%) from a Friend •10 (14%) from Health Care Center/Clinic •3 (5%) Other, from Ambulance or

Paramedic

•Amongst people currently using or recovering from OUD (n = 55) -45 (82%) had received naloxone •28 (35%) of participants had been prescribed naloxone before -19 (68%) Filled the prescription -6 (21%) Did not fill the script •2 (7%) Too expensive •2 (7%) Felt they did not need it •1 (3.5%) Pharmacy didn't have it •1 (3.5%) Unable to get to the pharmacy -3 (11%) Unspecified •Amongst people currently using or recovering from OUD (n = 55) -26 (47%) had been prescribed naloxone •18 (69%) Filled the prescription

Naloxone Use

•54 (68%) of responders know someone who has received a naloxone injection -Reported 75 use cases with information on who gave the naloxone: •32 (43%) A friend •20 (27%) They administered the injection •19 (25%) EMT •4 (5%) Other •Amongst people currently using or recovering from OUD (n = 55) -43 (78%) know someone who has received a naloxone injection

Discussion / Conclusions

•In January and February, 2018 we did nearly 100 Naloxone training sessions and distributed 100 free kits between 3 Phillips Neighborhood/

Franklin Ave community clinics

•Limitations: -Some survey questions were worded poorly: •Did not explicitly distinguish between receiving a Naloxone kit and receiving an injection •The pick-all that apply option was inconsistent •Strengths: -Survey administration targeted population of interest, receiving a large number of responses from individuals directly affected by OUD -100 more people trained or retrained on naloxone use and 100 morequotesdbs_dbs17.pdfusesText_23

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