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Lieutenant governor hears Duluth opioid concerns

Minnesota Lt. Gov. Tina Smith (right) talks with Tina Silverness, chief operating officer at the Center for Alcohol and Drug Treatment, during a tour of the facility on Wednesday, Sept. 20, 2017. Steve Kuchera / Forum News Service

DULUTH — The beds have been made at the Duluth Detoxification Center's new opioid withdrawal unit. Now, officials are eager to see them filled.

That should happen in the next few weeks — as soon as the facility can add staff members to serve clients in the first-of-its-kind service that promises to fill a critical treatment gap in the Northland, said Center for Alcohol and Drug Treatment Gary Olson.

"People overdose and they're in the emergency room and might be ready for treatment," Olson said. "This is a 24/7 operation. They can literally be there and be moved to the next step without any cracks to fall through. Those gaps in service are where we lose people."

Minnesota Lt. Gov. Tina Smith was on hand Wednesday, Sept. 20, for a tour of the new unit, which was announced earlier this month with the help of a federal grant.

Smith also led a roundtable discussion with elected officials, law enforcement, treatment providers and medical personnel, seeking input on ways the state can help combat opioid addiction.

"I'm really impressed by the appreciation people here have that this is kind of a hidden problem that we all need to figure out how to talk about so we can actually address it," Smith said. "I think that's happening here in Duluth."

Smith and other officials got a glimpse inside what will soon become a six-bed unit specifically for immediate opioid withdrawal treatment at CADT's existing detox facility at 1402 E. Superior St.

The new unit is not only segregated from the treatment center's alcohol detox unit; it also shares some key operation differences, Olson said.

While few alcohol patients are medicated, Olson said the new unit will use harm-reduction strategies and tapering medications to help ease clients off opioids.

"We know that 80 percent of people with addiction don't access treatment at all, and I think one of the reasons is that our treatment has a very high bar, which is lifelong abstinence," Olson said. "So harm-reduction strategies help us engage people who might not be quite ready. You need to start working with people sooner and stay engaged with them longer. Recovery is a long-term process."

Another key element of the opioid unit: Clients will need a referral from a hospital or treatment court program. Olson said that should prevent abuse by those who may try to use the program for a short-term supply of opioids.

Olson, though, stressed that the new unit should not be seen as one-size-fits-all solution to the opioid crisis. He said it's critical for the community to have many collaborative strategies combining all services available.

"In terms of addiction, the way forward is one individual at a time," he said. "There isn't a magic wand we can wave."

The withdrawal unit was established with the help of $350,000 that was received by St. Louis County from a state grant earlier this month. The county also agreed to chip in another $450,000 and the 6th Judicial District added $435,000 from a grant through the Substance Abuse and Mental Health Services Administration to get the unit going.

In the roundtable meeting, Smith heard from local officials who were concerned about the stress on city and county governments to fund necessary programs to combat the opioid epidemic.

Linnea Mirsch, director of St. Louis County Public Health and Human Services, told the lieutenant governor that she's aware of five mothers who overdosed this month — three of them fatally. The county is now having to handle child protection cases for all five.

Duluth Police Chief Mike Tusken noted that his officers are often the first on scene of an overdose and provide life-saving naloxone treatment. But the drug is expensive and there is no dedicated funding source, so the department is relying on organizations such as churches to keep it in stock.

Smith, after an hourlong meeting, pointed to two other ways the state could provide assistance.

She said the Minnesota Prescription Monitoring Program, which established through legislation last year to provide tools for doctors and pharmacists to manage patient care, could be improved. The program is voluntary and those who have used it are reporting that it has been plagued by technological issues.

Smith said she would also push for the passage of a bipartisan "opioid stewardship" bill introduced in the Legislature's most-recent session that would establish a 1 cent tax per pill for opioid medications to provide funding for prevention and treatment efforts.

"It would have a minimal effect on the cost of prescription medicine but make a world of difference for those who need help," Smith said.

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