Editor's Note: This is the fifth and final story in a series about opioid use and its impact on rural communities.
WORTHINGTON — Working in partnership, non-profit organizations, local businesses and groups targeting the area of substance use in Rock, Nobles and Pipestone counties are promoting education, prevention, treatment and recovery from opioid and substance use in rural areas.
Through a Rural Communities Opioid Response Program Planning grant with the Health Resources and Services Administration, Nobles, Pipestone, Rock, Martin and Wright counties have received funding to help address this issue. The aim of the HRSA grant is to support planning activities surrounding the prevention of and treatment for substance use disorders, including opioid use disorder. The overall goal is to reduce the morbidity and mortality associated with opioid overdoses in high-risk rural communities.
Managed by Children’s Dental Services, the $200,000 grant is in its second, three-year stage — implementation. The planning stage wrapped up in February 2022.
“The reality is that one of the largest prescribers (of opioids) in the healthcare profession is dentists,” said Sarah Wovcha, with Children’s Dental Services. “Through dentistry there's not only a lot of prescribing, but opioids uniquely impact the teeth in a very negative way … and recently opioids are found in an increasing number of substances because they’re laced with fentanyl. So we all came together under a rural consortium to prevent opioid misuse.”
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The first phase of the grant focused on fostering connections with partners, conducting needs assessments and developing plans. Children's Health Services reached out to groups like the Southwest Minnesota Opportunity Council, a community action agency, and #Luv1LuvAll, a Luverne-based group focused on addressing poverty. Both had connected previously with Children’s Dental Services to address oral health care needs in southwest Minnesota.
“Our rural communities are our hardest hit in terms of having a lot of misuse, but also lacking resources, lacking workforce, lacking screening, and lacking access to things like Narcan,” said Wovcha. “So we identified this grant and then looped in really important partners ... and we're doing work every day in the community.”
While the grant covers five counties, the work done in partnership with the Substance Free Coalition, which includes #Luv1LuvAll and SMOC, focuses on Rock, Nobles and Pipestone counties.
“A lot of the work and partnering is done between all three counties … we have a lot of overlap and it didn’t make a lot of sense to not work together on this,” said Terri Janssen of SMOC. She said different partnerships within Rock, Nobles and Pipestone counties were sometimes better used when they were able to share access and resources. “With what we're trying to do here, we are trying to work smarter, not harder.”
The implementation stage of the grant began in 2022, and partners have worked to address opioid use and overdose prevention, expanding access to evidence-based OUD treatment, and growing peer recovery and treatment options to help people start and stay in recovery.
“That's one thing that's kind of been worked on recently is setting up peer recovery specialists,” said Wanda Jarchow with #Luv1LuvAll. “We have four people trained and two that are interested in signing up for training. It's sort of like a mentor that would walk alongside someone struggling, but these peer recovery specialists have to be people in recovery. We've been meeting with them and we've been working on how can we get them out there to be used.”
As part of the recovery and education aspect of the grant, Project Morning Star, a sober living and recovery house in Worthington, and the Woodstock-based New Life Treatment Center have both acted as partners in addressing this. Beth Hoekstra with Project Morningstar was identified for her involvement with the grants, having given “great insight to needs, gaps and connection with partners to move the work forward.”
Additionally, Luverne alcohol and drug counselor Emma Lysne has worked with groups like the Steve Rummler Hope Network and #Luv1LuvAll-Luverne to provide naloxone training in Rock and Nobles counties. Lysne has trained over 600 people, and a second trainer was recently found to help in Lyon County.
In Nobles County, grant efforts were partnered closely with Sterling Pharmacy, which has locations in Worthington, Adrian and Fairmont, among others. As a naloxone access point, anyone who's been through the training can come to one of their locations and get a naloxone kit, and pharmacists are available to prescribe Narcan.
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“We've worked with other members in the community about getting Narcan in schools and nursing homes and for EMTs, fire departments, First Responders, police force, so that they all have that on hand as well,” said Amanda Schmitz, a pharmacist with Sterling Pharmacy in Worthington.
Sterling Pharmacy also dispenses packets of syringes without a prescription, as allowed by the Minnesota Board of Pharmacy. This harm-reduction practice helps limit the spread of blood-borne diseases and pathogens like HIV and hepatitis.
Other services provided by Sterling Pharmacy include the distribution of disposable RX packets, which people can use to destroy unwanted medications. The packets can be easily thrown away without concern of being used by anyone the medications weren’t intended for.
“We also have workflow processes in place that flag certain prescription combinations, indicating that a patient could benefit from the use of Narcan or naloxone,” said Schmitz. “That’s to help limit risk of (overdose), and reduce stigma in the community. Really, it's like seatbelts or a fire extinguisher. Hopefully, you never have to use it, but it's there if you need it.”
While grant funding helps pay for things like the Dispose RX packets, copays for people needing naloxone can also be covered by that funding.
“We're pretty much always looking for more ways to bring awareness about this issue,” said Schmitz. “It hasn't hit home for a lot of people yet. I think the whole point is to be ahead of the curve and get people prepared before it becomes an issue for more people.”
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