Minnesota doctors seek answers to opioid crisis

DULUTH, Minn. -- Saying the abuse of prescription pain pills has reached "epidemic proportions," the organization that speaks for Minnesota's doctors is reconvening a task force on the subject.

DULUTH, Minn. -- Saying the abuse of prescription pain pills has reached “epidemic proportions,” the organization that speaks for Minnesota’s doctors is reconvening a task force on the subject.

“In spite of things we’ve tried over the past couple of years, we have not seen a drop in  (overdose) deaths,” said Dr. Dave Thorson, president of the Minnesota Medical Association. “We’re seeing heroin overdoses increase. … The reality is that we have more evidence of how big a problem this is.”

The 14-doctor panel, chaired by Dr. Beth Baker of Minneapolis, includes Dr. Elisabeth Bilden, a toxicologist for Essentia Health in Duluth. The MMA announced last week that it was being recovened.

The U.S. Centers for Disease Control reported earlier this year that 78 Americans die every day from opioid overdoses, and that at least half of opioid overdose deaths involve prescription opioids such as oxycodone, hydrocodone and methadone.

In Minnesota, 572 people died of overdoses in 2015, the Minnesota Department of Health reported earlier this year, including 31 in St. Louis County -- where there were no overdose deaths at all from 2002-10.


The epidemic had a high-profile victim earlier this year in Minnesota with the death of the pop star Prince, who reportedly died from an accidental overdose of fentanyl, an extremely powerful synthetic opioid.

Doctors are involved because the supply of prescription opioids starts with them, one of Minnesota’s foremost experts on drug abuse said.

“The medical community has a tremendous role to play” in addressing the epidemic, said Carol Falkowski, director of the St. Paul-based Drug Abuse Dialogues. “Typically to address a drug epidemic it involves prevention, treatment and law enforcement. But with this epidemic, we have to look at the very practice of medicine.”

The medical side of the problem reaches back about 25 years, Thorson said, when doctors and medical students were encouraged to treat pain aggressively. As opioids were prescribed more freely, some patients became addicted to the drugs.

But there has been a “paradigm shift” in recent years, Thorson said, as doctors increasingly are learning to use opioids only for treating short-term acute pain - such as following surgery - and not for long-term chronic pain.

“We have people who are having orthopedic surgeries where they’re only being treated with opioids for three to five days and then they’re transitioning to Ibuprofen and Tylenol, which would never have been heard of five years ago,” said Thorson, a family doctor in the Twin Cities. “So I think we’re all realizing that there are other ways to treat pain.”

Thorson said he expects the task force to meet two or three times before reporting their findings to the MMA’s governing board. They’ll look at such issues as when monitoring patients’ prescriptions should be mandatory, when additional training in prescribing opioids is appropriate and how to expand the number of doctors licensed to prescribe suboxone, an opioid that is sometimes used for treating opioid dependence.

Better education for medical professionals is a key, Falkowski said. Medical schools provide future doctors with little training on addiction, she said, and few of those who enroll in addiction treatment programs were referred by their doctors.


“They aren’t trained about addiction,” she said of physicians. “They probably see it all the time, but don’t recognize it, don’t identify it and don’t know what to do about it when they do see it.”

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