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STATE OF AFFAIRS: Midwest Makes Strides In Mental Health, Addiction Awareness

STATE OF AFFAIRS: Midwest Makes Strides In Mental Health, Addiction Awareness

ONE YEAR LATER: Vertava Health Asks “Where Are They Now?”

An Update on the Progress of the Great Plains States

(August 11, 2016) – Over a year ago, Vertava Health took to the streets to bring you the most up-to-the-minute, detailed accounts of our nation’s drug epidemic state by state. We spoke with the nation’s top leaders in addiction, recovery, law enforcement and state government to keep readers informed on each state’s progress in battling an epidemic that is killing over 100 people a day in the United States. This week we checked in with seven states in the Great Plains region to give you a progress report on the efforts they were initiating and enforcing when we spoke to them last.

North Dakota

Happening Then Home to the exact geographical center of North America, the state of North Dakota became a center to a new program aimed at giving more people access to education in behavioral healthcare. Students in addiction treatment began to receive relief of their loan payback for up to five years. Happening Now U.S. Senator Heidi Heitkamp (D-N.D.) has convened leaders in Fargo and Jamestown on strategies to fight the opioid use crisis on the ground. Across North Dakota, opioid-induced deaths increased by 125% from 2013-2014 alone. Over 2,345lbs. Of OxyContin, Fentanyl, Prozac and other drugs that had been collected from Take-Back containers during the past six months were destroyed in a controlled burn conducted in April. Controlled burns of Take-Back drugs are conducted twice a year. This was the largest amount collected from the containers since the program started. More than 6.5 tons (13,158lbs.) of unused prescription drugs and over the counter medications have been collected and destroyed since the state’s Take Back program started in December of 2009. Currently, 35 pharmacies are participating in the Yellow Jug program, which launched earlier this year. An additional 40 pharmacies across the state are expected to be added to the program this month. Opiates have claimed 20 lives in Fargo during the past year, according to Fargo police. North Dakota had a significant increase statewide in overdose deaths. Heroin and opioid use have skyrocketed in the past year, with heroin and methamphetamine use growing by 400 and 438% over the past year in the Minot region alone. The Native American community has seen an almost 250% increase since 2010 in deaths from heroin overdose. Senate Democrats pleaded last week to restore funds cut from drug addiction treatment, but Republicans, facing a $310 million shortfall, cited the state’s bleak budget outlook and rejected amendments to increase the money. In 2014, 43 people in North Dakota died of drug overdoses, up from 20 people in 2013. It was the largest percent increase in drug overdose death in all 50 states, according to the CDC.

South Dakota

Happening Then Finance website Wallethub found South Dakota was second only to Nevada when it comes to gambling addiction, and the Rushmore State disputed that claim. An article in the Rapid City Journal said the state created nearly 2000 jobs and $300 million in preservation products from the lottery. Happening Now South Dakota is kicking off a campaign to remind South Dakotans that “Meth Changes Everything”. The campaign, led by the Department of Social Services (DSS), is geared at educating high school students and communities across the state on the dangers of meth use. The Circuit Court denied a request to place an initiated measure involving marijuana on the November 2016 general election ballot based upon an insufficient number of valid signatures. The Department of Social Services closed an adolescent inpatient chemical dependency program at the Human Services Center in Yankton and increased services for adults with chemical dependency needs. The department said it was due to a lack of demand for treatment beds for youth. Heroin arrests have gone up in the state this year. In all of 2015, .063 grams of heroin was confiscated in Pennington County. This year that number is already 5.3 grams. In Minnehaha County less than 9 grams was seized in 2015, but more than 70 grams have been seized already this year. Drug arrests in Rapid City are on pace to top last year’s record of more than 1300. 3.8% of high school students in the state report having tried meth. That is slightly higher than the national average of 3%. Approximately 15,000 South Dakotans age 12 and up were dependent on or used illicit drugs in 2015, including meth. In 2015, there were 2,125 meth-related arrests in 46 South Dakota counties. This is a 40% increase from meth-related arrests in 2014. A recent report from the Centers for Disease Control and Prevention found that farmers, lumberjacks and fishermen have the highest suicide rate than any other profession. Right now, South Dakota only has a rural helpline.


Happening Then According to a report last year, one out of every four children on the Pine Ridge Indian Reservation in the Cornhusker State were being born with fetal alcohol syndrome. That’s in comparison to an estimated one in every 100 nationally. The Centers for Disease Control and Prevention said about 3.3 million females in the U.S. between the ages of 15-44 were drinking and sexually active, but not using birth control to prevent pregnancy. The CDC recommended all women avoid alcohol unless they’re using contraceptives. Happening Now A new Nebraska Medicaid restriction that takes effect on October 1 will cap how many short-acting opiates can be prescribed to any one person per month at 150 pills – the equivalent of 5 a day. Statewide there are 1328 doctors prescribing more than 150 opiates for non-terminal illnesses to 1712 Nebraskans, according to the most recent survey of Medicaid prescriptions by the state Department of Health and Human Services. Health officials set the cap at 150 as a compromise, low enough to bring patients down to a safer level, but not so low to push them to heroin. Some doctors say weaning their patients down to 150 pills won’t be easy. This year the CDC issued physicians guidelines that included prescribing opioids as a last resort, looking for physical therapy alternatives, prescribing anti-inflammatory drugs, and prescribing lower doses. On January 1, Nebraska’s drug monitoring program launches, which will also cut down on overprescribing. It is one of the last states to put one in place. The 8th annual Maha Music Festival will center its focus on mental health awareness and resources, and will educate attendees on recognizing signs of mental illness and burying the stigma associated with it. This year the festival goers will band together in an effort to change the statistics August 20. Approximately 250 suicide prevention signs will go up in University of Nebraska-Lincoln parking garages. The city teamed up with the Lincoln Suicide Prevention Coalition to work on the effort last fall after a student died falling from a downtown garage.


Happening Then A legislative committee in Kansas tasked with combatting use in the KanCare system received much criticism after a voice vote passed. Care for Hepatitis C, which affects nearly 3 million people in the United States, with nearly 30,000 new cases each year, was decided to be contingent on people not drinking alcohol or going off of their medications. Happening Now Funding cuts to mental health services have caused layoffs at some of the state’s mental health centers after a $30 million hole in the state’s budget. It’s expected to result in a loss of 200 positions. In addition to the budget shortfall, many mental health centers in the state say they are having an extremely hard time getting paid by Medicaid for services offered to clients. During the past decade, hospitals have seen a drastic increase in the number of poison-related hospital visits, most due to prescription opioids. There were 454 suicide deaths in Kansas in 2014. The suicide death rate increased from 14.7 deaths per 100,000 in 2013 to 15.7 deaths per 100,000 in 2014. Males and females died from suicide at about the same average ages (around 46). Suicide remains the 2nd leading cause of death for the 15-44 age group in the state. It has fallen to the 4th leading cause of death for the 5-14 age group. It remains the 5th leading cause of death for the 45-64 age group. The suicide death rate in the state is up 6.6% from the 426 deaths in 2013. Almost ⅘ (78.6%) of suicide victims were male. The 2 age groups with the largest number of suicides were 45-54 (92 deaths) and 55-64 (76 deaths). The 3 most common methods of suicide were firearms (237 deaths), suffocation (123 deaths) and poisoning (65 deaths). Approximately one Kansan died by suicide each day in 2014. The average age of death by suicide was 46.8. It remains the 10th leading cause of death in Kansas and accounted for approximately 13,107 years of potential life lost in 2014. The May 2015 Kansas Health Statistics Report found there were nearly 4000 suicide deaths in the past decade.


Happening Then The Minnesota employment rate started the year strong by adding about 9000 jobs for the second month in a row, but that’s not all that was growing in the state. Authorities told us there had been an uptick in charges related to overdose deaths. Happening Now Records from the Minnesota Sentencing Guidelines Commission show that 23 offenders were sentenced for 3rd-degree murder in the past decade. ⅓ of those received probation for their conviction. Most of the cases surrounded drug dealers instead of drug users. The language of the statute enacted in 1987 that allows prosecutors in the state to go after drug dealers states that someone is guilty if they “proximately cause” a death, whether it’s on purpose or not.


Happening Then Iowa saw 762 drug overdose emergency room visits and 44 deaths from opioid overdose, compared with 36 in 2012 and 10 in 2005. 44 deaths is about 1.4 per 100,000. Happening Now The use of heroin and other opioids like Hydrocodone and Oxycodone has become a major problem in more rural parts of the state. While alcohol and marijuana remain the primary substances of use in Iowa, significant increases have been observed in the number of Iowans identifying heroin as their drug of choice. Iowa saw 636 admissions for treatment to heroin this year, compared to 186 in 2005. The state saw 1363 admissions for other opioids, compared to 422 in 2005. In 2005, Iowa had 2 heroin overdose deaths. Last year, they saw 19, and 33 from other opioids. Health care providers wrote 259 million prescriptions for opioid pain relievers in the United States, enough for every American adult to have a bottle of pills. Prescription opioid sales in the United States have increased by 300% since 1999, even though there has not been an overall change in the amount of pain we report. The United States accounts for nearly 100% of the Hydrocodone used globally and 81% of Oxycodone used. The Iowa Department of Public Health is funding select opioid treatment programs to provide medication-assisted treatment to Iowans in the form of methadone maintenance. In 2016, Governor Branstad signed Senate File 2218 and House File 2460 which increases availability for Naloxone for persons in a position to assist.


Happening Then The state ranked #1 in prescriptions sold in the Midwest. Happening Now Missouri is still the only state in our country without a prescription monitoring system. Prescription opioids are the fastest growing problem in the state. Between 2005-2014, hospitalization for opioid overdoses in Missouri increased by 137%. U.S. Senator Claire McCaskill, a Democrat, has requested an amendment in the new federal funds to help local governments within the state establish a prescription monitoring program. Missouri stands to get about $17 million of the $900 million allocations requested by President Obama.