The destructiveness of substance use disorders is visible every day in Minnesota. Babies are born having been substance exposed, families are being separated and communities endure the problems associated with substance use including violence, absenteeism, injury and crime.
The majority of substance use disorders in the state are related to excess alcohol usage with a rising second to methamphetamines. Opioids, including prescription opioids, are not too far behind.
Although treatment admissions for opioids come in fourth behind marijuana, they certainly are the deadliest if left untreated. With approximately only 10 percent of the state's constituents meeting the criteria for substance use disorder seeking treatment that leaves a lot of lives at risk to the opioid epidemic.
The opioid epidemic was ignited with the over-prescribing of prescriptions to treat pain that emerged in the 1990's and the inability to identify, engage and treat clients with evidence-based opioid addiction treatment. The full impact of these changes weren't fully recognized until the increase in deaths associated with opioid abuse emerged; from 1999 to 2015, the number of deaths involving opioid drugs quadrupled in the United States to over 30,000 in 2015.
In 2017, Minnesota providers wrote 41.0 opioid prescriptions for every 100 persons. The average U.S. rate in the same year was 58.7 prescriptions per 100 persons (per the CDC).
The age-adjusted rate of prescription opioid-involved deaths was 3.6 deaths per 100,000 persons in 2017. The age-adjusted rate of overdose deaths involving opioid prescriptions has not significantly changed since 2008.
In 2016, 395 Minnesotans died from opioid overdose, more than six times higher than the opioid overdose deaths in 2000. Prescription opioids account for the greatest number of overdose deaths in Minnesota, but since 2010, heroin and Fentanyl-involved deaths have increased in Minnesota. People addicted to prescription opiates all too frequently convert to heroin, because heroin in Minnesota is easily accessible, affordable and of very high quality.
In 2017, there were 422 overdose deaths involving opioids in Minnesota—a rate of 7.8 deaths per 100,000 persons compared to the average national rate of 14.6 deaths per 100,000 persons.
The greatest rise occurred among deaths involving synthetic opioids other than methadone (predominantly Fentanyl), with a nearly six-fold increase from 31 cases in 2011 to 184 cases in 2017.
Heroin-involved overdose deaths increased from 16 deaths in 2010 to 149 deaths in 2016 before decreasing in 2017 to 111 deaths. Prescription opioid-involved deaths have remained steady since 2008 with 195 cases of overdose deaths reported in 2017.
African Americans make up an estimated 5.8 percent of Minnesota populations, but they made up 10.1 percent of the treatment population for opioid abuse in state fiscal year 2015. In addition, the age-adjusted drug overdose mortality rate for African American/Blacks in Minnesota (per AAR: 20.5) is the sixth highest in the U.S. (among the 38 states for which data are available).
However, the age-adjusted disparity rate ratio of African Americans/Blacks relative to whites (per DRR: 2.0) ranks first in the U.S., meaning death due to drug poisoning was two times greater among African Americans/Blacks relative to Whites.
NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study revealed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births.
From 2010 to 2014, rates of NOWS more than doubled in Minnesota. Babies that are born with NOWS are more likely to be born preterm, have low birth weight and have inadequate or no prenatal care. It is important to remember that not all mothers of babies born with NOWS are diagnosed before birth as being dependent on opiates, not all pregnant women dependent on opiates give birth to a NOWS baby.
The most recent data on the rate of babies born with NAS/NOWS in Minnesota is from 2014 and is based on state inpatient databases. The rate of NAS/NOWS doubled from 2.1 cases per 1,000 hospital births in 2010 to 4.5 cases per 1,000 hospital births in 2014 (per the Healthcare Cost and Utilization Project).
Of the new HIV cases in 2016, 286 occurred in Minnesota. Among males, 13.0 percent of new HIV cases were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 6.3 percent of new HIV cases were attributed to opioid abuse.
In 2015, an estimated 7,803 persons were living with a diagnosed HIV infection in Minnesota—a rate of 171 cases per 100,000 persons. Of those, 13.8 percent of cases among males were attributed to opioid and prescription opioid abuse or male-to-male contact and opioid abuse. Among females, 14.2 percent were living with HIV attributed to opioid abuse.
There were approximately 51 new cases of acute HCV (0.9 per 100,000 persons) reported in Minnesota in 2016 according to the CDC. In Minnesota, there are an estimated 24,500 persons living with Hepatitis C (2013-2016 annual average), a rate of 590 cases per 100,000 persons. A large number of these cases were attributable to opioid and prescription opioid abuse.
The good news is that there are numerous centers of treatment and rehab available in Minnesota. There are many types of treatment centers such as long term addiction treatment facilities, short term drug abuse treatment, outpatient detoxification programs, outpatient substance abuse treatment services, inpatient drug abuse treatment and others.
There is a wide range of drug and alcohol rehab facilities available. They include individual psychotherapy, dialectical behavior therapy, couple/family therapy, trauma therapy, trauma-related counseling, cognitive/behavior therapy and others, to name a few. If you need rehab in Minnesota, all you need to do is place a call to any of the available rehab centers.
If you are addicted to alcohol or drugs, it is imperative that you look for professional help as soon as you possibly can. However, you might not know where to start or the options that are open to you. Similarly, you may have little to no idea about the differences between the different treatment facilities and the programs they have in store for their patients.
Do you need help finding the right drug or alcohol rehab facility in your area?
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