Local healthcare professionals offer help for those with opioid dependence

On the evening of Monday, Oct. 21, more than 40 community members convened at the Community Ambulance Service with one common goal: to initiate a community-wide discussion on opioid use.

"The Transcript" is now bringing that discussion to the page, so that readers can be aware of the risks associated with opioid use as well as options to decrease opioid dependency.

Opioids are substances derived from the opium poppy, a plant long known for its abilities to diminish the body's perception of pain. If you've suffered a serious injury or recovered from major surgery, you were likely prescribed opioid medications such as hydrocodone or oxycodone. If you took these medications, you might have found their effects quite pleasing. Beyond the pain relief, you likely experienced a calm and euphoric rest in your recliner, not giving a second thought about the risks of taking the medications as prescribed.

These medications also have an impact on other systems of the body. They are known for altering mood, slowing breathing and causing constipation. The highly addictive nature of opioids is made worse by the tolerance an opioid user will develop over time. Opioid users report to no longer feeling the euphoric high they once enjoyed. Instead they use the drug to try to find a sense of normalcy. Eventually, opioid users may find themselves taking upwards of eight pills a day, just to feel like they can perform basic daily functions.

For long term users, the risk of overdose is a cause for concern. Due to their effect on the part of the brain which regulates breathing, opioids in high doses can cause shallow breathing, clammy skin, convulsions, coma and death. By increasing doses or combining medications, users could easily become another statistic.

In North Dakota, overdose deaths increased from 20 deaths in 2013 to 61 deaths in 2015. This state isn't the only one on the rise. In 2016, there were an estimated 63,632 deaths in the United States due to drug overdose, a 21% increase from previous years.

According to Shane Wendel of Central Pharmacy, "We have an opioid consumption problem. The United States alone, 4.5% of the world's population, is responsible for consuming 80% of the world's opioids."

It is a problem that began in the mid-90s when doctors, pharmacists and other health care professionals were trained to assess and treat pain symptoms. Perhaps you have seen the pain chart in which a patient chooses what scale their pain is at. "The idea was to get ahead of the pain, to prevent patients from moving from a level five in pain to an eight."

Prescription opioids were the key to addressing patient pain, but they also contributed to a growing trend. The National Institute on Drug Abuse reports that 2017, North Dakota providers wrote 41.5 opioid prescriptions for every 100 persons. Now that medicine is shifting away from prescription opioids, it leaves a population of people dependent and at risk.

Wendel thought hard about the problem and various solutions before approaching Dr. Michael Page of CHI St. Alexius Carrington with an idea to open a clinic for those with opioid dependency. "The community needs this," he recalls telling Dr. Page, "and they need us to do it."

Central Clinic opened in June, making it the fifth opioid clinic in the state. "The goal is to help users return to life." says provider Dr. Michael Page. In the short amount of time that Central Clinic has been open, it has helped people do just that.

Registered nurse Terah Weisenburger serves as the point of contact for patients and helps see them through their treatment. Weisenburger explained that she likes to understand each patient's motivation for addressing their dependency so that she can help them keep perspective when things get tough.

Quitting opioids is no easy task. Withdrawals deliver agitation, aches, rapid heart beat, fever, runny nose, chill bumps, shivers, and trembles. Not to mention unpleasant gastrointestinal symptoms as well. It is part of Weisenburger's job to remind them, "It will get better from here."

Patients are prescribed suboxone, which will ease withdrawal symptoms and eliminate cravings. Suboxone is then used to replace the opioid and managed over time. This medication offers its users no high, meaning there is less potential for abuse. Even more, it negates the high from other opioids.

Weisenburger also works with patients to develop a plan for mental health, including addiction counseling and other components of recovery, including group therapy, practicing healthy habits and learning to cope with difficult situations. If needed, the clinic can provide referrals for inpatient programs in Bismarck and Fargo.

Central Clinic is authorized to administer medication-assisted treatment to up to 30 patients in this first year. In future years, Dr. Page can apply to see up to 100 patients annually. Space is still available for new patients this year.

No referral is needed and treatments are covered by most insurances or Medicaid, but may require pre-authorization.

Contact Central Clinic at (701) 652-2651.