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Prescribing Coalition Event Tuesday, November 18, SCSU Atwood Center

Fall Meeting of Stearns Benton Medical Society to Offer Hands-On, Direct Opioid/Controlled Substance Prescribing Training. MMA President and President-Elect Also Presenting.

Stearns Benton Medical Society invites members, medical professionals, Prescribing Coalition participants and interested community members to attend our Fall Meeting on Tuesday, November 18, 2014 at 5:30 PM in the Voyageur’s Room of the Atwood Center on the campus of St Cloud State University.  We thank our St. Cloud State Health Services Coalition partners for hosting this event.  We are combining the Medical Society’s annual meeting with a detailed presentation by internist and addiction expert, Dr. Charles Reznikoff of Hennepin County Medical Center.  His presentation will lead us with a detailed course on best practice opioid and controlled substance prescribing.  We would like this course to be the framework for a packaged voluntary certification/renewal course that would be offered regularly in our area and maybe throughout Minnesota for medical professionals involved in the prescribing process for opioids and controlled substances.  This would be similar to CPR or ACLS certifications and re-certifications, but voluntary.  It would change as needed similar to the other certification courses.  It would be for CME credit certified by the MMA.  Our community’s existing prescribing professionals would find this training helpful and supportive toward improving the quality and experience of this increasingly difficult part of medical practice.  Pharmacists and their colleagues would likely see benefits in standardizing our community’s prescribing process.  Medical groups and clinics might want to offer incentives for their prescribing medical professionals to maintain their controlled substance prescribing skills with this course and would likely see the benefit of having all their newly hired medical professionals taking the course initially and periodically after signing on to work there.  Dr Reznikoff’s presentation will serve as a foundation for us to build on for the full-length course that we will eventually develop.

We will also ask MMA President-Elect and family physician, Dr. Dave Thorson to present briefly on the role of primary care in controlled substance prescribing.  Dr. Thorson chaired the ICSI task force on Opioid prescribing that developed the guidelines referenced earlier in this blog.

We are also honored to have the current MMA President, Dr. Don Jacobs attending our meeting and hope that he can share in the conversation and offer some Minnesota Medical Association and state-wide perspective comments.

We want this event to be fun as well as informative. We have invited several other medical professionals and interested community members to attend to broaden the scope of our community health initiative for this year on Medication Safety.  Several have already contributed their participation to our unused medication drop-off events and Prescribing Coalition meeting conversations.  Please RSVP to Mandy at 320-252-8550. Call Pat Zook at 320-492-8207 for questions or comments.

35 Professionals and Community Activists Attend 3rd Meeting of The CM Prescribing Coalition

Stearns Benton Medical Society and the CM Circle of Health Host St Cloud Public Library Meeting, August 18, 2014

20140818_182131

35 concerned doctors, nurses, pharmacists, social workers, teachers, counselors, administrators, public health workers and other concerned citizens engaged in lively conversation regarding our effort to improve the state of controlled substance prescribing in our medical community.  A rough first draft of a community-wide controlled substance prescribing Policy was presented for consideration as a starting point (see previous posting below).  We discussed several concerns with the current state of affairs especially for opioid prescribing, but we will try to come up with a community prescribing Policy that will cover prescriptions for any controlled substance.  We discussed medication treatment agreements, patient prescription risk assessment, use of opioids for chronic pain, alternative modalities to treat pain and the availability of ancillary services and their insurance coverage among other issues.

Kim Tjaden agreed to begin researching to produce a complete listing of all alternative pain treatment modalities, their providers and contact info.  John Sebas  will research the ICSI policies on treatment of acute and chronic pain developed by their task forces in the past few years.  He will also research the 60-page Minnesota Substance Abuse Strategy. Abby Frericks and Matt Peckskamp will do some data research at the hospital and through County and State resources to get a handle on what measurable data there is to determine whether our campaign and Prescribing Coalition efforts are effective over the next 2 years.  This week I spoke with Dr Howard Epstein of ICSI who chaired their task force for the ICSI Acute Pain Treatment Protocol.  He is interested in what we are doing and is willing to advise us as we proceed.  He said that we can produce their protocols or guidelines in any of our posts or documents as long as we properly reference them as the source.

We will need volunteers to develop a 2 and 4-hour CME course for teaching proper controlled substance best practices.  Please call Pat Zook (320-492-8207) to volunteer.  We hope our experts in addiction medicine, pain management and ER work can help out with this.  We hope to offer this course as a recurrent certification training and update opportunity like taking the CPR and ACLS courses that we do now.  We will see if MMIC would be interested in offering malpractice premium discounts to individuals or clinics that achieve continuous or high-percentage levels of certification. Many other states have made mandatory CME in controlled substance prescribing a requirement for licensure and renewal.  We hope it doesn’t come to this in Minnesota.

We will have our next meeting within the next month.  Please watch for e-mail and blog notices for this and see if you can bring another colleague or two along.  Please RSVP to Mandy for all meetings at 320-252-8550.

Seniors Respond to Circle of Health Drug Drop-off Event August 16, 2014 in St. Cloud

Whitney Senior Health Expo a Hit with Seniors in Central Minnesota:

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Last Saturday morning the Central Minnesota’s health-conscious seniors flocked to the River’s Edge Convention Center for another popular Whitney Senior Health Expo.  The Circle of Health volunteers and Stearns Deputy Zwack collected 90 pounds of unneeded medications of all types from vitamins to narcotics.  Our “Medication Safety Station was very popular as we gave out about 450 free 7-day pill boxes and all 200 blank wallet medication lists.  We distributed all 200 lists that we had showing the 7 permanent medication drop-off sites at law enforcement centers in Stearns and Benton Counties.  We had hundreds of encounters with curious seniors and their family members eager to learn more about “Medication Safety” – this year’s public health campaign issue for the Central Minnesota Circle of Health.  People actually went home to get their meds to drop-off and returned before we closed to take the opportunity to safely dispose of their unneeded pills and potions.  We will be at the SummertimebyGeorge! festival in St Cloud tonight, August 20 offering another drug drop-off opportunity.  Please join us at the Medication Safety Station near the Rotary booth. 

Posters files now available at Fedex/kinko’s in St Cloud for Medication Safety

You can all St. Cloud FedEx/Kinko’s to have them print copies in any size you want including small cards, posters and banners for any of our Medication Safety Campaign posters.  They will expect you to pay for them when you pick them up.  The store is on the Northeast corner of Division and 25th Ave, across from Walgreen’s at 25th.  It is right next to Caribou.  Call them at 320-203-1013 and ask for printing from Pat Zook’s file.  They will answer as FedEx, but they really do both FedEx and Kinko’s. Clicking on any of these links below should take you to a master Adobe file for each.  If you can print them yourself, please do, and post them wherever you can for patients to see.

stow meds poster card

dont do poster card

dump meds poster card

know meds poster card_edited-1

List of Opioid Prescribing Guideline Out There for Review

Consider using one of these already-published guidelines as a model for your own or for your Clinic. Certainly there are plenty of others that may be just as good or better, but finding one that seems most workable for your practice, then fine tuning it makes the most sense.

Opioid and Controlled Substance Prescribing Guidelines:

The Journal of Pain Volume 10, Issue 2 , Pages 113-130.e22, February 2009

Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Non-cancer Pain

http://www.jpain.org/article/S1526-5900(08)00831-6/fulltext

 

Federal Guidelines for Opioid Treatment

Over 100 pages with several particular situations covered, but this draft is mostly for opioid treatment program certification, but the information is helpful

http://www.dpt.samhsa.gov/pdf/FederalGuidelinesforOpioidTreatment5-6-2013revisiondraft_508.pdf

 

Use of Opioids for the Treatment of Chronic Pain – A statement from the American Academy of Pain Medicine.

Not a guidelines but a very good summary of what guidelines should cover

http://www.painmed.org/files/use-of-opioids-for-the-treatment-of-chronic-pain.pdf

 

The American Academy of Pain Medicine’s chronic, non-cancer pain guideline

http://www.dir.ca.gov/dwc/DWCPropRegs/MTUS_Regulations/MTUS_ChronicPainMedicalTreatmentGuidelines.pdf

  

American Chronic Pain Association, Inc.

Very extensive and inclusive document of over 100 pages – (2013)

http://www.theacpa.org/uploads/ACPA_Resource_Guide_2013_Final_011313.pdf

 

Institute for Clinical Systems Improvement (ICSI).  Health Care Guideline.  Assessment and management of Chronic Pain.

Over 100 pages of current and extensive information.  (2013)

https://www.icsi.org/_asset/bw798b/chronicpain.pdf

 

Veterans Administartion /DoD CLINICAL PRACTICE GUIDELINE FOR MANAGEMENT OF OPIOID THERAPY FOR CHRONIC PAIN

160 pages used by VAH.  (2010)

http://www.healthquality.va.gov/guidelines/Pain/cot/COT_312_Full-er.pdf

 

Practice Guidelines for Chronic Pain Management: An Updated Report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine

Pain management from an anesthesiologist viewpoint

http://journals.lww.com/anesthesiology/fulltext/2010/04000/practice_guidelines_for_chronic_pain_management_.13.aspx

Please Post This List of Permanent Law Enforcement Drop-off Sites for Unused Medications

Please post this list of permanent drop-off sites for Stearns and Benton Counties wherever patients might find it useful.

Stearns and Benton County Permanent unused drug drop-off sites Law enforcement office locations

 Stearns County:

1) Stearns County Law Enforcement Center

http://www.co.stearns.mn.us/LawPublicSafety/SheriffServices/PublicSafety/MedicationDropBox

807 Courthouse Square, St. Cloud, MN 56303 Monday – Friday, 8:00AM – 4:30PM, Call 320-259-3700

2) Waite Park Police Department

http://www.ci.waitepark.mn.us/index.asp?Type=B_BASIC&SEC=%7B3FBCF595-36DE-494A-8262-D6CD7E9D7160%7D

19 13th Ave N, Waite Park MN 56387 Monday – Friday, 7:30AM – 4:30PM, Call 320-251-3281

3) Sartell Police Department

http://www.sartellmn.com/police-department

310 2nd St S, Sartell, MN 56377 Monday – Friday, 7:30AM – 6:00PM, Call 320-251-8186

4) Melrose Police Department

http://www.cityofmelrose.com/index.asp?SEC=25D69E90-1EBF-4209-9157-38FC8A55B03D&Type=B_BASIC

225 1st Street NE, Melrose, MN 56352 Monday – Friday, 8:00AM – 4:30PM, Call 320-256-7211

 

5) Paynesville Police Department

http://www.paynesvillemn.com/

221 Washburne Avenue, Paynesville, MN 56362 Monday – Friday, 8:30AM – 4:30PM, Call 320-243-3714

Benton County:

1) Foley, Minnesota.  The Benton County Sheriff’s office

http://www.co.benton.mn.us/County_Sheriff/Drug_Disposal.php

The Benton County Sheriff’s Office has a medication disposal site located in their main lobby at 581 Highway 23, Foley, MN 56329.

8:00 AM – 4:30 PM, Monday-Friday. Call at 320-968-5000

2) The Sauk Rapids Police Department.

http://www.ci.sauk-rapids.mn.us/index.asp?Type=B_BASIC&SEC={EC1F1FCD-29CC-46D8-B1AC-19CFD4D4CB7F}

The Sauk Rapids Police Department is located at the Sauk Rapids Government Center (250 Summit Ave. N, Sauk Rapids,  MN 56379)

8:00 AM – 4:30 PM, Monday – Friday. Call 320-251-9451