mortiz095

Last November, the CDC issued a report detailing the rise of prescriptions for opioid (narcotic) pain killers such as oxycodone (Percocet, Oxycontin), hydrocodone (Vicodin, Norco), methadone, morphine (MS Contin), fentanyl patches (Duragesic), and others, from 1999-2008. As expected, prescriptions for these medications have increased pretty dramatically. Here's the chart from that report, showing sales of opioid pain relievers (OPR), admission for addiction treatment related to OPR and OPR deaths per 100,000 persons. Basically, sales more than tripled, treatment admission quadrupled and deaths almost tripled. Since 2008, these trends have continued if not accelerated. In Minnesota for instance treatment admissions for opioid addiction are now greater than that for cocaine, methamphetamine, cannabis or other non-alcohol drugs. (Alcohol of course, continues to be the elephant in the room, with all indicators much higher than all other drugs combined.) However, the rates for these i...

I appreciate readers of my blog, especially those who comment. This kind of dialogue is important and informative. However, I have some suggestions if you wish to leave a comment. I have received several comments with personal information in the comment itself. All comments are moderated, so I don't publish these, at least not as is. Sometimes I will go to the trouble of inserting into a post excerpts that delete any personal information, but it is much easier if you don't put it there in the first place. If you want to contact me directly, send me an email at DrWillenbring@gmail.com. Even then, remember that email is not secure, so I discourage highly personal information in emails as well. Although the risk of the email being interrupted is small, information about substance use can be very destructive if it did fall into the wrong hands. If you wish to make an appointment to see me, call my office number at +1-612-276-2055. My current practice is cash (or credit card) only, ...

Last weekend I was on call for psychiatry at United, the hospital in St. Paul that I work for. It's been a moderately busy weekend for me, but not because there isn't any more demand for services, but because our inpatient beds are full. And guess what? So are the inpatient psychiatry beds not only throughout the Twin Cities Metro Area, but also the entire state! Halfway through the weekend we sent a patient to the last open adolescent psychiatry bed in Fargo, ND! So there are two patients this weekend who have had to stay in the emergency department, because there is no place to admit them. I continue to be amazed that I live in a country that would send its mentally ill children hundreds of miles away from their families because it's not willing to pay for the services they need locally. And as usual, among the patients newly hospitalized whom I saw, about half were addicted to a psychoactive substance, usually alcohol. This is also typical. Now that I'm cutting back ...

After two years, it finally feels like things are coming together. Allina Health continues to be a great place to try out new ideas for addressing alcohol and pain, across hospitals and clinics. I've been able to recruit up to three primary care clinics in the SBIRT+ project, which is focused on addressing alcohol in primary care. (SBIRT+ stands for Screening, Brief Intervention and Referral to Treatment, Plus Point of Service Care. Point of service care reflects treatment for alcohol dependence (not just at-risk drinking) in primary care. The NIAAA Clinician's Guide uses this model.) Allina is also developing a collaborative care model at a pilot clinic and I expect to be involved in that effort, which is focused on coordination of care and reduction in preventable hospitalization for patients with complex chronic illnesses. Heavy drinking is common among people with chronic diseases who demonstrate high cost and poor outcomes. To reach the goals of reducing costs and improvin...