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Rural Minnesota is facing its own drug crisis



"I make sure there is a sharps container, test strips from Narcan, (fentanyl), HIV information," said Buying Later.

Born in Duluth, raised in Claude and a veteran of the social asset in Minneapolis, Purchase launches a delivery service that plays a unique role in the fight against drug overdoses and death in rural areas of the northern country.

This is a difficult struggle where there are no resources in the metropolitan areas.

"It's hard to make a decision about looking for care," says Debra Wemsley, a behavioral health specialist at college at the University of Minnesota. Continuing and professional research.

"Then, when you have external barriers that exist, whether it is a distance, lack of access, lack of treatment facilities, a lack of choice for the types of treatments that one can seek, this makes it even more difficult for people get the care they need. And in the end, yes, it leads to overdoses and death. "

Those involved in the struggle in the north of Minnesota point out profits when it comes to situations of life or death. Narcan (aka naloxone), a used drug to turn opiate overdoses, saves the lives of rural areas and cities, they say. Carlton Lake County Sheriff mentions 12 overdoses to which her lawmakers have been dealt with since 2017. In six people, the victim has been revived since the deputies arrived and were taken to an ambulance in a hospital. The other six MPs ruled Narcan. "I believe Narcan has definitely saved them in these cases," wrote Lake in an email.

But less help in rural areas to tackle the underlying problem, according to Adam Shadiow, CEO of the Arrowhead EMS Association, which represents the first respondents in the northeast of Minnesota.

"We need to extend programs to help people get out of the cycle of addiction to these drugs," he wrote in an email. "There is an instrument to help people who respond to the first reactions to overturn opioid overdose after it has occurred but there is little help for the person being overstated after they have been treated and released."

  Sue Purchase explains that it keeps a sharps container, mini-containers for sharp objects to give people strips of narcans and fentanyl to supply people in rural areas.

Sue's purchase explains that she keeps a sharps container, small sharps containers to give people narcotics and fentanyl to supply people in rural areas. "Public health is for everyone," said Purchase. Tyran Schank / tschank@duluthnews.com

Limited treatment options

Although it may seem illogical, treatment with medication – the use of drugs to combat drug addiction – is recommended along with counseling and behavioral therapy for abuse of Substances Managing Mental Health Services

In Minnesota, 12 of the 16 drug delivery providers are located in the seven district districts of Twin Cities, Wamsley said. One of the other four is in Duluth, the Alcohol and Drug Treatment Center. Only such providers can release methadone, an opioid that is used in controlled doses to control appetite for other opioids. This means people on the other side of Arrowhead and Iron Range looking for methadone treatment should travel to Duluth. And not just from time to time.

"Because this is so strictly regulated, patients usually have to visit the daily methadone clinic for their daily dose," says Colin Planal, senior research fellow at the State Center for Supporting Access to Health Services, which is linked to the University of Minnesota

"So access is limited to people in rural areas unless … they are able to manage long distances to get their daily dose of methadone," Plonalp said. "And it makes it hard to just keep your everyday life, keep things, stuff like that."

There are other ways to treat medicines, each with its own barriers, he said. Unlike methadone, buprenorphine may be prescribed by your doctor – if he or she has been refused by the federal government to do so. "And they can take the medicine home with them and take their daily dose, so in some cases they do not have to drive millions and miles to the methadone clinic," Plonalp said. "(But) there is a shortage of healthcare providers who have these buprenorphine prescriptions. And this particularly affects rural areas. "Finally, there is naltrexone (aka Vivitrol), which, unlike methadone and buprenorphine, is not an opioid, but an" antagonist "that blocks opioid receptors in the brain. Doctors do not need to be released to prescribe naltrexone, Plonalp says, but many refuse to do so because they do not feel they have the necessary training.

Again, this is especially true in rural areas. In the metropolitan areas, the doctor can consult patients or refer them to addiction specialists, he said. "But in rural areas where primary care providers know that they do not necessarily have access to these same professionals in their region, this may contribute to their hesitation to go down this path of prescribing naltrexone."

  Sue Purchase has a sharps container (left) designed to keep clean needles on one side and uses needles in another compartment and fentanyl test strips (right). Tyler Schank / tschank@duluthnews.com

Sue Purchase has a sharps container (left) designed to keep clean needles on one side and uses needles in another compartment and fentanyl test strips (right). Tyler Schank / tschank@duluthnews.com

Although the heroin and other opioids can be considered as urban phenomena, the number of opiate deaths increases at greater speed in the greater Minnesota than in The mountain area of ​​the Bliznatsi subway, Plonalp said. Between 2000 and 2017, opiate deaths increased five and a half times in twin cities; in the greater Minnesota deaths have increased by about 12 times.

Meanwhile, methamphetamine, a drug that is particularly identified with rural America, has returned to a new form.

"The met you see now is not the home lab material we saw 10-15 years ago," said Lieutenant Jeff Casel, commander of the Special Drug and Violence Group. – It's pretty dry. When they implemented the changes in the law, it really did a good job of drying these labs.

"The Mexican cartels took advantage of this. They flooded the market. There is a lot of methamphetamine. "In rural America, methamphetamine has never left," says Mark Kondoyiani, director of Colorado's treatment and recovery of behavioral health.

Maybe it is more deadly than before

"Now he is rising again. It is increasing. This will be different because it will involve higher mortality. We already see it. "

The reason, Kondoyian told a group of journalists in Denver last month: Without knowing the consumers, some of today's methane are covered with fentanyl, an extremely powerful opioid who is also blamed for death when added to other opioids heroin

"And I do not know this is a deliberate process on the part of drug dealers or if they are unhygienic practices," he said. "A grain of fentanyl on your scales while measuring different products can be fatal. So we do not know – we just know that the supply of drugs is already tarnished. American Centers for Disease Control and Prevention report that in 2016, 11% of overdose deaths including meth also include fentanyl. (Most, 22% related to heroin.)

Caselle had no reports of fentanyl methane in northeastern Minnesota, he said. But he is aware of this scenario.

"You do not know what you're going down the street," he said. "There may be someone who says it's a heroin bag, and it turns out to be pure fentanyl … Buying a street is a crack."

This is not what consumers perceive, however, says Marcia Gurno, about substance abuse. Prevention and Intervention Team for Public Health and Human Services in St. Louis County. "They will tell us, adults and children," I trust my dealer. "The CDC report showed that methamphetamine was the eighth drug among the overdose deaths in 2011 with 1887. Met remains the eighth in 2012, then climbs to seventh in 2013 and 2014, fifth through 2015 and fourth in 2016 (behind fentanyl, heroin and cocaine) by 6,762 deaths – an increase of more than 250% in 2011. The volume of meth seems to be high, the US Drug Enforcement Agency reported last week, that its division Omaha has reported a 31% increase in seizures of methamphetamine in the first half of 2019. Total for the division, which includes Minnesota, Iowa, Nebraska, North and South Dakota, is about 1437 pounds or a metric

Fighting

Fighting drug overdoses in rural areas is a multifaceted effort involving law enforcement agencies, social services agencies , Religious Organizations, Public Health, Medical Staff … and Purchase of Sue

After working on the front line for anti-drug addiction in Minneapolis for more than 20 years, the purchase returned to Northland a year ago, "wanting to arrest the gaps that I've always known that they exist now especially for people who are poor and use drugs.

A part-time purchase at the Rural AIDS Network in Duluth and Virginia takes the exchange of the agency's needle on the road with what she calls Sisters for harm reduction. Reducing harm is the idea behind the needle exchange. The thought is that people who decide to shoot drugs will have the opportunity to do it in a sanitary way.

But the Purchase knew that some people could not easily get to Ryan's shop on Duluth's First Street or Virginia's satellite office. That's why in May she began mobile needle exchange by bringing her syringes and other harm reduction tools. During that time she has given 10 000 syringes, said Purchase last week.

"These are all donations," the Purchase said. – I'm not funded.

Not just syringes, but other supplies such as Narcane and tapes that can tell the user if any fentanyl is in the medicine to be consumed.

She

The buyer's visit last week was for a household that has seen an overdose "over and over again," she said. "It was the best experience," said Buyer. "We managed to hold an incredible conversation. (The host) talks about how he wants to get to Duluth, but he can not because he did not have a car. "

  Sue Buyer contact information is seen on her card. Tyler Schank / tschank@duluthnews.com

Sue Purchase contact information as shown on your business card. Tyler Schank / tschank@duluthnews.com

To get help

  • Call the opiates hotline at 218-730-4009.

  • To reach the harm reduction nurses, text or call Sue Purchase at 218-206-6482. 19659054]
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