Tag: Addiction

Rural Recovery Resources

Mental illness and addiction are big issues everywhere — but especially in rural areas like Osceola, Wisconsin, that lack local treatment resources. As my partner, Nicole Smith, M.D., said well, “What we lack at Osceola, is we don’t have integrated behavioral health, we don’t have therapists on staff. For better or for worse, Osceola doesn’t have mental health beds.”

All of that is about to change!

Exist Media Company — Lakeland, Minn.

Osceola Medical Center (OMC), a rural health clinic and critical access hospital, has committed to rapidly creating local services for mental illness and addiction. The Osceola Community Health Foundation (OCHF) recently raised $61,000 at its annual gala to launch an integrated behavioral health program. And OMC’s board of directors just prioritized creating “psych safe” hospital beds so we can stop boarding patients in the emergency department and transferring them far from home.

“We want to be known as the people who show up in the best and worst of times for our patients and their families,” said Kelly Macken-Marble, OMC’s chief executive officer.

Many thanks to Jill Leahy, Director of the OCHF; Exist Media Company; and countless others for imaging a better future for our community. ✸

The Books Before the Big Book

About 20 years ago, I ran across this in an essay by C.S. Lewis:

Every age has its own outlook. It is specially good at seeing certain truths and specially liable to make certain mistakes. We all, therefore, need the books that will correct the characteristic mistakes of our own period. And that means the old books.*

Photo Credit: PBA Galleries

Lewis argued, “I do not wish the ordinary reader to read no modern books. But if he must read only the new or only the old, I would advise him to read the old.” He also offered this suggestion: “It is a good rule, after reading a new book, never to allow yourself another new one till you have read an old one in between.”

My reading habits immediately changed. I started reading old books—in many cases, very old books.

And so it is that we will be considering Richard R. Peabody’s The Common Sense of Drinking, which was published in 1931, at an upcoming residential recovery retreat at Hazelden Betty Ford’s Dan Anderson Renewal Center. The book contains ideas and phrases that were later popularized by Alcoholics Anonymous such as “once a drunkard always a drunkard” and “halfway measures are of no avail.”†

Many thanks to Kim Albers and Peg Schroeder for inviting me back!

* C.S. Lewis. Undeceptions. London: Geoffrey Bles, 1971, p. 161–166.
† The first edition of the Big Book appeared in 1939.

Doubleheader

The Twins were eliminated by the Astros yesterday, however, it’s still baseball season! In that spirit, I’m “pitching” a split doubleheader today in two different ballparks through the wonders of Zoom.

The first presentation is for the Minnesota Sheriff’s Association at its Correction Care Division’s Annual Conference. The subject is identification and management of substance withdrawal syndromes (I’m the medical director for two county jails).

CentraCare Health; St. Cloud, Minn.

The second outing is for CentraCare Health at its Opioid and Controlled Substances Prescribing Training. I’m the middle reliever in a line-up that includes Drs. Michael Massey (pain medicine) and Lynn McFarling (medical informatics). The two-hour event is designed to fulfill Minnesota’s new(ish) legislative mandate for provider education. My contribution deals with unhealthy substance use with special attention to patients with chronic pain syndromes.

CentraCare Health; St. Cloud, Minn.

Just click on the above images or hyperlinked text to access my PowerPoints. ✸

Telehealth Addiction Care

There is currently considerable interest in telehealth addiction care. Allina Health began offering it in February 2019 to address geographic voids in greater Minnesota. We were thus well-positioned for virtual care when the Covid-19 pandemic occurred about a year later.

Jeff Wagner interviewed me on WCCO Television on September 12th about our work at Allina. Please see here and here for previous media appearances.

WCCO Television

Many thanks to Sarah Jackson with Media Minefield for her partnership on this timely and important subject! ✸

Telehealth Addiction Care

Leah Beno interviewed me on KMSP Television yesterday morning about telehealth addiction care. Please see here and here for the context.

KMSP Television

Many thanks to Sarah Jackson with Media Minefield for her partnership on this timely and important subject! ✸

Telehealth Addiction Care

Mike Max interviewed me on WCCO Radio this morning about telehealth addiction care. Allina Health’s work that began at New Ulm Medical Center was the context

WCCO Radio

Here are some of my source documents

Many thanks to Sarah Jackson with Media Minefield for her partnership on this timely and important subject! ✸

Pain & Addiction: Common Threads

On November 1st, I’ll be presenting on the messy intersection between opioid addiction, chronic pain syndromes and other mental disorders. Please click here or on the image below for a full-sized PDF of the conference announcement.

You can register for the event here.

I’m still messing with my slides, however, my presentation will be a “new and (very much) improved” version of material that I’ve delivered to other audiences (for example, here and here)

Many thanks to Taylor Gilard, Susan Gordon, the University of Minnesota’s School of Nursing and Allina Health for involving me in the event.

—
Update: Here’s my PowerPoint.

—
Update: I’ve given this presentation a few times now. Here’s a link to a recorded webinar

Suboxone Treatment in Jail

The Saint Cloud Times recently featured CentraCare Health’s correctional care (“jail medicine”) program. This unique public-private partnership is designed to identify and treat mental illness and addiction while inmates are in custody. We then link them to a special clinic following release to the community for ongoing management. (I serve as the medical director for the program.)

Captain Mark Maslonkowski. Photo: Jason Wachter

We launched in the Benton County Jail on October 1st, 2017, and in the Stearns County Jail on January 1st, 2o18. As outlined in the article, the early signals are promising: fewer ambulance trips between the jail and hospital, fewer detox admissions and decreased total cost of care.

As far as we know, we’re the only Minnesota counties starting inmates on Suboxone, the medication to treat opioid addiction, while in custody. And, one needs to look far and wide to find other examples nationally.

Our ever-growing provider team includes:

Providers see inmates in jail and following release to the community. This continuity of care is unprecedented. Health authorities (a statutory term) have historically focused on inmates’ immediate medical needs in jail without regard for the bigger picture. This penny-wise but pound-foolish approach doesn’t resolve some big reasons—mental illness and addiction— for criminal recidivism. Thus the revolving door.

Special thanks to my partners in crime (sorry! couldn’t stop myself):

  • Captain Susan Johnson (Benton)
  • Katy Kirchner, director
  • Captain Mark Maslonkowski (Stearns)
  • Kenzie Moehle, supervisor
  • Heather Qunell, manager

Sunday Sermon

Well, not exactly. They didn’t let me get anywhere near the pulpit!

I did, however, speak at Gustavus Adolphus Lutheran Church for its weekly Table Talk series (the title is a nod to Luther). Last week, I presented on addiction. Today, I held forth on Rational Emotive Behavior Therapy (REBT), which is a way to reduce emotional disturbances by thinking more clearly.

My “text” for last week was Romans 7:15. I also wandered through DSM-5 and Doug Sellman’s “Top 10” on my way to Gerald May’s brilliant conceptualization. I didn’t have a text today, however, “renew your mind” would have been apt.

Many thanks to Dr. Arland Hultgren  (see, also, Amazon) for inviting me to visit such a wonderful parish. And also Rev. Tim Nelson for connecting us.

P.S. I’m a PK (pastor’s kid) and so far have avoided seminary myself. But I wound up in the “belief business” anyway. §