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Home / Health / Rewiring the Brain: North Iowa Physicians Work to Break Up Opioid Silos Mason City & North Iowa

Rewiring the Brain: North Iowa Physicians Work to Break Up Opioid Silos Mason City & North Iowa



One of the best known drug abuse treatment facilities in Northern Iowa, Prairie Ridge, Mason City, has been in operation for more than four decades.

And executive director Jay Hansen and associate director Lorrie Young, two of the local leaders,

Both Hansen and Young have said that alcohol is the main drug dependency that is still treated in Prairie Ridge – about half of all Shots Are Alcoholic – Opioids Are Increasing

Although only 6 percent of all their images are related to these drugs, Young emphasized that opioids and heroin kill anyone who quickly abuses them, regardless of their background, financial status, or reputation in the community. 1

9659003] "In my first 30 years (medical) practice, I've never seen heroin before," said Young. "And now it's rare that we do not see anyone in our heroin-dependent housing program, it's much more common."

Young, Hansen, and other local medical officials pointed to a lack of resources and the role of stigma, among others Factors as reasons why the opioid crisis in North Iowa was difficult to combat.

It is crucial to remove these barriers to stigmatization and to help those who are addicted to the help they need, officials said. But this mentality can not only come from treatment centers, she added, it must be a collaborative effort between law enforcement, the medical field, state legislators and the public.


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  Lorrie Young

Lorrie Young

Penetrating Stigma

Jay Hansen has worked almost all his life in the medical field and addiction treatment. He has been in Prairie Ridge since 1974 and became its Managing Director in 1980.

Since he started, a lot has changed – which drugs were an issue, the public's view of the addiction and the treatment options available – but one of the main problems he still experiences is the stigma that exists with different ones Types of substance abuse is associated.

"I would say stigma is just pervasive and pounded into our culture," said Hansen. "The extent to which we prosecute drug-related policies in our society is an indication of the size of the stigma, and as we pump billions of dollars into law enforcement, we try to punish people for a health problem. "

Stigma also becomes a significant problem when it affects people before they become adults, some argue.

Shanda Hansen and dr. Amanda Boeke are two who have this belief. They work at Francis Lauer Youth Services, right on the street of Prairie Ridge.

Iowa substance abuse treatment shots

This chart shows the number of shots in substance abuse treatment facilities across Iowa. Overall, it indicates approval for all types of drugs. The data comes from the drug abuse and psychiatry administration.

Year Heroin Other Opiates / Opioids Total
2014 637 1.383 28.485 19659027] 2015 876 1.445 19659024] 28,760
2016 904 1,380 27,554
2017 788 1,043 24,971

Hansen, the community-based center director at Mason City, focuses on marketing and public relations. Boeke, the Chief Residential Officer for sites in Ames and Mason City, focuses on child behavioral development and the science behind why young children may become addicted.

For Boeke stigma comes from the idea that it is difficult for parents to admit their child has a drug problem. Hansen added that this could be a challenge, especially outside urban areas where treatment may be accepted in public.

"It seems that in rural Iowa, where everyone knows everyone, there is more pressure to keep things under lock and key." It does not really suit this perfect model of the perfect family, "said Hansen.

That's a problem, especially since families know that their children are addicted to opioids, according to Associate Director of Young, Prairie Ridge. She said addiction is still not widely regarded as a public health problem, as is the case with known conditions such as For this reason, families may feel discouraged to ask for help.

"If my child had cancer, maybe I would start a GoFundMe page," Young said. "I would start a blog and around Ask for prayers and support.

"If a parent's child has an opiate addiction, you do not see those things, but it's just as deadly."


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  Dr. Amanda Boeke

Dr. Amanda Boeke



Finding a Cause

To understand the opioid dependence, what matters is a "rewiring" of the brain.

Thus, several officials in North Iowa have the power of state, including Jay Hansen.

"This is a brain disease, its neurotransmitters have been changed," he said. "When you are hungry, there are some things you would not do to get food, and that's exactly what happens with addiction: you starve for dopamine."

And when people are addicted, it's hard to get the drugs Not just because of their strength, but because of their accessibility to stop, officials argue. [19659040] Not only is it the usual postoperative medication, Boeke said, because many opioids and other drugs come from different channels outside the United States.

"It's really scary how accessible these things are," she said. "The epidemic has been around for a long time and started overdose of analgesics, but now you can go online and these substances are made in other countries and you can order them off the street."

There is another problem – the idea that people should not tolerate pain without medication.

Boeke said many primary care physicians and doctors in the area are still learning the signs of dependency. It creates a natural divide between doctors trying to relieve patient pain and inadvertently over-prescription drugs that can lead to substance abuse.

Dr. Joseph Behr of Mercy Medical Center, North Iowa said there are steps doctors are taking to ensure that pain management is safe, including reviewing the prescribing policies that are established throughout the Mercy network. Behr collaborates with the Opioid Guardianship Team, which encourages caregivers, pharmacists, providers, mental health leaders and drug users, and others, to work on opiate abuse.

The prescribing guidelines are reviewed annually, he added. "However, the treatment always differs from patient to patient because of their pain," says Behr.

"Monitoring drug compliance and potential abuse must be part of ongoing care," said Behr. "This happens in conjunction with signed agreements with patients."

Finding a balance between the drugs needed and other methods of treating pain can be difficult, officials say. Many have argued that there needs to be a more holistic approach to pain.

This includes Young, who thinks that today we almost regard medications as a compulsory route to treating physical pain.

"Reality is in human life, it will be pain," said Young. "Physical pain, emotional pain, psychological pain, instead of helping people to find coping strategies to cope with a certain amount of pain, we've just come up with a pattern to put it all away."


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Ron Osterholm


Big Pharma

Another potential issue faced by medical, law enforcement, and local opioid abuse investigators is whether pharmaceutical companies have distributed too many pills to rural communities Company on site is McKesson in Clear Lake. A joint 60-minute Washington Post investigation in December revealed that the anti-drug agency may have had a tough case against McKesson, and the agency wanted to pay the company more than $ 1 billion. That did not happen, despite the DEA arguments that the company is providing corrupt prescribers with too many prescription painkillers.

Jay Hansen's view of McKesson and other companies is open.

"It's all about marketing, big pharma has to be expensive," said Hansen. "You have marketed this as safe and effective, that if you take medications for chronic pain, as prescribed by your doctor, you will not become addicted."

McKesson, however, has rejected the allegations in the report since December Officials argue that the company is investing in programs that help prevent problems caused by the opioid epidemic.

"We only distribute opioid medicines to pharmacies that are DEA-registered and government-licensed, and we only distribute in response to orders that pharmacies submit," said Kristin Chasen, a spokeswoman for McKesson, in an email ,

Chasen added that their company does not market opioids or boost demand for this type of medicine.

No matter how much responsibility McKesson and other similar companies have for everyone involved in the crisis to find a solution, according to Boeke and Shanda Hansen.

"I do not think only the manufacturers made us do that," said Hansen. "Everyone can take a piece of the cake, it's just what we do with this piece that comes forward that will make the difference."


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  Shanda Hansen

Shanda Hansen



What works?

Prairie Ridge offers several treatment options for patients: group therapy, residential programs, behavioral therapy, and other programs

But according to Jay Hansen, the power of opioid addiction means success more likely when the patient chooses a drug-based program.

Hansen, citing national statistics, said traditional methods – including group therapy, inpatient care and counseling – resulted in a 10 percent pass rate. Certain drug therapy, including drugs like Suboxon or Vivitrol, may increase that figure to about 70 percent, he added.

The problem: one of these medications can be a bit expensive, and there is a shortage of providers in the region that can manage you, added Hansen and Lorrie Young.

Regarding the younger population who may experience opioid dependence, Boeke said that multidimensional family therapy is a key part of Francis Lauer Youth Services' programs. It is an evidence-based program focused on a holistic approach to treating children with addictions.

"We are not just focusing on the child," said Drs. Boeke. "This kid is not the problem we fix and send home, we really try to help the system that they come from … if we can heal the system we send them back to, I think ours Success is higher. "

One of the ongoing problems in treating patients is that recovery facilities operate in a different setting than other corporations that combat the opioid problem – including law enforcement agencies, doctors, politicians and judicial officials.

This point was summed up by Ron Osterholm, health director of the Cerro Gordo health department: "Whenever you work in silos There are always problems and we all owe them."

However, it helps that Prairie Ridge and Francis Lauer in Eisenhower Avenue in Northern Avenue next to each other. Both offer different forms of outpatient services and behavioral health programs, and try to identify the main causes of addiction for each patient.

And Boeke, Young and Shanda and Jay Hansen stress that every patient being treated is different. They added to this challenge, along with a lack of funding and the evolving nature of opioid addiction, makes the subject difficult for them and the addicts.

Although silos still exist, Shanda Hansen is encouraged that more dialogue begins. She, Young and others hinted, among others, at Mason City police chief Jeffrey Brinkley, who has begun to eliminate these silos.

"There is so much value in these discussions because we all know that we work with limited resources," Shanda said Hansen. "We use our resources only to achieve the best possible result, and it comes from this communication, it comes from building these relationships, and understands what each of us does, at least on the surface."


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