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August Meeting Minutes

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Attendees
◾Kjirsten Anderson, Regional Prevention Coordinator (Other Substance Abuse Organization)
◾ Jessica Bigirindavyi, Hennepin County Sheriff’s Office (Law Enforcement) 
◾Tara Helm, North Memorial Health/ PFC (Healthcare)
◾Camryn Krause Ferris, Joint Community Police Partnership, Crystal (State/Local/Gov’t)
◾Casey Landherr, Robbinsdale Police Department (Law Enforcement) ◾Teresa Lunt (Parent)
◾LeeAnn Mortensen, Hazelden Betty Ford Foundations (Other Substance Abuse Organization)
◾ Shane Mikkelson, Osseo Police Department (Law Enforcement)
◾Sheila Nesbitt, North Memorial Health (Healthcare) 
◾ Miamon Queeglay, Brooklyn Center Schools (Schools)
◾ Paula Van Avery, Joint Community Police Partnership, Brooklyn Park (State/Local/Gov’t)

Steering Committee Members Not in Attendance
◾ Marie Maslowski, Maple Grove Hospital (Healthcare)
◾ Alyssa Nyberg, Fairview Behavioral Services (Other Substance Abuse Organization)
◾ Lauren Prnjat, Hennepin County Regional Poison Center (Other Substance Abuse Organization)

Welcome & Introductions

LeeAnn called the meeting to order. Attendees introduced themselves and shared something they are still hoping to do before summer ends. The July meeting minutes were approved.

Conference Takeaways

LeeAnn, Jessica, Tara and Marie attended 2019 Summer Institute in Adolescent Health: Marijuana, E-Cigarette & Opioids among Adolescents: Navigating the Now at the end of July. They shared takeaways with members. Tara shared that the conference was broken into 3 sections:
1. Describing the trends and current patterns of youth substance use,
2. Exploring the why of substance use discussing the history of marijuana in the US and hearing from communities that were disproportionally impacted,
3. Exploring how to equip professionals and parents on prevention—hearing from youth on prevention, messages for parents.

1. Day One: Describing the Trends
◾ Presenters from MDH shared current drug trend data for youth from MN. Dana Farley from MDH discussed the underlying causes that lead to substance use, describing the inability to address stress, trauma from childhood or mental health issues. He emphasized the need to focus on the population and community when trying to prevent substance use. The data that is collected on current trends is used to inform action and create system change, “quantitative data validates and qualitative data illuminates”. Christina Thill from MDH described e-cigarettes having the same amount of nicotine in a juul pod as a pack of cigarettes, although new findings indicate that it may be more like the same amount of nicotine as two or three packs of cigarettes. She also reported that 1/3 of high school e-cigarette users report having used their vaping device for recreational marijuana. Youth are highly influenced from social media sites and companies like JUUL claim they are not targeting youth. Kari Gloppen from MDH shared facts on opioids, stating males are more likely to use opioids than females, and ¼ of ER visits in MN are youth.
◾ The keynote Dr. Seth Ammerman shared information about vaping and marijuana. He discussed potential risk of vaping, such as 35% of THC inhaled directly and the addictiveness of marijuana, especially on the developing brain. He also discussed the traffic safety concerns from increased use of marijuana in communities and the inability for people to react suddenly when under the influence of marijuana. He discussed the different forms of vaping, such as dabs and wax—the highly concentrated forms of marijuana. This is a concern for naïve users because if they are unaware of the product, they may start with a high concentration product, which could increase the potential for becoming addicted. He also described the toxins in products and the mismatch between the labeled & actual nicotine or THC content. He said the label is accurate 10% of the time according to some studies. Currently, there are no long-term studies of what happens when you inhale contents that allows it to be aerosolized. These products are “not water vapor”, aerosol is a toxic chemical! He also described different products available from the FDA that are approved NRT (nicotine replacement therapies), including Patch, gum, lozenge, inhaler, nasal spray, as well as non-NRT products including bupropion (Zyban) or varenicline (Chantix).

◾ In the afternoon, a panel of representatives from states where marijuana is legal had a radio talk show with a moderator. The radio show guests included representatives from Canada, Colorado, Washington, and California. Canada’s representative described that they took the stance to legalize marijuana commercially as a way to minimize harms through strict regulation. Access to marijuana is only available in Canada via online stores or select dispensaries that are operated by the government. Their 3 main goals were to keep youth safe, to protect public health and to prevent the black market. In Washington, of those using, youth are using marijuana more frequently. There is a concern about the health and safety risk of marijuana. In addition, many individuals in Washington do not see cannabis as dangerous, so they are more likely to engage in risky behaviors. If prices stay high, then there doesn’t seem to be an increase in youth use. Colorado has seen high numbers of traffic crashes and Washington described the trend to co-use substances, which is contributing to more severe crashes that is caused from a gap in knowledge about marijuana. Canada has been practicing harm reduction messaging as a way to educate youth and Washington has been using abstinence messaging to discourage <21 from using with pro-social messaging topics such as ways to reduce stress (not including using substances), ways to stay healthy and other empowering messages to focus on protective factors.

2. Day Two: Describing the Now
◾ Lucien Gonzales, MD presented on understanding adolescent substance use and mental health. There is a need to address underlying issues of substance abuse, asking questions like “why did they start using substances in the first place?”—it’s likely due to trauma. He stated that using cannabis, in adolescence, significantly increases the likelihood of psychosis episodes later. He also talked at length about the stigma that is attached to someone’s substance use and the need to evaluate “the lens” that you see people to ensure you aren’t attaching stigma to their care, especially if you are working with in treatment setting.

◾ In the afternoon, Rae O’Leary shared that she had testified before Congress the week prior at a congressional hearing that unveiled the untruthfulness of JUUL. She is a research nurse at a tribal nation in South Dakota and described how their community was targeted by JUUL. She demonstrated how untruthful and manipulative these companies are that target youth.

3. Day Three: Exploring the How
◾ Sion Harris from Harvard Medical School discussed marijuana and vaping. She said there is a need to address the deceptive marketing, especially what is going on online—learning to look at images with a “practiced eye”. There is a narrative that marijuana is “not as dangerous as alcohol”. Today’s pot is much more potent and with that, it carries greater risks. She described that as the THC level increases, more negative effects are seen, some so concerning in teens that they have presented to the ER with heart attacks. She shared these key messages:
a. Vaping chemicals
i. Switch the language—“it’s an aerosol, not a vapor”, vapor conveys it is water
ii. Discuss the harmful chemicals in e-cigarettes
b. Vaping industry
i. Discuss the marketing practices that companies use to lure customers in
ii. Teens do not want to be manipulated
c. Addiction
i. Talk about nicotine addiction & its social costs
ii. Students do not want to be controlled by anything or anyone
iii. Nicotine withdrawal sets in within 2 hours so share how they won’t be able to do regular activities without an interruption, if addicted
iv. Cost of addiction—some spend $150 per week to support their vaping addiction

Later that day, a youth panel of students from 3 different metro schools discussed their advocacy skills in trying to prevent vaping in their cities or schools, and the challenges they faced while standing up to their peers.

Workgroup Updates

The Medicine Abuse Prevention Workgroup has been planning a prescriber education symposium with the date of Wednesday, October 2. This event is open to all North Memorial Health providers (if you know of a provider from a different health system that is interested in attending, please speak with Tara) with topics including:
• MN Prescription Monitoring Program (PMP) integration with Epic – a seamless process for providers to check customer’s controlled substance prescription history.
• Gains/successes in the North Memorial Health system and what’s been seen statewide.
• How changes in practice have been implemented.
• Having difficult conversations with patients and exploring alternative therapies while still acknowledging chronic pain.
• Informed decision-making to avoid getting “the letter” from MN DHS about overprescribing.

During the July meeting, those members working in the Realtor & Homeowner Outreach Education Workgroup, discussed the need to get some baseline information from realtors about what is available to them around the topic of medicine storage or disposal. Sheila sent out a notice to coalition members, requesting volunteers to contact a realtor in northwest Hennepin to ask some questions.
[Action Item]: Teresa, Randy and Casey volunteered to call a realtor. Please send your responses by the end of August, if possible.

Questions include:
1. To what extent do you talk with sellers about protecting (locking up) their medicines for showings or open houses?
2. Have you received any information or been asked to talk with sellers about safe storage and disposal of medicines? From/By whom?
3. What would be the two best ways to get information or reminders to Realtors® about safe storage and disposal of medicines?
4. How helpful would it be to have
a. a brief article in a newsletter from the Minneapolis Area Association of Realtors?
b. A packet of information delivered to your broker office?
c. Print brochures that you could give to sellers?
d. Reminders posted in a Facebook group? Which one(s)?

Please name the above in the order you think would be most helpful.

5. What other thoughts do you have about promoting safe storage and disposal of medicines to people who are selling their home?

Year in Review

Tara reviewed with attendees the coalition’s major accomplishments from August 2018 to now, with some expected action items for later this fall. Highlights included the wrap-up of the prescription disposal awareness campaign from July 2018 through November 2018 with Voom Creative, our graphic designer; a partnership with the University of Minnesota School of Public Health to apply for grants through the National Institute of Health and Center for Disease Control and Prevention (awaiting results); we hosted a police chief meeting among the 9 agencies in northwest Hennepin County that are in our service area to discuss our prevention strategies; Teresa Lunt testified on behalf of the coalition at a MN Senate hearing about the negative health implications and public health consequences of legalizing commercial marijuana; a RAVE was conducted in Excelsior during St. Patty Day events; we participated in the National DEA RX Drug Takeback Day Event at Robbinsdale Hy-Vee; a digital billboard aired on 394 near 252 with a medicine abuse prevention message; we partnered with other drug free coalitions in the metro area and Hennepin County Public Health to host an event to discuss e-cigarette use with school administrators; we opened a new medicine disposal box at Brooklyn Park Police Department; POLD was published in a medical journal (JAMA); an awareness flyer discussing the expanded social host ordinance in Osseo was sent out residents as an insert in the July utility bill; we sent out a back-to-school toolkit to school administrators in our 3 school districts as a prevention resource for schools to address the vaping epidemic; and Crystal Police Department opened a new medicine disposal box in August. This fall, North Memorial Health will be integrating the MN Prescription Monitoring Program (PMP) within Epic, the healthcare software system, and we will be sponsoring a provider education event that will discuss the new feature of Epic being integrated with the MN PMP. These great accomplishments could not be done without our devoted coalition members so thank you for all of your effort and support!

Coalition Functioning Survey

The Coalition Functioning Survey results were briefly discussed, highlighting findings from the new questions added this year that describe the relationship of the coalition with North Memorial Health. North Memorial Health has housed PFC for all ten years that it has been a Drug Free Community grantee. As DFC funding ends and Coalition members examine potential funding sources for the future, they also were asked to reflect on the value of North Memorial Health to the Coalition. All respondents who answered this question (100%, n=32) are aware that North Memorial Health has been the “home” for Partnership for Change. PFC members value the relationship and support of North Memorial Health: (100%, n=25). All respondents think the Coalition’s affiliation with North Memorial Health contributes to the Coalition’s credibility, provides solid infrastructure, that North Memorial Health’s reputation benefits PFC, opens doors with community stakeholders, and that North Memorial Health’s leadership raises the visibility of substance use issues in PFC communities. Coalition members also believe PFC adds value to North Memorial Health. Respondents (n=25) say they have become more aware of North Memorial Health’s commitment to substance use prevention (96%), that PFC has helped North Memorial Health increase awareness of substance abuse problems in PFC communities (100%), helped North Memorial Health build new external partners in PFC communities (100%), and increased overall visibility of North Memorial Health in PFC communities (100%). All respondents (100%) believe North Memorial Health is a leader in substance use prevention in PFC’s communities and that by addressing substance use issues, PFC contributes to North Memorial Health’s mission to empower community members to achieve their best health. These results were shared with leaders at North Memorial Health, and we are hopeful that the coalition will continue past our grant funding. 

Community Partner Sharing

Upcoming Events & Trainings:
Golden Valley City Council Meeting Council considers ways to regulate the sale of tobacco products
• TONIGHT! August 13th 6:30pm at 7800 Golden Valley Road, Golden Valley, MN 55427

Hennepin Energy Recovery Center (HERC) Tour
• Thursday, August 15th at 10am, tour will last approximately 1.5 hours, HERC, 435 North 5th Street, Minneapolis, MN 55401
• Learn about the disposal of prescription medications & the county waste management system
• RSVP to Kjirsten Anderson (kanderson@ansrmn.org or 612-504-0118)
• Wear appropriate clothing & bring visitor agreement form

Hazelden Betty Ford’s Hot Topic: Learning from Law Enforcement: Drug Trends & Prevention Efforts
• Thursday, August 15th 11:30am-2:00pm at 11505 36th Ave. North, Plymouth, MN 55441
Webinar: Kratom for Opiate Withdrawal: Really Promising or Really Addictive?
• Wednesday, August 21 12:00pm
• Matthew Polacheck, PsyD, MA, will examine the risks and benefits of using kratom to self-detox. What do researchers know about the herbal supplement? Is it a natural botanical with the potential to end the opioid epidemic or a dangerously addictive unregulated substance? This webinar examines the effects and impact of kratom on the substance use field.

SAMMn Event with Kevin Sabet

• Registration Link: https://www.evite.com/event/00B6FW6PYQRAEARZIEPJVFXETKYW4M/rsvp?gid=02BDKUVE7PEJ24XB6EPJWJCFMLQ5AU&utm_campaign=view_invitation_bt&utm_content=&utm_medium=email&utm_source=GUEST_UPDATE_EVENT
• Thursday, September 12 from 6-8pm in St. Paul, MN

Substance Abuse Prevention Skills Training

• September 16-19, 2019, Mankato, MN

Marijuana Workshop
• 10am-2pm on September 25, 2019, Cambria Hotel 9655 Grove Circle North, Maple Grove, MN
• Hosted by Regional Prevention Coordinators Jenilee Telander and Kjirsten Anderson with Guest Speakers Dr. Ken Winters, Kim Bemis, Sheila Nesbitt, and Jackie Siewart.
• Cost: $20 per person, including the cost of lunch.
• Registration Link: https://www.eventbrite.com/e/marijuana-prevention-workshop-tickets-66689374715
• Objectives:
o Participants will leave the workshop with talking points about marijuana to bring back to their communities
o Participants will leave with prevention strategies to consider to prevent marijuana use among youth and young adults
o Participants will learn about benefits of smoke-free housing policies, intersection of smoke-free tobacco policies & marijuana, answers to commonly asked questions from property managers, how managers are preparing for potential future of increased marijuana use/resources available to stakeholder’s interested to make their building smoke-free
o Participants will have an opportunity to start planning what conversations & next steps they have in their communities

Car Seat Clinics: Click here to learn more! Reach out to Sheila if you would like a printed flier to post. Please share with others!
• September 21st 10am-1pm at Golden Valley Fire Station
• November 4th 4-7pm at West Metro Fire & Rescue at New Hope

Minnesota Prevention Program Sharing Conference We hope to send 2 coalition members to this conference! If interested, contact Tara!
• Thursday, October 24th & Friday, October 25th
• Duluth, Minnesota

Adjourned at 3:58pm

Next Meeting is: Tuesday, September 10, 2019, 2:00 to 4:00 p.m. at Osseo City Hall, Community Room B, 415 Central Ave #1

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