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S.D. retailers face uphill battle for survival amid frequent market changes

Mark Andersen, South Dakota News Watch correspondent

Overall retail sales have climbed steadily in South Dakota in recent years, but who is getting the money and how they are getting it are changing.

Maintaining a successful brick-and-mortar retail business continues to be a challenge in South Dakota as online retail continues to surge, chain stores grow rapidly and low-price dollar stores pop up regularly in small towns.

The rapid and expansive transformation of the South Dakota retail marketplace has created uncertainty for many businesses and the more than 97,000 state residents employed within the industry.

The ongoing market disruptions are threatening some retailers, particularly in smaller towns.

Many employees and owners of some of the state’s roughly 13,900 retail establishments have felt the bite of rapid change.

Retailers face almost constant change ranging from the emergence of giant online retailers to evolving technology including delivery services to the rapid growth of low-price “dollar stores” that can hurt long-time local retailers in rural areas.

What emerges over the next decade will be a marketplace shaped by conflicting consumer desires for better convenience and lower cost versus a desire for something unique, social and enjoyable.

Transformation has always been part of the retail story. Since craftsmen gathered in open-air markets through the rise of department stores and shopping malls, shoppers have hastily embraced new trends and discarded old. Across the state, struggling shopping malls and aging rural main streets demonstrate this evolution.

Even in small cities that have been aggressive and progressive in promoting local retail, such as Sisseton in Roberts County, fears remain that some businesses won’t be able to keep up with the fast and frequent changes in the retail marketplace.

“It’s scary when you’re a smaller town, seeing people going out of town to buy groceries and gifts,” said Lacey Babekuhl, who works in accounts and marketing for a Sisseton building center and formerly served as a local housing and redevelopment official. “You really do run the risk of losing everything your neighbors have worked for all of their lives. Families, friends and neighbors have put their savings on the line for this community.”

Meanwhile, the constant change is creating opportunities for some retailers and business owners, particularly those willing to adapt and do so quickly.

South Dakota retail sales have grown in the past several years, climbing from $25.1 billion in 2013 to $28.5 billion in 2018, according to state Department of Revenue data.

Many local retailers have added their own online presence and try to stay up on successful business trends.

Debra Jensen, co-owner of Black Hills Bagels in Rapid City with her husband, Jack, said they strengthen their position in a competitive market by connecting with employees and customers in ways that chain stores cannot.

The business has endured a years-long construction project on the road it fronts and the arrival of a competing bagel chain directly across the street.

“We can’t compete on price alone,” Debra Jensen said. “But there’s a market for hand-formed bagels, custom sandwiches and enhanced customer service.”

Staying vigilant about trends and being nimble in reacting to them — while also holding firm to longstanding principles — has also helped the business thrive, Jensen said.

She said the couple realized long ago that for the store to remain successful they would have to pay attention to what the corporations were doing but do it better. Three years ago, Debra read an article that by 2020, 40 percent of restaurant business will be delivery.

They found people weren’t willing to pay for delivery service, but they weren’t willing to tip. Over time, larger business orders have compensated for the small ones, making the delivery system profitable.

For now, the pace of the current retail transformation toward online sales isn’t easing. Internet sales should account for 12.4 percent of all retail sales this year, up steadily from 6 percent in 2013. Online sales are predicted to account for 14 percent of the retail market next year, and the Centre for Retail Research expects online growth will continue for a decade.

Increasingly, online also takes a larger bite of Christmas sales. Amazon collects a third or its sales revenue during the fourth quarter, according to annual reports. This holiday season, sales at online and other remote retailers are projected to surpass those at brick-and-mortar stores, climbing 12 percent over last year.

Amid last year’s closures at Sears, ShopKo and Kmart, the Centre for Retail Research declared a retail apocalypse, but mostly it was 17 national chains with outdated business models that disappeared. Stores in South Dakota were among them, but that alone doesn’t signify the demise of local retailers.

Meanwhile, the ongoing proliferation of discount retailers further complicates matters for longtime retailers in smaller South Dakota towns. The rapid spread of dollar stores, following closely upon the spread of Walmart super centers, further erodes already slim profit margins there.

Dollar Tree, which operates 15,000 Family Dollar and Dollar Tree stores in 48 states, including 43 in South Dakota, planned to open 546 more stores nationwide.

Across the Northern Plains, the spread of dollar stores place additional pressure on local grocers. Over the past five years, 39 out of 137 full-service grocery stores in North Dakota towns with fewer than 2,100 people have closed or no longer offer full service, according to the North Dakota Rural Electric & Telecommunications Development Center. Anecdotal evidence shows the same trend occurring in South Dakota.

Nathan Sanderson of the South Dakota Retailers Association sees a resurgence on main streets among the whirl of retail change. In the era of decline of the shopping mall, some also see a downtown renaissance as customers seek unique social experiences and local wares.

“Take a look around at Sioux Falls main street and downtown Rapid City,” he said. “Look at what Main Street Square and the presidential sculptures have done for Rapid City.”

The market has seen a shift in consumer preference away from standard shopping malls toward the unique and special, the handmade items, he said.

“The determining factor is the extent to which the people of the community invest in that community,” Sanderson said.

These pockets of brick-and-mortar resilience belie the simplified narrative of local retail dying at the hands of expanding online.

“Internet sales are a growing component of retail, but that doesn’t mean the death of retail,” Sanderson said.

David Bruns, manager of the Food Center in Redfield, S.D., population 2,300, is doing what he can to keep his business thriving despite the challenges created by a Dollar General.

“They’re affecting all small towns,” Bruns said of dollar stores.

To build customer loyalty, the Food Center has launched a rewards program, offering points for every dollar spent, and a saver card, which gives stamps redeemable for glass products.

The Redfield Food Center has also switched warehouses to bring in different brands, hoping to distinguishing itself from other regional stores.

Redfield customers, Bruns said, still lament the town’s loss of their ShopKo, which also sold groceries. The closure, however, didn’t cause much of a bump in Food Center sales. If anything, he said, people now leave town for things that only ShopKo sold, so now they also may be grocery shopping outside of town.

The lack of local competition hasn’t affected his prices, Bruns said.

“I’m still trying to compete against Walmart and the bigger stores, so I keep prices aggressive as if there were two stores here,” he said.

The dollar stores will change the landscape, Bruns said. “It’s just they’re coming everywhere,” he said. “It’s kind of sad in my opinion.”

Over time, Lacey Babekuhl has developed affection for Sisseton. The Sioux Falls native vacationed in the town as a kid. As a teenager she couldn’t imagine living in a place with “nothing to do.”

Now, she can’t imagine living anywhere else, and saving the town is part of her new job. Sisseton has about 2,400 residents, and the population hasn’t changed much in 20 years.

The event that stimulated retailers to take action last summer was a major road and sewer reconstruction project that detoured shoppers around the town.

A few months ago, retailers formed a non-profit association, built and launched an app to bundle local sales deals — like an online shopper, and began recognizing local retail sales staff for exceptional service. The big focus is on educating the community about the importance of buying local.

“Amazon is not going to help fund your kid’s baseball team,” Babekuhl said. “That’s the local businesses that do all of that.”

Babekuhl works as an accounts specialist at Tri State Building Center with the understanding that promoting Sisseton is part of her job. The goal is to really connect with local customers and the community, Babekuhl said.

“At this point, we’re seeing a lot of engagement,” she said. The app for bundled sales promotions has been downloaded 800 times.

“Sisseton is seeing a comeback on Main Street and Veterans Avenue,” she said. “There are new shops, and boutiques more aimed at the younger demographic.”

Appealing to the next generation and creating a better experience for shoppers will be key, she said.

“This is about growing the community,” she said. “We want to make this a place where people want to visit and a place where people want to come back to after college.”

Wide-ranging reforms proposed to make S.D. youth treatment homes safer for residents

Governor’s recommendations follow News Watch investigation into abuses at youth home in Plankinton

Bart Pfankuch, South Dakota News Watch

Gov. Kristi Noem has proposed a major overhaul to how South Dakota oversees, inspects and updates the public about conditions in privately run youth homes across the state.

Ender Murray facial
This image taken by the Aurora County Sheriff's Office shows injuries sustained by 10-year-old Ender Murray at the hands of an employee of Aurora Plains Academy in 2013. Photo: News Watch file

Youth treatment facilities in South Dakota would be subjected to far greater state scrutiny and oversight, and public access to inspection and complaint information would be heightened under a series of reforms proposed by Noem.

Among the proposals: more independent inspectors would be hired; inspections would become more frequent and some would be unannounced; and a full-time, independent monitor would be hired solely to hear and review complaints of abuse from facility residents.

“The health and safety of the next generation is our top priority. We cannot let kids fall through the cracks,” Noem said in a December news release announcing the proposed reforms.

In late June 2019, Noem ordered the state Department of Social Services to undergo a full review of licensing and inspection practices of all privately run youth facilities in the state.

The order came shortly after the publication in early June of an investigation by South Dakota News Watch that uncovered a pattern of abuse of children, questionable reporting practices and lax state oversight at the private Aurora Plains Academy intensive residential treatment facility in Plankinton, S.D.

The resulting 48-page state report, published in December by DSS Secretary Laurie Gill, included involvement of six state agencies and was ordered by Noem in response to “recent scrutiny” and “several media and public information requests.”

Aurora sign
Residents and parents say youths housed at the Aurora Plains Academy intensive treatment facility in Plankinton, S.D. have endured physical and psychological abuse over a period of years. Now, Gov. Kristi Noem says she will increase oversight of privately run youth homes. Photo: Bart Pfankuch, South Dakota News Watch

The report makes 10 recommendations, some of which may require legislative approval but all of which are intended to improve the safety of children and youths in the state treatment system that is largely privatized.

“I’ve tasked my Department of Social Services with improving the well-being of kids and youth placed in treatment facilities across the state. In the 2020 [legislative] session, I will bring legislation that prioritizes the safety of at-risk kids,” Noem said.

The News Watch investigation showed that over a period of years, numerous residents of Aurora Plains had been physically, mentally and sexually abused or tormented by employees of the academy, which operates mostly on federal Medicaid funding but is overseen by the state. The News Watch investigation also uncovered that all state inspections are pre-announced, that public access to information about the facilities and any problems is highly limited, and that employees at the academy sometimes pressured colleagues to minimize or alter reports on incidents in which children were harmed.

Aurora Plains is one of eight residential youth treatment centers in South Dakota, but is the only intensive treatment facility.

The News Watch report was published four months after a tragedy at another private youth home, the Black Hills Children’s Home in Rockerville, where a 9-year-old girl walked away in February and has never been found.

In the days after the News Watch articles were published, Noem said in a statement that, “As a mom, it deeply saddens me to read the stories of these kids. Regardless of whether a situation happened 10 years, 10 months or 10 days ago, abuse is never OK. I hope we can learn and take corrective action where it is needed to protect our most vulnerable population.”

The DSS review focused on the licensing, accreditation and certification process of youth homes; the complaint and investigative processes; corrective action plans; and transparency and confidentiality of investigations.

Major recommendations from the report include:

— Increasing on-site licensing inspections from annually to twice per year. Beyond the scheduled bi-annual inspections, state regulators for the first time would make unannounced inspection visits throughout the year. Facilities under a corrective plan would be inspected quarterly.

— Hiring additional independent, contracted inspectors to increase and improve inspection of facilities, and to “provide an independent investigation which will allow for further objectivity.”

— Hiring a “grievance monitor” to provide an entity outside state agency control to receive, review and monitor grievances directly from children and youths.

— Making available to the public a “central repository” of DSS inspection reports, and revising corrective action plans — documents that outline violations and require improvements — to heighten state monitoring of compliance and to make the reports easier for the public to access and understand.

— Producing an annual online report by the Child Protective Services division of DSS of allegations of child abuse or neglect and resolving any investigations into those claims.

“I have asked [DSS] Secretary Gill to develop a work plan to implement the comprehensive list of recommendations included in the report,” Noem said in the December news release.

In the summary of her report, Gill wrote, “The state must clearly maintain its focus on ensuring children and youth placed in treatment facilities across the state are safe. There are areas needing attention and support to improve procedures and practices.”

Moody County 4-H donated 16 gift bags to the Moody County Breadbasket

Moody County 4-H

Our Moody County 4-H Jr. Leaders met recently to donate 16 gift bags full of baking essentials to the Moody County Breadbasket. Members decorated their paper bags with Holiday greetings and received a tour of the Breadbasket as well. These 4-H members also made Christmas cards for Meals on Wheels recipients and residents at Edgewood Assisted Living in Flandreau.

Detox center earns high marks for accreditation

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By Dave Baumeister, County Correspondent

SIOUX FALLS – Elizabeth Brown, the director of the Minnehaha County Detox Center, gave good news to commissioners at their Tuesday, Dec. 17 meeting.

Brown reported that the center received a 98% at their accreditation review, earning another three years of accreditation for the facility from the South Dakota Division of Behavioral Health.

All of the commissioners seemed very happy to learn of this, and they told Brown so.

Commissioner Cindy Heiberger took the opportunity to applaud the work of Brown and the center, while Commissioners Jeff Barth and Gerald Beninga both pointed out the growth and improvement in the county’s detox facility in past years.

Commissioner Dean Karsky compared the past detox facility to a “cave,” and he commended Brown for the improvements and for helping people at the “lowest point in their existence.”

In regular business, the commission voted unanimously to transfer $303,662 from the county’s general fund to emergency management fund. This money represents a state grant that emergency management uses for its operating budget.

Commissioners also voted to sign the 2020 agreement with Lutheran Social Services to provide for its Evening Report Center.

Juvenile Detention Center director Jamie Gravett spoke about the benefits of the program in providing an evening alternative for youth who may have a conflict or little supervision at home.

While this service is mainly for young people awaiting their court dates, Gravett said that because of the support they receive in this program, it can have a positive effect on their lives.

Heiberger added that often kids would go there “post-adjudication,” as well.

“They would ask the judge to let them stay there, because they were safe, and they were learning things,” she said. “It was a much better situation for those kids.”

She also explained that while the county funds the youth’s time at the center pre-adjudication, the United Way pays for the services after any trial.

Because of the holiday, there was no commission meeting on Dec. 24, and the next meeting will be Tuesday, Dec. 31.

That meeting will be at 9 a.m. on the second floor of the county administration building at 6th and Minnesota in Sioux Falls.

Meetings are open to all, and public comment is always encouraged.

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County IT director works to organize, develop Minnehaha’s technological needs

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By Dave Baumeister, County Correspondent

Writer’s note: This is the fourth in our series of stories about people who work “behind the scenes” to help Minnehaha County operate.

SIOUX FALLS – Two weeks ago, Minnehaha County Information Technology Director Monte Watembach was excited when a partnership with GovTech Services came online to give local property owners the ability to pay their taxes remotely.

Minnehaha County Information Technology Director Monte Watembach
Minnehaha County Information Technology Director Monte Watembach

While most county residents (who pay property taxes through escrow accounts at their banks) paid no notice to this, Watembach had been working “behind the scenes” for the past five months to see that this became a reality.

Instead of running down to the county administration building at 11:59 p.m. on the last day of April or October to drop off that property tax check, Watembach and his staff of 12 have helped usher Minnehaha County into the 21st Century by working with GovTech to create a system, like so many other businesses, that let taxpayers make payments via the Internet.

With this system, local residents can pay individual property taxes, or a large business can pay taxes on multiple properties all at the same time.

Although this is a huge benefit to county residents and is certainly newsworthy, working with an outside service provider on software and systems is not what the Minnehaha County IT Department usually does, according to Watembach.

As part of its function, the IT department will develop applications of its own to be used specifically by the county’s various departments.

“We’ve developed applications for multiple departments,” Watembach said, “which can be especially rewarding and a lot of fun!”

He explained that much of what the county had been using, and to some extent still uses, is what he refers to as “legacy-based software.”

This computer software may have been purchased or developed years in the past.

“It is stable and reliable, but not the most functional,” Watembach said.

He described it as older software that people have gotten comfortable with over years of use, but the legacy-based software is not something that has kept up with improvements in computers and other software.

Watembach described this type of older software as being “keyboard driven,” while newer “intuitive software” is for more mouse-driven and graphical users.

“We have a mix of employees around the county,” he explained. “Some have been using the legacy software for decades, but it is harder for new employees to be able to use the older applications."

In recent months, the Minnehaha County Commissioners have had discussions about certain departments needing to train people in different areas, as older employees retire.

And Watembach sees the problems with those newer employees having to learn older systems – especially when computers may not exist that can support those systems.

“There has been a generation working with the older applications,” he explained. “And it will be really difficult when they retire.”

But that, again, is where the county IT department comes in, as they develop their own intuitive-based applications which are friendlier to new employees.

“The intuitive software is designed so users can figure it out, and it is easy to use,” he said.

While Watembach has a business degree from the University of South Dakota, he credits “on the job training” as giving him the skills he has today.

After graduation, he went to work for Gateway Computers in Sioux Falls, and it was in the private sector that he learned all about computers and software.

Around 2002, Watembach moved into the public sector as a data center support person for the city of Sioux Falls. But in December of 2010 he got to head up his own department as the IT Director for Minnehaha County.

And he says that he likes that.

“Being in charge lets me create my own vision and see it through.”

He explains that working IT means he is in charge of tech for “12 or so different companies” or departments that make up the county.

He and his staff do projects for those departments at different times, but he can’t say that he spends more time with any one department over the others.

“That all depends on the projects, but after we get new software in place, there is not so much interaction (with those departments),” Watembach said.

Ideally, he would like to see all county departments migrate off legacy applications, but he says he does have to be sensitive to the current employees.

“The older software has been consistent. It works. It is reliable, but it won’t be able to serve long-term.”

However, he feels that the county is fortunate in that they are making good progress in completing needed changes.

One big step they are making toward the future is planning for a new Metro Communications Center.

Again, this is another area that commissioners, as well as those with the city of Sioux Falls, have been looking at for some time.

At their last meeting, county commissioners accepted a rental agreement to house Metro Communications for 2020, but space constraints in the Public Safety building are making that more difficult.

Watembach said that from what he knows so far, land for the new center is being planned for the northeastern edge of the city, and the current facilities will serve as a “back-up” communications center.

But whatever project comes along, members of the Minnehaha County IT Department led by Monte Watembach will, no doubt, be working “behind the scenes” with purchased software or developing their own to help the county be more organized and efficient.

GMS 6th Grade Holiday Drawing Contest Winners!

Holiday Drawing Winners

As always, we love featuring the creative works of our students. They are the future after all. Their drawings were judged by former teacher and Garretson School Board member Ruth Sarar, who rated them by creativity, originality, unique idea and drawing skill. In first place (third from the left) is Lucie Frewaldt winning $30 in Garretson bucks. Second place (far right) is Nathan Roberts winning $25. Third place was Ethan Magnuson (left) and Honorable Mention was Hope Wheeler (second from the left) each winning $20. Congratulations to our winners and thanks to all the kids who submitted drawings! Happy new year to all!

Thanks to all our Holiday Contest sponsors:

Garretson in 2019, a year in review

by Carrie Moritz, Garretson Gazette

Hard to believe we’re at the end of a decade. Now we start the roaring ‘20’s, with hopes it doesn’t end like last century’s. The Gazette was packed with news throughout the entire year; the addition of another full-timer at the office ensured we were able to bring you as much news as possible.

This last year saw the culmination of the 3rd Street and Main project, or at least, stage 1 and a half. The Garretson area had record flooding both spring and fall, which put our farmers in a hard place, along with national happenings that also affected our farmers. The brand-new daycare opened for business, and Garretson made the Sioux Falls news for positive reasons (though South Dakota as a whole did not make national news for the best reasons…but We’re On It). Plus so much more. Enjoy this year in review (Part One of Two)!

wrestling

In January, winter sports were in full swing, with Garretson High School girls’ basketball, boys’ basketball, and wrestling each coming away with wins and losses. Hayden Pierret performed well at the Lincoln Holiday Wrestling Tournament, earning top seed and second place in the 126-pound weight class. Dakota Johnson and Dominic Abraham also placed in the top 8 in that tournament. The wrestling team continued to perform well the rest of the season, with seven GHS wrestlers making it to the State Tournament in Rapid City.

Cold temperatures were also in the news, with Sioux Falls, SD being the coldest place on earth on January 29.

Pippa the dog

In February, the Gazette chronicled how the town came together at the end of January to search for a missing pup. Pippa took off from her uncle’s house while her parents were on vacation, and extremely cold temperatures made her chances for survival slim. She was discovered stuck under the tracks just north of town by a BNSF Railroad employee, who knew to look thanks to B Squad Rescue’s “Missing” posters that had been posted just a few hours earlier. Pippa was a B Squad Rescue pup, and the Brandon-based non-profit’s mission is an honorable one.

GHS continued with exemplary work, with the One Act Play bringing home gold medals from their State Performance in Aberdeen. They had won Regions at USF in Sioux Falls in January. The FFA celebrated National FFA Week with an act of service, packing 50,000 meals with over 50 volunteers.

Meals being packed for Meals of Hope
Meals of Hope organized by Garretson FFA

Garretson also made the Sioux Falls news several times in 2019, starting with KDLT profiling both Omar Thornton and Tyler Ramsbey for their series, “Someone You Should Know.”

In March, the Gazette brought news that Palisades State Park was awarded an extra $500,000 from the SD Legislature, which tied into a purchase made in March of 279 acres, more than doubling the size of the park.  Since that announcement, Garretson individuals, business people, and the City Council have been working diligently to ensure the park is still connected to the town, especially as the entrance will be moved another 2 miles away and no longer keeps Garretson in sight.

ice floes in splitrock park
Photo taken by Heather Tyrrell, Splitrock Park ice floes.

March ended with a bang, as ice floes piled up along the shores of Split Rock Creek and the Big Sioux River, along with massive flooding. The floes caused a lot of damage in the area, including the loss of a beloved bench in Split Rock Park, and nearly wiping out Hardy Park in Brandon. The winter weather continued in April, with a storm that shut down much of SE SD and SW MN for nearly a week.

April also saw a run off for Ward III City Council representative, with both Tom Godbey and Dwayne “Jake” Jacobson both putting their hat in the ring. Godbey won the seat by 3 votes (22-19).

Spring sports started up, despite the cold and rainy weather that impacted practices and competitions. Track got off to a strong start, and the team performed well throughout the season, with 13 competitors entering the State contest in May. The highlight of the track season was the 1st place 6’4” high jump win claimed by senior Trevor Fiegen at the State contest. Golf saw Rave Ulich take first place at the Jesse James Golf Invitational with a score of 38.

Trevor Fiegen high jump
Trevor Fiegen's 6'4", 1st place high jump at State. Photo submitted

In May, discussion about the Emerald Ash Borer again entered the fray, with a great informational article by local Master Gardener Colleen Collier. At least one reader let the Gazette know they had changed their ash tree plans thanks to the information presented. Luckily, as of the end of the summer, it still had not been discovered in Garretson, but it is likely to make its appearance in 2020.

The Gazette was able to feature two more Legionnaires in the lead up to Memorial Day, Duane Megard (Korean War) and Alton Rogen (Korean War), thanks to the diligent reporting of Marty Leubke. Veterans Dale Schmiesing and Harlowe Sundem were able to partake in the Midwest Honor Flight in May. Along with four others in September and October, six Garretson area veterans were able to visit Washington, DC in 2019, a wonderful service provided by donations and sponsorships. The Gazette ran a full feature on the Honor Flight in October.

GHS class of 2019

The GHS Class of 2019 graduated 27 students, with Valedictorian Brennan Mudder and Salutatorian Keara Beck giving the Farewell Speech. The GHS Golf team won runner up at Regions, sending 8 to State.

Not all news in early 2019 was good news, however, as we learned at the end of May that the Jesse James Opera House had been ruined by a roof leak. At the same time, it was discovered the entire building had been badly affected, which closed the Senior Center permanently as well. As of the end of 2019, no plans have been made for the future of the building.

Look for Part Two in the next issue, where we look back on the Street Project, the successful 4th of July 100-year Legion celebration, and much more.

News for 1-2-20 (Subscribers)

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1-2-20 Front Page

Click to download and read Issue #1 Full Version

Happy New Year! This week's issue has Part One of the 2019 Year in Review, a profile on a long-time tax/bookkeeping/lawyer businessman, and recaps of winter sports over the holiday season, plus much more.

There's a lot going on in our community. Keep up with all of it with the Community Events Calendar on page 4. You can download it here and have it easy to hand! Community Events Calendar


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Prairie Doc: Opioids: The Good, the Bad and the Ugly

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Dr. Richard Holm, MD

Richard P. Holm, MD

My patient was in severe pain, suffering from an obstruction in his gastrointestinal tract as a result of spreading cancer. I knew that morphine, one of the opioids, would provide immediate and merciful relief, and it did. We are thankful that we have something that can palliate pain and provide comfort for severe acute pain, especially for patients at the end of their lives. That’s good!

In contrast to the good that opioids can do for certain acute pain, we know they are not very effective for musculoskeletal or neuropathic pain and fail terribly in helping long term pain and chronic pain syndrome. Despite this inadequacy, opioids are still being over-prescribed for most post-operative musculoskeletal pain.

Also, our bodies quickly develop tolerance to opioids, thus continually requiring increased doses to get the same effect. In addition, withdrawal symptoms from opioids can be significant making it difficult to stop taking opioids once hooked. It is estimated that about 75 percent of those taking illicit opioids got started from a prescription, more than 100,000 people are regularly using heroin and about 12 million people are taking non-prescribed illicit opioids. That’s bad!

It gets worse. Opioids have an insidious potential for overdose which depresses the drive to breathe so much as to suffocate people to death. In the U.S., it is estimated that about 70,000 people die each year from opioid overdose. In comparison, 83,000 die from diabetes, 56,000 from influenza and pneumonia, 47,000 from suicide and 40,000 from motor vehicle crashes. That’s very bad!

Ultimately, care providers need to prescribe opioids very judiciously and people must be careful when taking prescribed opioids. AND people need to avoid dangerous illicit forms. We do have an antidote to opioid overdose called naloxone (or Narcan®). If given soon enough, it displaces the opioid from the brain pain receptor and the victim starts breathing again. Thus, every ambulance and emergency room have multiple doses of this lifesaving reversal agent readily available.

Unfortunately, in response to this opioid epidemic, the drug manufacturer of naloxone, which costs 50 cents to six dollars to make, raised its price up to $4,000 for a dual pen auto-injector. Fortunately, a generic version will be available soon with a two-pack of auto-injectors for $180. Until then, we pay the higher price. That’s ugly!

Bottom line: If we hope to find help for this crisis, we need to understand the good, the bad and the ugly about opioids.

Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central.

News for 12-19-19

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Dec 19 2019 Front Page

We wish you a Happy Holidays and wishes for a great New Year! Enjoy our Christmas issue, jam packed with photos from Hometown Christmas, Letters to Santa, holiday drawings, and much more.

We will not be publishing an issue next week due to the holiday; we will see you in the new year with our January 2 issue!

There's a lot going on in our community. Keep up with all of it with the Community Events Calendar on page 4 in the on-line or paper version. With your on-line subscription, you can download it here and have it easy to hand!


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On-line Subscribers Get More!

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