Let’s Talk About Addiction—The “Other” Public Health Threat

While all eyes are on the Coronavirus pandemic, another public health crisis continues to kill more than 2,000 Michiganders every year: opioid addiction. Opioids, including heroin, morphine, codeine, and hydrocodone, are used to treat severe or chronic pain. While they are highly effective, they can also be extremely addictive—which, combined with a skyrocketing number of prescriptions, has led to widespread abuse across Michigan and the United States. 

The numbers show that Michigan has been hit particularly hard by opioid addiction. While the national rate of drug overdose deaths is roughly 21 per 100,000 people, Michigan’s rate in 2017 was almost 28 per 100,000 people, and these deaths were increasingly linked to opioids. In 2018, doctors wrote almost 63 opioid prescriptions per 100 Michigan residents. Even more surprisingly, this number represents a significant improvement, as the number of opioid prescriptions in Michigan decreased by 22% between 2015 and 2018 after surging in the early 2010s. Still, more Michiganders died from drug overdoses than traffic accidents in 2018, and the majority of overdoses were opioid-related. 

In August 2019, Governor Whitmer signed an executive order to create The Michigan Opioids Task Force to combat opioid misuse and increase access to substance abuse treatment. Most importantly, the Task Force can help our government treat opioid addiction like the public health issue it is by reducing stigma and helping, instead of criminalizing,those who are suffering. However, to succeed, we need to take some important steps. We must:

Expand Syringe Service Programs (better known as “needle exchanges”)

The opioid epidemic is about more than just overdoses—intravenous (IV) drug use also has a major impact on the spread of infectious diseases within our community. In Michigan, the number of young adults (under 40) with Hepatitis C grew from 292 in 2000 to 3,774 in 2018, and 80% of those infected reported a history of IV drug use. In addition to reducing disease transmission, needle exchanges provide services like HIV and hepatitis testing and related vaccinations, referrals to substance abuse programs, and access to naloxone (Narcan). 

Eliminate barriers to recovery by removing prior authorization for treatment medications

Too often, people who are seeking treatment for addiction can’t just go straight to their doctors and be on their way--insurance companies increasingly ask for pre-authorizations before patients can receive prescriptions or medical services. Michigan removed this requirement for Medicaid recipients in December, noting that by eliminating treatment delays, providers could work with patients when they are ready to be served and potentially increase their success in recovery. 

Expanding Medication-Assisted Treatment in Michigan Prisons

Even when people end up incarcerated, their substance use disorders can persist. In fact, more than 20% of Michigan inmates have opioid use disorders, and those leaving prison are 40 to 120 times more likely to die of an overdose than non-incarcerated people—especially within two weeks of release.The Michigan Department of Corrections (MDOC) has started medication-assisted treatment programs at three correctional facilities in Michigan with the goal of expanding treatment to all facilities by 2023. 

No matter what the crisis, it takes proactive, evidence-based leadership to keep our communities healthy and strong. Supporting the efforts of our Governor and the Michigan Opioids Task Force will go a long way in making sure opioids are used safely and only when necessary, and that people experiencing addiction are given the compassionate care they deserve.