Opioid Resources in Northern Michigan

Misuse of opioids is a serious national health crisis. Every day in the United States, 130 people die from an opioid overdose. In Michigan alone, the number of people diagnosed with an addiction to opioids between 2010 and 2016 increased by a staggering 493 percent. This crisis affects us even here in northern Michigan. In fact, in the five-county area that our largest hospital and regional referral center – Munson Medical Center – serves, the average age-adjusted death rate from opioid overdose from an overdose per 100,000 residents was 17.1 versus the national average of 15.6, according to the Center for Disease Control and Prevention (CDC). Moreover, Munson Healthcare hospitals report that 39.6 percent of patients treated in the emergency department for substance use disorder will return to the ED within 90 days.

What Are Opioids?

Opioids are narcotics used for pain relief that produce morphine-like effects on the body. These drugs have significant side effects and can even lead to death when misused. Common names of opioids are hydrocodone (Vicodin, Norco), oxycodone (Percocet, OxyContin), morphine, codeine (Tylenol #3, Tylenol #4), Fentanyl, methadone, and tramadol (Ultram).

What We Are Doing to Address the Opioid Crisis in northern Michigan

The spotlight on the opioid crisis both nationwide and in our region has encouraged important action on several fronts. At Munson Healthcare, we are seeing a slight positive turn in statistics and are committed to helping our community resolve this issue within our mission and role as a health care provider.

Our efforts to provide care and help stem the opioid crisis are numerous and varied, involving both inpatient and outpatient care. We continue to expand these efforts through several collaborations, educational initiatives, and now additional programs and front-line staff made possible through grant support.

Specific actions Munson Healthcare has taken include the following:

• Participating in two community roundtable discussions on opioids.
• Establishing an Opioid Task Force to examine our processes and practices.
• Developing a controlled substances and opioids toolkit to help educate staff and physicians and ensure we have the right policies and practices in place to help address this problem.
• Reducing the number of opioid pills prescribed in Emergency Rooms by nearly 75 percent over an 18-month period (as of April 2019).
• Introducing a medication assisted treatment (MAT) pilot program to help area residents struggling with an opioid-related disorder, thanks to grant funding from the Michigan Opioid Partnership. This program will care for people suffering from opiate use disorder, beginning with Munson Medical Center’s Emergency Department and continuing with treatment and maintenance care in the community with collaboration from our partners: Addiction Treatment Services, Munson Family Practice Center, Traverse Health Clinic, Northwest Michigan WORKS, Dr. Julia Riddle and Behavioral Health Services.
• In addition to this collaboration with the Michigan Opioid Partnership, we also received a three-year $1.5 million grant from the federal Substance Abuse and Mental Health Administration in late 2018 that also allows us to use the gold standard of opioid use disorder care. This includes expanded access to medications, behavioral health treatment, recovery coaching, and care coordination.
• Installing MedSafe medication disposal bins at nine Munson Healthcare sites, as a safe, free way for community members to dispose of unused or expired medication. Since those installations in 2018, nearly 1,800 pounds of medical waste has been collected (as of June 30). Much of that waste represented unused opioid medications.

Alternative Pain Care

It is important to note that though we are in this opioid addiction crisis, there remains a proper use for opioids in the care of certain patients. We also understand the need for pain relief for certain classes of patients can be met through alternative means.

Provider education within our health system has emphasized alternative pain care. Examples include:

• Non-opioid medications such as acetaminophen, ibuprofen.
• Non-medication therapies such as ice, elevation, physical therapy, splinting.
• Acupuncture and mindful practice when appropriate and if the patient is open to these.

The opioid crisis will take continued collaboration and concerted efforts to solve. With the help of the Michigan Opioid Partnership and like-minded providers and agencies, Munson Healthcare will continue our efforts to reduce and ultimately put an end to the opioid crisis affecting our region and beyond.

Resources for Opioid Treatment throughout Northern Michigan