Health and Wellness Statewide News

Overdoses mostly down since the creation of prescription tracking databases

Image by mohamed Hassan from Pixabay

Written by Patrick Bailey

Michigan drug overdose deaths have trended downward in recent years. In 2018, the Michigan Department of Health & Human Services (MDHHS) reported a drop in fatalities, the first decrease in six years.

Certain populations continue to struggle. The COVID-19 pandemic isn’t helping matters either.

The majority of overdose deaths continue to be linked to opioids. In 2018, for example, out of 2,599 overdose deaths statewide, opioids factored into 2,036 fatalities, according to MDHHS.

MAPS Data

One reason behind the downward trend in overdoses is because prescriptions are being better monitored statewide.

In 2003, the Michigan Automated Prescription System (MAPS) was first launched. It was designed to track prescription activity statewide. The goal was to better identify drug diversion — when pharmaceuticals move from legal channels to illegal markets-occurring among prescribers, pharmacies and patients.

The prescription monitoring program (PMP) got a reboot in 2017, when Appriss Health’s PMP, AWARxE, replaced the existing system. A more user-friendly framework and real-time data were added to better battle the opioid crisis.

The PMP is overseen by the Department of Licensing and Regulatory Affairs’ (LARA) Bureau of Professional Licensing. It focuses predominantly on Schedule II-V drugs. Schedule IIs have a higher potential for abuse and dependence since they include illegal substances like cocaine and methamphetamine, but also legal drugs like oxycodone, Adderall or Vicodin.

Prescribers and dispensers who register with MAPS’ online database are asked to report suspicious activity, including when:

  • Patients have controlled substances but no documentation
  • People are selling, sharing or borrowing controlled substances
  • They come across forged or altered prescriptions
  • The prescribing party is questionable

Some Progress Made

Since Michigan has cracked down on opioid abuse, the state overall has seen numbers decline in a desirable direction. Over the two-year period of March 2016 to March 2018 there were 239,608 fewer opioid prescriptions issued to patients — from 10.4% to 6.3%, according to Michigan.gov.

Multiple provider episodes — where an individual sees five or more providers and fills five or more prescriptions at different pharmacies-also went down statewide, from 34.4 per 100,000 in March 2016 to 10.9 per 100,000 in March 2018.

The tracking shows good results, in that there were an estimated 30% more drug-related overdose deaths in 2015 compared to 2013.

Men had higher numbers of overdose deaths compared to women, with the exception of the very youngest (17 and under) or the oldest group analyzed (ages 76 and up).

Detroit and Grand Rapids had the most drug related deaths, according to michigan.gov (https://www.michigan.gov/documents/lara/BPL_ApprissStatewideOpioidAssessementMICHIGAN_03-29-2018_620258_7.pdf). That could in large part be due simply to their being the state’s most populated communities. Lincoln Park and Ecorse have the highest drug-related death rates, according to the same website. Flint over that same period ranked primarily in the bottom of the top 10 cities with the most overdose deaths. (In 2013, for example, Detroit reported 88 deaths, or 0.418 deaths per 1,000 patients, compared to Flint’s 21, or 0.337 deaths per 1,000 patients.)

Not A Total Success

Despite the success stories, there are disparities.

Some communities continue to see losses, and not in declining fatality rates.

Most counties statewide did see a drop in overdose deaths, but 23, including Genesee County, did not. According to MDHHS, the county had the greatest increase in Michigan in 2018, with 60 more drug deaths for a total of 221 (https://www.michigan.gov/documents/mdhhs/Drug-Overdose-Deaths-MI_2017-2018_690602_7.pdf).

The good news is that for whites overall overdose rates are down 6.5% and opioid deaths fell 5.1%. The bad news is that opioid deaths have soared by 19.9% among Blacks, and their overdose fatalities overall are up 14.7%.

Considering that as of July 2019, 53.7% of Flint’s population was Black (according to census.gov) the data and the trends are problematic.

COVID-19 Curveball

COVID-19 has complicated things in recent months, too. This year emergency calls for opioid overdoses have gone up 26% from April through June, compared to the same period in 2019, according to the Detroit News.

ER responses went up 33% from April to May alone, and it’s risen for all ages and all demographics, except for residents ages 65 and older.

That could be in part because people seem to be rejecting going to emergency or seeking medical attention since the pandemic began.

It’s not clear, however, how many deaths have occurred because of opioids during COVID-19. Not all the data has been collected on that.

In the meantime, experts advise never using drugs alone, and to be sure to have naloxone on hand to temporarily reverse the effects of an opioid overdose. (Medical help should still be sought, since naloxone only works for a short amount of time.)

Complications

There is value to the tracking system, however. From 2013 to 2015, the data revealed one out of every 100 patients who visited 21 or more prescribers or dispensers died. Having a system in place that can better identify who may have a dangerous habit or illegal practice is poised to prevent overdose deaths.

While there were fewer deaths due to pharmaceuticals like oxycodone and hydrocodone, the presence of super-potent opioids like Fentanyl are behind some recent upticks. (In 2011 Fentanyl was connected to 4% of overdoses in the U.S. By 2016 it factored in 28.8% of cases, according to the Centers for Disease Control and Prevention https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf).

Further adding to the problem are Flint’s woes. In addition to drug overdoses, the county struggles with a 20% poverty rate (welfareinfo.org), the aftereffects of the 2008 recession and the water crisis. The problems can lead to depression, anxiety and stress, pushing people further into addiction, necessitating the need to find rehab.

There are several resources available offering help with opioid addiction for those in Flint and Genesee County.

One local rehabilitation option many have found great success with is Life Challenge Ministries, offering a one year residential rehabilitation center. Life Challenge is a 501(c)(3) Christian charity organization registered in the state of Michigan. For details on Life Challenge Ministries visit https://lcministries.org/

Author Bio: Patrick Bailey is a professional writer mainly in the fields of mental health, addiction and living in recovery. He attempts to stay on top of the latest news in the addiction and the mental health world and enjoys writing about these topics to break the stigma associated with them.

 

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