Facing the crisis: Doctors emphasize education and awareness during ‘opioid crisis’

Many organizations in Mecosta and Osceola counties host drug take-back events in an effort to keep unneeded medications out of circulation and off the street to prevent future overdose due to opioids. According to Mary Kay VanDriel, president of Spectrum Health Big Rapids and Reed City hospitals, in three years of partnering with Ten16 Recovery Network and local law enforcement to hold medication and needle take-back events, they have taken a total of 1,255 pounds of unneeded medications and 946 pounds of needles out of circulation. (Pioneer file photos)

By Taylor Fussman and Meghan Gunther-Haas, Pioneer Staff Writers

Editor’s note: This is the second installment in a two-part series on opioid abuse compared to the need for medications containing opioids in pain management locally and nationwide. The first part of the story was featured in the Friday edition of the Pioneer.

MECOSTA, OSCEOLA COUNTIES — When hearing the phrase “opioid overdose,” many people may picture someone who has a drug abuse problem. This, however, is not always the case, as medical professionals say an overdose could happen to anyone.

Many doctors say there can be a medical necessity for prescribing opioid medications, but a fear of this class of drug has spread across the country.

This fear has stemmed from a real problem existing within the medical community for the past several years involving over-prescribing medications containing opioids to patients, and a resulting increase in abuse and overdose due to these substances. Some of the overdoses are purely accidental.

“My husband almost died of an opioid overdose,” said Susan DeVuyst-Miller, assistant professor of pharmacy practice at Ferris State University’s College of Pharmacy. “He had surgery. He had some medical problems that made it so his body couldn’t tolerate the medications. Had he had the ability to continue to take his medications, he would have died.”

Similar stories, and those of long-term addictions, are not uncommon. However, state mandated changes implemented this year requiring physicians to take precautionary steps before prescribing an opioid medication have worked to reduce the number of medications dispensed.

Unintended consequences of prescribing practices

This cutback has limited some access to necessary opiates.

“Many patients these days cannot get their opioids. Pharmacies may or may not be stocking them like they used to, but I think a lot of physicians are hesitant to prescribe because of all the new Michigan laws that came into place,” said Claire Saadeh, an FSU College of Pharmacy professor who works in the outpatient cancer center and inpatient pain management division of Sparrow Health Services.

“The drug companies that make opioid products have been asked to scale back their production of medications,” she said. “We are going to be reducing access again, reducing supply, which will indirectly turn into some access issues, probably.

“I think we’re going to see opioid numbers go down, but I have cancer patients come to our supportive care clinic, that have said, ‘I have cancer and my oncologist won’t prescribe any opioids.’ This is kind of really frustrating for the patients.”

When faced with the rising difficulty in obtaining opiates, due to either state mandated changes, providers no longer prescribing the drugs or a lack of funding, some patients are turning to the streets.

Dr. Thomas Wright, division chief for Spectrum Health Medical Group, has noticed a recent rise heroin usage.

“All this work at eliminating opioids is making a difference. Opioid prescriptions are declining, but heroin use is going up,” he said. “It calls into question whether or not what we are doing with prescription opioids is just shifting the problem somewhere else.

“I don’t know the answer to that, but I think a lot of people are asking that question.”

Opioid addiction and overdose

Saadeh explained because of this increase in heroin use by people who cannot obtain opiates, it has become increasingly important to educate her students at FSU and people in the community about the stigma surrounding opioid use and addiction, and the current state of the “opioid crisis.”

Wright explained there are three elements to navigate in regards to opioids and addictions.

The first element being dependence, meaning a patient cannot stop the medication suddenly. Dependence is followed by tolerance, or the tendency to take a higher dose over time because the previous dose isn’t effective anymore. Finally, addiction, which Wright said can be defined a lot of ways, is the continued use of a substance in spite of negative consequences, and an inability to control the use of that substance.

“The job of the family physician is to have reasonable compassion and to practice rational management of opioid therapy in the management chronic pain. It’s a tricky course to navigate,” he said. “It’s also their task to identify patients who are on excessive doses of opioids and try and wean them in an appropriate fashion.”

Despite a concerted effort among doctors across the state to safely and effectively wean patients off high doses of opioids, so they don’t turn to street drugs or other potentially dangerous alternatives, there are still many people struggling to manage an opioid addiction.

According to the Center for Disease Control and Prevention (CDC), in 2016, 63,632 drug overdose deaths occured in the U.S., and substances containing opioids were involved in 42,249 of these overdose deaths.

Combating addiction and overdose

DeVuyst-Miller, who also works in the adult medicine clinic of Cherry Health Services in Grand Rapids, explained an effective method for preventing overdose due to opioid medications is naloxone. Naloxone is a medication used to block the effects of opioids, especially in an overdose situation, through injection or a nasal spray.

“I carry naloxone on me because of the work I do and the different agencies I work with and know there is a potential I could have somebody overdose,” she said.

She added the stigma surrounding opioid addiction may extend to dispensing naloxone, but it is important people understand the potentially life-saving benefits of having this medication on hand.

“There are persons who have an addiction, and they also need naloxone. We shouldn’t have stigma around the knowledge of it or dispensing of naloxone,” DeVuyst-Miller said. “It should be just like an EpiPen or a fire extinguisher. We never want to have to use them, but we need to make sure we have the resource in case we have an opioid overdose, whether it’s from prescription or street drugs.”

To combat potential overdoses, various organizations and individuals are working to raise awareness of opioids and reduce the number of prescription medications taking up space on a shelf.

Ten16 Recovery Network, in Big Rapids, is one organization in the community actively working to accomplish these goals.

Deb Schafer, Ten16 prevention and outreach manager, said the organization works with schools and youth to prevent substance use disorders from developing.

Along with drug take-back events, Spectrum Health plans to hold several events and conferences in the next couple months to educate the public on multiple aspects of the opioid crisis.

“This is not about opioids specifically — this really is about teaching kids how to handle prescription medication carefully,” Schafer said.

In addition to programs to educate youth and adults in the community, many organizations host drug take-back events in an effort to keep unneeded medications out of circulation and off the street to prevent future overdose events.

Schafer said take-back events are helpful because it is common for people with an opioid addiction to obtain the substance through someone they know who was prescribed medication.

“Many people don’t realize that we live in a society where we want to helpful to each other — that’s not a bad thing — but when you are helpful to each other by sharing medication, it can truly harm the other person,” she said.

According to Mary Kay VanDriel, president of Spectrum Health Big Rapids and Reed City hospitals, in three years of partnering with Ten16 Recovery Network and local law enforcement to hold medication and needle take-back events, they have taken a total of 1,255 pounds of unneeded medications and 946 pounds of needles out of circulation.

“Community support has been great. More than 900 people have participated in helping us keep these items off the streets via 26 take-back events to date,” she said.

Deb Schafer, Ten16 prevention and outreach manager, said in addition to drug take-back events, storing medications in a lock box can be a helpful tool in ensuring no one is taking substances that were not prescribed to them.

To continue to educate the community on the multiple aspects of the opioid crisis, Spectrum Health will be hosting several events in the next couple months.

In October, at the Mecosta/Osceola Career Center, there will be an opioid conference which will include speakers, a panel of experts discussing local impact of an response to opioids. There also will be break-out sessions, and more details will be provided when planning for the conference is complete.

There also will be two events titled “Helping the Whole You” in November to provide information and increase awareness of the issues.

The first will be from noon to 1:30 p.m. on Wednesday, Nov. 14, at the Big Rapids Department of Public Safety, and the second will be from noon to 1:30 p.m. on Thursday, Nov. 15, at Michigan Works in Reed City.

Although doctors, patients and the public as a whole have come a long way in reducing the number of opioid medications in circulation, physicians say there is still work to be done to educate the public and combat the stigma surrounding opioid addiction.

“Many people, not all people, but many people, assume the people that are going to overdose are drug abusers,” DeVuyst-Miller said. “It is unfortunate that a drug abuser has a likelihood to do it, but that doesn’t mean their life doesn’t have value.”

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