Michigan's statewide effort to reduce the number of people dying from opioid overdoses has been working.
A collaboration among state and county agencies, hospitals, first responders, and community non-profits across the state — along with federal money for drugs to treat overdoses and addiction — has moved Michigan from having the 13th highest number of opioid overdose deaths in the nation, a decade ago, to the 36th.
"So that's a massive reduction," said Dr. Chad Brummett, co-director of the Opioid Prescribing Engagement Network (OPEN) at the University of Michigan. "I think people should be proud of that. We shouldn't take our foot off the gas."
But many fear that is exactly what might happen, if federal funding for key drugs are slashed, and Medicaid eligibility is reduced.
Narcan, Narcan everywhere, for everyone
A key feature of Michigan's success in reducing the number of people who are dying of opioid overdoses is the widespread availability of a drug called naloxone. Known by the brand name Narcan, it works by blocking the effects of opiates on the brain and by restoring breathing.
First responders are not the only ones who have access to to naloxone in Michigan. It's in emergency departments, county health departments, community nonprofits that serve people with substance use disorder, and, increasingly, in vending machines in places like libraries. You can have the state mail it to you.
Barbara Locke is director of prevention programs at Community Health Awareness Group in Detroit. She said her agency not only distributes naloxone to clients and others, but educates them on how to use it.
"The client is the first responder, because if we can train you to reverse an overdose amongst your peer networks, then you're doing the job even before a first responder gets there," Locke said. "So we help our clients build relationships. Don't get high alone. We also do education with family members. You know our parents, they don't want their kids to use drugs, but they also don't want them to die."
The Michigan Department of Health and Human Services said a reduction in federal funding for naloxone would significantly impact the state’s ability to continue these impactful efforts. Of the 419,364 naloxone kits that were distributed in the state in fiscal 24, the agency said, 91.7% or 384,888 were federally funded. The rest were paid for with funds from Michigan's share of settlements from lawsuits filed against opioid manufacturers and distributers.
Medicaid expansion helped many afford drugs to treat their substance use disorder
Michigan's focus has gone beyond simply making sure people survive overdoses. The state's Medicaid expansion, which increased the income threshold for qualifying for the government health insurance program, has allowed people with substance use disorders to gain access to expensive drugs to treat their dependency, such as methadone, buprenorphine, naltrexone, and lofexidine.
Jimena Loveluck is the health officer with the Washtenaw County Health Department.
"That's also a really significant part of why we also have a decrease in overdose deaths because more and more people, thanks to Medicaid expansion, have been able to get access to opioid use disorder medications," Loveluck said. "Cuts to Medicaid could really have a very negative impact on accessibility to medication that is used to treat people with opioid use disorders."
Loveluck said the state may need to shift funds from its opioid lawsuit settlements, in order to cover both naloxone distribution and medications to treat opioid dependency. But some experts think even so, there will still be a significant shortfall — and shifting those funds will leave other important programs stranded.
Education is a big part of Michigan's effort. Experts hope that will continue whether federal help continues or not.
The University of Michigan's Chad Brummett said it's crucial to reach out to young people across the state to spread awareness of the dangers of opioids.
One way his group, OPEN, is doing that, is with a musical. (Yes, you read that right.) "Painless: The Opioid Musical" follows a group of students forced to sit through a drug awareness assembly at school — bored at first, it’s not long before they begin to realize their own connections to the ongoing crisis. School of Music, Theater, and Dance students from the University of Michigan have been touring the state since 2022, and plan to start again in fall 2025.
"We've done 24 schools so far," Brummett said. "That's why we were in Marquette last week. I stood in the back of that room and I'm like, I'm getting hairs in back of my neck because 150 kids paid attention the whole time, they stayed around, asked questions, and were taking pictures, were super engaged. I mean this thing is real."
Barbara Locke of the Community Health Awareness Group agreed that educating young people about the opioid crisis and its dangers is crucial.
That's because, she said, these days, the first weed a young person ever smokes might be laced with fentanyl — before they've ever learned anything about how to stop an overdose with Narcan.
"So we started a program recently called Project YOUR, Youth Overdose Understanding Risk, to train our young to be ambassadors, to help them educate each other, how to reverse an overdose, what drugs look like, what their risks are. And now they're ambassadors. They're educating their peers because they don't listen to me. They don't listen to us. They do listen to each other."
Locke said groups like hers will have to make do, but she called what appears to be the pending loss of federal funds for naloxone, and cuts to Medicaid eligibility, "tragic."
"Funds like that turn the tide," Locke said. "But it doesn't change our dedication to our clients. And I'm comfortable saying that. We worked on a shoestring before.
Will it be harder? Yes. But as I tell my staff, focus on the client that we're here to serve."
