Lansing —The Snyder administration is battling a surge in overdose deaths in Michigan linked to the abuse of pain and anxiety medications — an issue experts say was previously almost invisible to the public outside the families dealing with it.
Later this month, a committee headed by Lt. Gov. Brian Calley will make recommendations for addressing Michigan’s part in what the U.S. Department of Health and Human Services calls America’s “unprecedented drug overdose epidemic.”
Prescription drug and opioid addiction has led to a fivefold increase in drug deaths in Michigan since 1999, a trend that Calley said leaders “must come together to reverse ... before more Michiganders are hurt.”
“We are losing kids in schools. People are losing their jobs because of these drugs,” said Cass County District Judge Susan Dobrich, who sees the problem daily in her courtroom. “It’s shocking how many prescriptions there are out there and it’s scary there are so many people on the roads, driving on painkillers.”
Prescription abuse is a “huge problem” made worse, and harder to counteract, because the drugs are legal, said Dobrich, president of the Michigan Association of Treatment Court Professionals.
Opioid analgesics or painkillers accounted for 1,001 or nearly 20 percent of the 5,062 Michigan deaths caused by “unintentional drug poisonings” between 2009 and 2013, according to state statistics.
The state’s health department has said overdose deaths linked to opioids were increasing at a faster rate than for illegal drugs such as heroin — also on the rise — and cocaine. A state report also noted that another class of medications called benzodiazepines — prescribed for anxiety — accounted for about 9 percent of deaths.
The Michigan Automated Prescription System, which tracks controlled drugs, hints at why this is happening: 20.8 million controlled substance prescriptions and 1.4 billion pills were in circulation in 2013 alone, the equivalent of 139 pills for every state resident.
Still, Gov. Rick Snyder’s decision to raise the issue and create a task force in his January State of the State address surprised many lawmakers and pundits. Experts say the problem had been largely invisible to residents not directly affected by addicted family members or friends.
Opioids are powerful painkillers that can lead to the use of highly addictive and dangerous illegal substances, especially heroin, Snyder said. They include drugs such as fentanyl, codeine and hydrocodone, or brand names such as OxyContin, Demerol and Vicodin.
Waterford resident Jeannie Richards, whose son died of a heroin overdose in 2011 after he first got hooked on painkillers, recalled an earlier state task force that seven or eight years ago “came together and they did nothing.” She said she hopes this effort will be more productive because the problem is bigger now. “I’m very optimistic,” said Richards, who has formed a group called Bryan’s Hope to push for policy changes in honor of her son.
Richards said drug addictions have been shrouded in secrecy for too long because of the stigma that goes with them. “We go to great lengths to keep it secret when, in fact, we need to bring it out to get victims help,” she said.
Mirrors national trend
The pattern of prescription abuse in Michigan mirrors a national trend.
According to a recent U.S. Department of Health and Human Services report, the proportion of overdose deaths attributed to opioid painkillers doubled from 30 percent to 60 percent between 1999 and 2010. Opioid overdoses caused 16,651 deaths in 2010 alone, the report said.
“The abuse of opioid analgesics results in over $72 billion in medical costs alone each year,” the federal agency said. “This is comparable to costs related to other chronic diseases such as asthma and HIV.”
A Michigan Prescription Drug and Opioid Abuse Task Force hearing in August brought an outpouring of testimony from professionals dealing with the fallout and anguished witnesses to sons, daughters, nieces and nephews destroyed by drug abuse.
Lansing resident Anne Kesler described how a nephew was introduced to the anxiety drug Xanax by a girlfriend at 16 and developed an affinity for prescription medications. The results were three trips through rehabilitation clinics, three wrecked cars and one nonfatal overdose.
His growing addiction was aided by a 30-day prescription for Vicodin following a wisdom tooth extraction and a prescription for OxyContin following an appendectomy when he was 18, she said.
By the time his parents and family realized what was happening, Kesler said, “he was like a train that was out of control. He’d go to doctors and say, ‘I’ve got this or I’ve got that’ and get a prescription. He was taking anything he could get his hands on — Xanax, OxyContin.”
He died at 24 in April from a mixture of fentanyl and heroin that he obtained on the streets, she said. It’s a powerful blend experts say is becoming alarmingly common in overdose fatalities.
“I would say, first of all, the doctors have to take some responsibility,” Kesler said. “Kids are getting this stuff ... as young as 12.”
Pills for every malady
Robert Gerds, administrator of the Oakland County Medical Examiner’s Office, said opiate abuse is an outgrowth of an industry that produces pills to cure every malady and sells them endlessly on television.
Hydrocodone, an opiate painkiller that is used in drugs such as Vicodin, is the most prescribed drug in Michigan, comprising nearly a third of all prescriptions, according to state records.
“We make it very convenient to die of a prescription overdose,” said Patty Roland, manager of operations for the Macomb County Medical Examiner’s Office.
More than 75 percent of those who died of opiates had valid prescriptions and didn’t mix the drugs with heroin or cocaine, according to a 2014 state report that analyzed prescriptions and death records.
“The majority had legitimate prescriptions … their deaths were accidental, and many didn’t realize how much they were taking,” said Dr. Su Min Oh, one of the report’s authors.
Statewide, prescription drug-related deaths skyrocketed during the late 2000s, but leveled in the past few years as heroin deaths increased.
Many medical professionals suggest that tightened restrictions on opiates forced users to turn to street drugs. Heroin has less “quality control” than prescription opiates, leading to more overdose deaths, Gerds said.
“The doctors have gotten smarter about tracking prescriptions. Law enforcement has gotten more aggressive, so it’s harder to find these prescription drugs on the street,” said Kyle Rambo, executive director of Catholic Social Services of the Upper Peninsula. “It’s gotten more expensive. Folks who are addicts are turning to the low-cost, what’s available alternative, and that is heroin.”
Rambo’s Marquette-based agency last year treated about 400 people for substance abuse, a number that has remained consistent for years. In the past, the agency may have treated users for meth addictions. Now they are abusing prescription drugs, and Rambo said many users are simply prone to abusing drugs.
“It’s been on the increase for years,” said Bob Mellin, deputy director of clinical operations for Great Lakes Recovery Centers, an Ishpeming-based treatment facility.
“The danger with opiates is that you never know if your brain has a neurological pathway that is prone to addiction unless you are prescribed a painkiller. You can have no history of abuse, but it’s like your brain gets hijacked and you’re off to the races.”
Staff Writer Christine MacDonald contributed.