Calley: Fight overdoses with tighter drug monitoring

Gary Heinlein
The Detroit News

The Snyder administration wants heightened monitoring of pain killer prescriptions to be the centerpiece of a state-led battle against the growing number of addictions and deaths in Michigan linked to widely used drugs called opioids.

Lt. Gov. Brian Calley unveiled recommendations of a state task force calling for increased reliance on the Michigan Automated Prescription Service to guard against unintended over-prescribing of addictive pain-control medications.

Doctors would have to report pain killer prescriptions they issue and consult the data base before writing new ones under the proposals Calley presented at the Detroit Medeical Center. DMC Chief Administrative Officer Conrad Mallett was a task force member.

The Legislature would need to appropriate more money to update the MAPS.

But if every doctor in Michigan were to sign up for MAPS right now, the system would crash, said Macomb County District 41-B Judge Linda Davis, a task force member. Calley noted the system is not set up for continual use, which limits its effectiveness.

The sweeping recommendations — ranging from a campaign to educate the public about the potential for accidental pain-killer addiction to a proposed law shielding people from prosecution when they seek emergency help for friends who overdose — were greeted as helpful and overdue.

“Other states already are doing it and quite successfully,” Waterford advocate Jeannie Richards said about the proposed prescription reporting mandate. Richards has formed a group called Bryan’s Hope to push for policy changes in honor of her son, who died of a heroin overdose in 2011 after he first got hooked on pain killers.

Richards said she’s optimistic the task force report will result in overdue policies to combat Michigan’s prescription abuse crisis. She hopes it signals a new urgency.

“I know it’s going to take some time, but time’s not on our side,” Richards said. “Just in the time we’ve had this phone conversation, probably two more people have died of overdoses.”

“I’m impressed by the breadth of the recommendations,” said Cynthia Arfken, a professor in Wayne State University’s Department of Psychiatry and Behavioral Neurosciences. “Expanding treatment should also be included. Unfortunately, in Wayne County heroin is too often a cause of death and needs to be addressed.”

A stronger reporting requirement for the Michigan Automated Prescription Service is envisioned as becoming a valuable resource for doctors issuing new prescriptions for opioids such as Vicodin or OxyContin.

“I look at this as empowering doctors with information,” Calley told The Detroit News. “People would naturally think if I go to one doctor to get a prescription for an opioid, that that doctor would be able to tell whether I got another prescription two hours earlier at the emergency room the next town over. And the truth is they can’t today.”

The lieutenant governor chaired a 21-member Michigan Prescription Drug and Opioid Abuse Task Force that since June has studied a growing prescription drug abuse crisis in Michigan. The task force included doctors, other health experts and lawmakers.

“One of the most important things we can do is bring this problem out of the shadows,” said Attorney General Bill Schuette, who also is a member. “This is a problem that does not see race, or socioeconomic backgrounds; it can affect anyone.”

Gov. Rick Snyder ordered the task force study and put Calley in charge because prescription drug and opioid addiction has led to a fivefold increase in drug deaths in Michigan since 1999. He wants the state to confront what has become a nationwide problem that some other states are handling better.

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 are increasing at a faster rate than for illegal drugs such as heroin — also on the rise — and cocaine. A prior state report noted that another class of medications called benzodiazepines — prescribed for anxiety — accounted for about 9 percent of deaths.

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.

Among its nearly three-dozen recommendations, the task force calls for:

■Updating pain clinic licensing regulations for the first time since 1978.

■Increasing sanctions against health professionals who violate proper prescribing and dispensing practices.

■Limiting criminal penalties for low-level offenders who seek medical help for overdoses.

■Requiring added training in pain medication use as part of continuing education for doctors who prescribe the medications.

■Boosting the number of drug-addiction treatment specialists practicing in Michigan.

■Increasing awareness that state laws limit criminal or civil liability for emergency use of Naxolone, an injectable drug that reduces the effect of opioid overdoses and prevents deaths. Research its possible use the way EpiPens are used for people with severe allergies.

■Bolstering drug take-back programs where people can turn in leftover prescription pills.

■Better training law enforcement officers to recognize and deal with drug addicted subjects they encounter.

But the lieutenant governor cautioned against forming the impression the task force report is loaded with heavy-handed provisions.

“We have taken special care through all of this to make sure that this doesn’t hinder the ability of people to receive these very effective prescriptions for pain management,” he told The News. “All the work that we’re doing is try to avoid, prevent and then deal with addiction when it happens.”

There are recommendations, for example, to increase use of state drug courts, special courts that send lower-level addicted offenders to treatment rather than jail, and to have health insurers provide better coverage for drug treatment.

“We have to get past the idea that if a person is addicted, that is a bad person,” Calley said. “Addiction is a biological thing, not a willpower thing. ... We can view this as a health care process. People would never shy away from seeking treatment for diabetes, so we don’t want people to be afraid to seek treatment for addiction, as well.”

Calley said Michigan ranks in the bottom half among the states for dealing with the problem of prescription abuse. Carrying out the recommendations, he said, will make the state a leader.

There’ll be a state-level board or committee to coordinate the process. But Calley promised he personally will see that the plan is implemented.

Making recommendations was one part the task force’s work, and that job is now done. Seeing those recommendations through to the point they become policy is now the mission, Snyder said.

“I hope,” Snyder said to members of the task force as the press conference began, “you’re ready to roll up your sleeves even further.”

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