Michigan steps up fight against opioid addiction

Michael Gerstein
The Detroit News

Lansing — Lt. Gov. Brian Calley signed a 10-bill package Wednesday aimed at reducing Michigan’s rapidly growing opioid addiction by requiring doctors and the state to better track and control the flow of opioid-based prescription drugs.

Calley signed six bills that will collectively require doctors to use a new online prescription tracking state database, set up a legitimate doctor-patient relationship and limit the number of pills dispensed in a given seven-day period. It comes as the number of heroin and prescription opioid overdose deaths in Michigan has doubled during the past five years.

Health and addiction experts have long urged the medical industry to adopt new prescription opioid standards. Many heroin addicts start out using legal painkillers first, and even people who take such drugs as directed by a doctor can still wind up addicted.

Calley and other public officials have called for legislation to stop “pill mills,” or unscrupulous doctors who authorize too many prescription painkillers and end up feeding addiction.

“It’s now claiming more lives than car accidents each year,” Calley said at a Wednesday press conference.

In 2015, 1,275 people died from heroin and opioid-related overdoses — 884 were caused by prescription opioids and another 391 from heroin, according to the most recent data from the state Department of Health and Human Services.

By comparison, 963 people died in car accidents in 2015, according to the Michigan State Police.

The 2015 heroin and prescription opioid overdose deaths represented a nearly 100 percent increase over the 639 deaths in 2010 — 195 from heroin overdoses and another 444 from prescription opioid overdoses.

“This will make a huge difference. It’s about earlier detection and prevention,” Calley said about the legislation.

“We’ve done a lot of great work to try and save lives after a person becomes addicted,” said the lieutenant governor, who chairs Gov. Rick Snyder’s task force on opioids. “What we’re doing now is the work to prevent the addiction from happening in the first place and to detect it earlier in the process and get ahead of this epidemic.”

In overall Michigan drug poisonings, 1,981 people died in 2015, according to the state, a 12 percent rise from the 1,745 fatalities from the year before.

What legislation does

One of the bills Calley signed Wednesday was by Sen. Tanya Schuitmaker, R-Lawton, and requires that doctors review a patient’s history on a new online database called MAPS before prescribing opioids. The measure was recommended by Snyder’s task force.

Calley said Schuitmaker’s bill is “very central to making progress in the fight against the addiction epidemic that has swept across this state and across the nation.”

He also praised a bill from state Rep. Andy Schor, D-Lansing, for expanding treatment options for Medicaid recipients in need of opioid addiction help. Lawmakers need to keep working to expand treatment, “but it seems like there’s never enough,” Calley said.

“At the end of the day, the most important aspect for whether a person recovers, the first thing is wanting to get better. And there’s so much more awareness today; there’s so much more acceptance among people to seek treatment than what we saw a few years ago. That makes me hopeful that we can turn this around.”

A related bill from Sen. Dale Zorn, R-Ida, requires the state to record opioid prescriptions in MAPS in an effort to keep tabs on doctors who prescribe too much. It’s also meant to help doctors know when patients are hopping from office to office to get too many pills.

According to the report, every state except Missouri has a prescription drug tracking system for pills. MAPS came online in 2002 but experienced a major upgrade in April that lawmakers and health professionals hailed as a cornerstone of the state’s opioid epidemic battle.

The legislation Calley signed Wednesday also would stop a prescriber other than veterinarians from distributing opioids without first looking into a patient’s prescription history on MAPS.

Other bills would require a “bona fide” patient-doctor relationship before a doctor could prescribe opioids and limit the supply of opioids.

Legislation signed last year by Snyder allotted $2.5 million for a new cloud-based database and did not require doctors to check the system before prescribing addictive painkillers to patients.

Although some in the industry say the system could help fight the state’s opioid-abuse epidemic, the Michigan State Medical Society has voiced strong concerns that requiring use of the new system would be time consuming and add more work for doctors.

As of Tuesday, 24,639 licensed doctors and pharmacists have voluntarily signed up to use the state’s drug tracking database and more than 4,000 nurses or office managers on behalf of licensed medical professionals, according to the Department of Licensing and Regulatory Affairs.

Blue Cross Blue Shield of Michigan CEO Daniel Loepp in a Wednesday statement called the package “a strong step forward that strengthens Michigan’s efforts to reduce addiction and abuse.”

2018 campaign overtones

But the bill signing had political overtones since Calley is running for the Republican gubernatorial nomination in 2018 against Saginaw obstetrician Jim Hines and Attorney General Bill Schuette, who wasn’t invited to the event. Calley and Schuette’s office backed the legislation.

Schuette wasn’t invited to Wednesday’s bill signing even though an Attorney General’s Office representative participates on Snyder’s opioid task force, said spokeswoman Andrea Bitely.

“We could have at least sent a representative, if not the AG himself,” she said.

Bitely noted that Schuette attended a White House event in October when President Donald Trump declared the opioid crisis a national public health emergency. Trump has endorsed Schuette for the GOP gubernatorial nomination.

Calley and Schuette have traded barbs in the past two months after the lieutenant governor accused Schuette of “politicizing” the Flint water contamination crisis. Snyder’s Health and Human Services Director Nick Lyon and Chief Medical Executive Eden Wells have been charged with involuntary manslaughter by Schuette’s office.

Schuette later called the “politicizing” comment “nonsense” in a year-end interview with multiple media outlets and suggested that his criminal prosecution of state and local officials in the Flint crisis won’t be stopped by “those that would want to sweep it aside or ignore it.” The attorney general would not say who that might be.

Bitely said Schuette is “very passionate” about fighting addiction and went so far as to require that assistant attorneys general be trained in administering an overdose rescue drug known as Narcan in case someone experiences an overdose during a court proceeding.

“We made great progress today in the fight against the opioid addiction epidemic and that should be celebrated by anyone who cares deeply about the issue,” Calley said. “I’ll go ahead and ignore petty complaints about who got invited to the bill signing ceremony and continue to focus on the people we are trying to help.”