The non-medical use of prescription type-drugs, defined by the usage of drugs without a prescription or only for the intention of experiencing the drug's effect, has increased dramatically across the nation and in Michigan as well.

The effects of substance abuse are far-reaching, extending beyond individuals to families and society. Therefore, there is an urgency to monitor the burden of substance and prescription drug abuse in Michigan.

The Prescription Drug Crisis In Michigan

In 2008, poisoning surpassed motor vehicle crashes to become the leading cause of injury death in the United States. Since 2003, over 90% of all poisonings have involved drugs, with the largest increase in poisonings related to opioid analgesics (pain relievers). A similar national pattern has also been seen in Michigan with poisonings exceeding motor vehicle crashes to become the leading cause of injury death in Michigan in 2009.

The number of opioid-related hospitalizations increased 242% between 2001 and 2014 (from 99,317 to 240,518 hospitalizations). The number of adults admitted for prescription drug treatment increased by 238% between 2003 and 2013.

The number of deaths in Michigan caused by drug overdose increased 27.5% between 2013 and 2015(from 1,553 to 1,980 deaths). In 2015, Michigan had the15th highest rate of death due to drug overdose when compared to the other U.S. states and the District of Columbia.

In 2017, Michigan providers wrote 74.0 opioid prescriptions for every 100 persons. This represents a 25 percent decline in Michigan opioid prescriptions since 2013 (per the CDC).

The rate of overdose deaths involving opioid prescriptions has not followed this trend and steadily rose to 7.0 deaths per 100,000 persons through 2016. In the past year, however, the rate decreased to 6.5 deaths per 100,000 persons.

In 2017, there were 2,033 overdose deaths involving opioids in Michigan — a rate of 21.2 deaths per 100,000 persons, which is higher than the national rate of 14.6 deaths per 100,000 persons. The greatest increase in opioid deaths was seen in cases involving synthetic opioids (mainly Fentanyl), from 72 deaths in 2012 to 1,368 in 2017.

Deaths involving heroin increased from 263 to 783 deaths in the same 5-year period. It helps to understand that the bulk of heroin abusers had prescription opioids as their gateway drug into heroin abuse. Prescription opioid involved deaths also climbed from 378 deaths in 2012 to 678 deaths in 2016 but saw a recent decline to 633 deaths in 2017.

Daniel et al observed gender differences in diversion patterns (n = 210), reporting that approximately 20% of the girls and 13% of the boys in Michigan borrowed and/or shared prescribed medications, representing a statistically significant gender difference in lifetime use. Of the girls, 16% borrowed and 15% shared their prescription medications while 7% of the older girls had shared prescription medications more than 3 times.

Fifty-eight percent of the youth acknowledged at least 1 motivation for sharing drugs: 40% of the girls and 27% of the boys shared because the receiving person had a prescription for the drug but had run out. Thirty-three percent of the girls and 27% of the boys received their diverted drugs from a family member.

In a study of stimulant use conducted by Musser et al children diagnosed with attention-deficit disorder or attention-deficit/hyperactivity disorder (n = 161) and their school administrators were surveyed regarding stimulant use and abuse; 16% of the students had been approached to sell, give, or trade their stimulant medication.

In an earlier study of 10- to 18-year-olds, it was found that when students reported the source of diverted opioid analgesics, more than 33% were from family and approximately 17% were from friends. However, McCabe and Boyd found that college students were most likely to get diverted drugs from peers, and women were significantly more likely than men to get diverted prescription sedative or anxiety, sleeping, and pain medications from family members.

NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study showed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births.

In Michigan, the NAS/NOWS rate increased eightfold from 0.9 cases per 1,000 births in 2004 to 7.1 cases per 1,000 births in 2014.

Of the new HIV cases in 2016, 747 occurred in Michigan. Among males, 7.0 percent of new HIV cases were attributed to opioid and prescription opioid abuse or male-to-male contact and opioid and prescription opioid abuse. Among females, 20.5 percent of new HIV cases were attributed to opioid abuse.

In 2015, an estimated 14,615 persons were living with a diagnosed HIV infection in Michigan—a rate of 174 cases per 100,000 persons. Of those, 12.8 percent of male cases were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 21.4 percent were living with HIV attributed to IDU.

There were approximately 107 new cases of acute HCV (1.1 per 100,000 persons) reported in Michigan in 2016 (per the CDC). In Michigan, there are an estimated 70,000 persons living with Hepatitis C (2013-2016 annual average), a rate of 910 cases per 100,000 persons. A large number of these cases were attributable to opioid and prescription opioid abuse.

Addiction Treatment In Michigan

The fortunate news here is that there are numerous centers of treatment and rehab. There are many types of treatment centers such as long term addiction treatment facilities, short term drug abuse treatment, outpatient detoxification programs, outpatient substance abuse treatment services, inpatient drug abuse treatment and others.

There is a wide range of drug and alcohol rehab facilities available. They include individual psychotherapy, dialectical behavior therapy, couple/family therapy, trauma therapy, trauma-related counseling, cognitive/behavior therapy and others, to name a few. If you need rehab in Michigan, all you need to do is place a call to any of the available rehab centers.

CITATIONS

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf#page=40&zoom=auto,-80,792

https://www.carnevaleassociates.com/our-work/emerging-drug-trends-prevention-issue-brief.html

https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf

https://www.getsmartaboutdrugs.gov/news-statistics/emerging-drug-trends

https://www.ncbi.nlm.nih.gov/books/NBK234579/

https://www.shadac.org/publications/50-state-analysis-drug-overdose-trends-evolving-opioid-crisis-across-states