Newsletter October 2018

From the CEO's Desk

Joseph Sedlock

Chief Executive Officer 

I have provided information to the MSHN Board of Directors via my written reports over the past several months on the Federal, State and Regional responses to the opioid epidemic. This article will attempt to focus more on the State level. Dr. Debra Pinals, the Medical Director for the MDHHS Behavioral Health and Forensic Programs, gave an excellent presentation on this topic at the Statewide Substance Use Disorder Conference on September 18, 2018. Much of the content for this article is drawn from her presentation.

The number of opioid deaths increased 174% between 2011 and 2016 (the most recent date for which data is available). This roughly equates to the death of nearly five people per day in our State. In 2016 there were 32,473 people in SUD treatment for opioids or heroin.

The State of Michigan, and MSHN, is using a three-pronged approach to the opioid crisis.

The first tier focuses on Prevention, including promoting awareness and reduction of demand (the state is also addressing reduction in supply). Some of the activities associated with prevention activities include efforts to reduce opioid prescriptions, increasing drug "take back" programs and multimedia campaigns.

The second tier is Early Intervention, which includes identifying co-occurring conditions and risk of addiction and overdose. Some of the activities associated with early intervention are programs aimed at increasing coping skills, monitoring and adjusting prescription dosing, care coordination and collaboration and increasing programs for screening, brief intervention and referral to treatment (primarily in primary care settings).

 The third tier is Treatment, including increased treatment services and emergency services. Some of the activities included in this tier include expanded access to medication-assisted treatment (MAT), increased availability of overdose rescue services (including Naloxone), and expanded recovery support services.

In 2017, Medicaid funded $58M on substance use disorder services; in 2017, that figure was about $80M, about half of which was spent to treat opioid related addictions.

There are many interdepartmental initiatives at the State level to coordinate the response of the State. Monthly coordination occurs between all administrations at MDHHS and the Michigan State Police, Department of Licensing and Regulatory Affairs, the Governor's Office and others.

Mid-State Health Network is involved in every tier of the state plan to address the opioid epidemic. We have partnered with MDHHS and with a large number of providers in our region to ensure that our citizens have access to the prevention, early intervention and treatment services they need. We have instituted a very robust Naloxone distribution system in our region, which is managed by MSHN staff. We have committed millions of dollars to ensuring that our system is responsive and responsible.

One accomplishment worthy of special mention is the establishment of a MAT-inclusive policy under the leadership of MSHN Chief Clinical Officer Dr. Dani Meier, which has now been adopted statewide. Medication-Assisted Treatment (MAT) is a standard of care that is broadly recognized as an essential pillar in any comprehensive approach to the national opioid addiction and overdose epidemic. This policy, now an MDHHS contract requirement, seeks to ensure that no consumer is denied access to or pressured to reject the full service array of evidence-based and potentially life-saving treatment options, including MAT, that are determined to be medically necessary for the individualized needs of that consumer. If a provider does not have capacity to work with a person receiving MAT, either because of their abstinence-based philosophy or some other issue, the provider is required to work with the consumer to participate in treatment at another provider that can provide ancillary services (counseling, case management, recovery supports, recovery housing) while the client pursues his or her chosen recovery pathway.

In the last two years, MSHN has doubled the number of MAT treatment provider sites in the MSHN region.

Please visit the State's "Stop Overdoses" website at www.michigan.gov/stopoverdoses for more information and resources.

  ​​​​Please contact Joe with questions or concerns related to the above information and/or MSHN Administration at Joseph.Sedlock@midstatehealthnetwork.org

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