(l-r, seated) Lauren Rousseau, Hon. Linda Davis, Brandy McMillion, Tish Vincent and Ashton Marr were conference presenters at last month’s “The Opioid Epidemic: Finding Solutions to a Public Health Emergency,” held at WMU-Cooley Law School’s Lansing campus. At the podium, Jacqueline Freeman, director of Pre-Enrollment Programs and Diversity at WMU-Cooley Law School, prepares to introduce the speakers.
Photo courtesy of WMU-Cooley Law School
By Cynthia Price
Legal News
Statistics abound concerning the severity of the opioid crisis, but as various segments of society scramble to find solutions, the question is, “What really works?”
A panel addressed that last month when Western Michigan University-Thomas M. Cooley Law School’s Lansing Campus held a half-day conference. About 35 people from all areas of interest attended, and five to ten more saw it live-streamed at other campuses.
“The Opioid Epidemic: Finding Solutions to a Public Health Emergency” pulled together six women who are working to make sense of the increased prevalence of opioid use disorder, and explored the viability of approaches to reducing it.
The panelists were, in order of their speaking: Lauren Rousseau, a WMU-Cooley professor and president of the Northwest Wayne Chapter of Families Against Narcotics (FAN); Judge Linda Davis of the 41B District Court in Clinton Township, chair of Governor Snyder’s Prescription Drug and Opioid Abuse Commission and president of FAN; Brandy McMillion, an Assistant U.S. Attorney specializing in opioid crimes; Tish Vincent, Director, Lawyers and Judges Assistance Program, State Bar of Michigan; Ashton Marr, Certified Peer Recovery Mentor and program manager at the Washtenaw Recovery Advocacy Project, who is in long-term recovery from opioid use disorder; and Kristen Lee, a University of Toledo College of Law graduate, also in long-term recovery.
In 2015, drug overdoses accounted for 52,404 deaths in the United States; 63.1% of those deaths involved an opioid. Overdose is not the only way in which opioids are claiming lives, but the unregulated nature of the street drugs that people often turn to brings high risk.
Though many experts say it is not the whole story, there is certainly merit to the narrative that the main cause of the opioid epidemic can be found in the over-prescribing of opiates in the 1990s and 2000s. From 1991 to 2011, prescriptions nearly tripled, from about 76 million to about 219 million. (Since then, the number has decreased somewhat.)
Two of the presenters remarked that it had been a mistake to start regarding pain as “the fifth vital sign,” and the history of that decision is informative.
In 1991, the president of the American Pain Society wrote an editorial that took physicians to task for failing to assess and treat patients’ pain, and opined that a fear of prescribing opioids was one of the causes. By 2001, The Joint Commission (formerly The Joint Commission on the Accreditation of Healthcare Organizations) released a set of standards to help address pain.
As a 2017 report from The Joint Commission points out, that editorial opinion operated on “the conventional wisdom of the day that ‘therapeutic use of opiate analgesics rarely results in addiction.’” The Joint Commission has since revised its recommendations about opiates and intends to continue doing so.
Clearly, this means that one of the solutions is to recommend to doctors that they reduce the number and amount of opioid prescriptions, substituting non-opiate pain management. Such tools as the Michigan Automated Prescription System can help doctors and pharmacists identify drug-seeking patients.
The flip side of that coin is investigating and charging health care providers who deliberately supply both patients with the opioid use disorder who seek excessive prescriptions, and those who sell prescription pills on the streets.
“I really need people to understand that the majority of physicians don’t do this. We charge the physicians that are doing this strictly for greed,” said Brandy McMillion. She went through a list of characteristics that help the U.S. Attorney’s office find those physicians and pharmacists.
Much of the WMU-Cooley discussion centered on innovative approaches to getting people with the opioid use disorder into treatment, which is what FAN does in a variety of ways.
Prof. Rousseau shared her personal story of intensely helping a young man who was in and out of treatment and eventually murdered. She became involved with FAN because of her strong belief that educating people about the reality of the epidemic is critical.
Judge Davis is herself an embodiment of that education, speaking to over 200 groups a year. At the forum, she said, “We need to change the whole culture of how we look at this. We don’t deal with things any more, we pill them to death. We can lecture people until we’re blue in the face but until we put resources toward this and give them tools to do different things, nothing will change.”
FAN launched a program in 2017 called Hope Not Handcuffs, which allows people with opioid addiction to come in to a police department or agency and ask for help, which will be provided through a FAN “angel coordinator.” Judge Davis said that of the over 940 people placed in treatment, all but two or three were able to enter within 24 hours. Plans are underway to expand the programs across Michigan; there are currently 20 FAN chapters.
Another potential solution is, of course, counseling, but Tish Vincent of the State Bar’s Lawyers and Judges Assistance Program (LJAP) noted that attorney counseling programs must take into account such factors as avoidance of losing one’s license. Though statistics are not available for opioid disorders, Vincent said that the legal profession has a much higher rate of addiction to alcohol than the general populace.
She noted that attorneys who have a substance-abuse-related grievance against them may enter a two-year LJAP program, and any disciplinary action will remain private.
There has also been significant success seen through peer recovery programs, where those who have been through it help those who are just seeking help. Ashton Marr, who also works with the Washtenaw Sheriff’s Department, said, “A national advocacy movement estimates that one third of all American households have someone living in them who’s affected by addiction.
“This is not the other – this is you, this is me.”
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