November 22, 2017
It's a term we've been hearing a lot lately: opioid crisis.
Nearly 100 people a day die from an overdose of drugs that, in many cases, were obtained legally for a legitimate health problem, according to the Centers for Disease Control and Prevention.
In 2015 — the most recent year for which there are statistics — 33,000 people died after overdosing on this classification of drugs that includes prescription painkillers, illegal heroin and synthetic opioids such as fentanyl. About half of the deaths were attributed to prescribed opioids.
This week, the White House Council on Economic Advisors announced that the cost of the opioid epidemic in 2015 was $504 billion, or about 2.8 percent of gross domestic product.
But what does it all mean? How did the United States become the nation consuming 80 percent of the world's opioids with only 5 percent of the world's population? How do we solve what some are calling the biggest public health crisis to impact the nation, one that prompted a recent presidential emergency declaration?
U-M's Office of Academic Innovation, in collaboration with the Institute for Healthcare Policy and Innovation, hopes to answer some of these questions through a teach-out on the crisis. Faculty experts from across the university will share their research and expertise on opioids, and put the epidemic into perspective.
"Complex and timely problems like the opioids crisis are the reason we created the Teach-Out Series," said James DeVaney, associate vice provost for academic innovation. "We are reimagining two-way public engagement and the teach-outs allow us to share and create new knowledge through public dialogue, support public learners in pursuit of knowledge, and influence decision-makers at all levels.
"We have a great deal to learn from the lived experiences of our teach-out participants, and our faculty experts have much to share as we look to design solutions to this crisis."
Faculty from Michigan Medicine, School of Public Health, College of Pharmacy, School of Dentistry, School of Social Work, and LSA — many of them affiliated with IHPI, Precision Health at U-M and the U-M Injury Center — address the issue from multiple perspectives:
• What is the history of this crisis?
• How did it become an epidemic?
• Who is most impacted?
• Does anyone really need these drugs?
• Are there alternatives?
• What is being done to address the crisis?
• What more needs to happen?
• How can patients and the public be part of the solution?
Teach-outs are open learning opportunities on timely topics offered online through videos and other interactive materials. At any time while the content is posted, participants can take advantage of the self-guided studies. Because Academic Innovation leaders believe this topic will be of great interest it will be posted on Coursera for three weeks, beginning Dec. 4.
In his video segment, Jay Lee, research fellow at the U-M Center for Healthcare Outcomes & Policy and a general surgery resident at Michigan Medicine, talked about efforts to get physicians to stop prescribing the drugs so frequently, and, when necessary, to do so in smaller quantities. Michigan researchers are leading a campaign to change physician prescribing behavior. This is the initial project of the university's Precision Health initiative.
"From my perspective, physicians really need to own this problem," Lee said during the taping of his piece for the teach-out. "We were very much a part of creating it, prescribing too much pain medication and not being as aware of the risks as we should have been."
Rebecca Haffajee, assistant professor of health management and policy at the School of Public Health, whose research includes use of data to monitor physician prescribing and patient behavior, explained how states have been scrambling to put policies in place to better track and monitor use of the drugs. About 1,500 bills have turned into almost 500 pieces of legislation, she said, but added more must be done to use the data to effect change.
She said the solution is not as simple as eliminating access to prescription drugs.
"If we cut (access) off and (patients) are addicted, where are they going?" she said.
Michael Smith, clinical assistant professor of pharmacy, related a bit of the history of how this classification of drugs has evolved and noted that even though they have been the drugs of choice for pain management for a couple of decades, opioids aren't as effective as once hoped.
"What we came to realize today is that a large number of these medications — particularly opioids — are not effective for many pain states," he said, adding that this contributes to their abundance in the community.