According to the Substance Abuse and Mental Health Services Administration (SAMHSA), medication for opioid use disorder (MOUD) is an evidence-based approach to treat opioid use disorder (OUD), prevent overdose, and sustain recovery. Medications, such as methadone, buprenorphine, and naltrexone, improve treatment outcomes and reduce the utilization of emergency departments and hospital care by decreasing:
- Withdrawal symptoms
- Infectious disease transmission
- Poor birth outcomes
- Illicit opioid use
Critical Access Points
Hospitals and jails across Michigan are critical access points to those with opioid use disorder. Our work with these partners focused on equitably engaging all those with OUD by reducing stigma, addressing structural racism, and improving access to treatment.
Critical Access Points
In collaboration with the Michigan Health & Hospital Association (MHA) Keystone Center, the Michigan Opioid Partnership led the Emergency Department Medication for Opioid Use Disorder (ED MOUD) initiative, which was designed to increase access to evidence-based ED MOUD throughout the state and support the transition to long-term office-based treatment upon discharge. From 2019 to 2023, participation in the ED MOUD initiative grew from six to 75 hospitals—representing approximately half of Michigan’s emergency departments and all ten prepaid inpatient health plan regions.
We funded organizations working in Michigan’s correctional system to expand access to medication for opioid use disorder and enhance identification of substance use disorders at jail intake and with first responders and post-overdose response. Wayne State University’s Center for Behavioral Health and Justice received a grant to coordinate the effort and work in partnership with the county jails and outpatient providers to serve inmates with addiction.
Addressing Racial Equity in Opioid Treatment
From 2017 to 2021, the rate of opioid overdose deaths among Black Michiganders doubled, according to Michigan’s Department of Health and Human Services.
We partnered with New Detroit and Vital Strategies to create a training module for emergency department providers treating patients of color with OUD called Just Care. Twenty-five emergency department physicians in Southeast Michigan participated in the pilot implicit bias training. An evaluation from Johns Hopkins University found that participating providers became more knowledgeable about key concepts and disparities through the training.
Changing the Patient Experience
Championing medication for opioid use disorder requires cultural change. Regardless of the setting, patients need to be greeted by providers—physicians, medical staff, first responders, or jail staff— who understand opioid use disorder as a disease and offer evidence-based treatment.
Identify Patients with OUD
Patients enter an open and accepting environment. Non-stigmatizing signage encourages them to disclose their opioid use disorder and to ask for help. Clinicians are trained to screen patients, spot the signs and symptoms of opioid use disorder, and to approach patients compassionately.
A practitioner assesses the patient for withdrawal and administers or prescribes medication to begin treatment. If the patient is experiencing opioid withdrawal, the initial dose helps reduce the painful symptoms and allows for better a tolerated discussion about harm reduction, treatment, and recovery.
Connect to Community-Based Care
Trained staff, such as a peer recovery coach, social worker, or case manager, supports the patient as they make their way to an outpatient provider. They provide the patient with a warm hand-off to community-based care and assist them in scheduling their first appointment. This is essential to the success of long-term treatment and recovery.
“Walking through the jail doors is already a traumatic event…but being able to tell people that there is help waiting for them inside can be the first step…to rehabilitation.” Heather Wiengand LPC, HealthWest
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