TRAVERSE CITY — Two gatherings drew a who’s-who of leaders active in opioid outreach.
Munson Healthcare President and CEO Ed Ness announced a $400,000 grant from the Michigan Opioid Partnership initiative at a well-attended press conference Friday.
The night before at an equally well-attended gathering at Northwestern Michigan College’s Milliken Auditorium, Caroline Brunt, a street nurse from Vancouver, Canada, detailed her decades of “boots on the ground” work delivering healthcare services to people who use drugs.
Ness and Brunt don’t know each other, yet their public remarks both stressed the enormity of the task in northwestern lower Michigan and the necessity of working together — even as they come at the problem from different angles.
“This is an issue we’re not going to solve just as a hospital,” Ness said during the announcement. “It’s going to take a partnership. This grant is an example of that partnership.”
The grant, spread over two years, will be used by the hospital’s Emergency Room staff to provide medically assisted treatment to people “who present to the ER with an opioid use disorder,” said Munson Chief Medical Officer Dr. Christine Nefcy.
In contrast, Brunt’s visit was sponsored by Harm Reduction Michigan, a Traverse-City based nonprofit group that brings healthcare services directly to people who use drugs — in homes, on streets, or at a needle exchange location at 501 W. Front St.
“What we’ve learned is that to impact the individual, you have to have a conversation,” Brunt said. “We need to be working together and we need to be meeting people where they are.”
Brunt introduced “Bevel Up,” a 45-minute documentary film funded by the National Film Board of Canada, on the work of street nurses in Vancouver. The title refers to the angle of a needle when injecting drugs. A needle that is used “bevel up” will do less damage to a person’s veins.
A panel discussion followed between Brunt, Harm Reduction volunteer Pam Lynch, Safe Harbor board chairman Mike McDonald, and Goodwill Inn outreach coordinator Ryan Hannon.
“We don’t see that level of suffering in our community, but we do see it in some individuals,” said Hannon. “People are not using drugs for fun or excitement. They’re using them to keep warm, to forget physical or sexual abuse, they’re using them to survive.”
The Michigan Opioid Partnership, which invited Munson to apply for the grant, includes the Michigan Department of Health and Human Services, the Michigan Health Endowment Fund, Blue Cross Blue Shield of Michigan Foundation, the Ethel and James Flinn Foundation, The Jewish Fund, Superior Health Foundation, and The Community Foundation of Southeast Michigan.
Spokeswoman Lynda Zeller said that Munson’s grant was one of the first to be approved.
“We used state data on hospitals and jails, looking for high opportunity and high need,” she said. “Munson had both and we’re excited about the possibilities in this region.”
In 2018, Munson received a $1.5 million grant from the Federal Substance Abuse and Mental Health Administration, allowing the hospital to expand its opioid use disorder treatment by strengthening peer-to-peer recovery coaching and implementing a program for pregnant women.
According to Nefcy, 11.8 percent of patients discharged from Munson Healthcare emergency departments in 2018 had an opioid use disorder, a figure that dropped to 8 percent in 2019.
Opioid overdoses per 1,000 patients decreased during the same time from 7.9 percent to 6.2 percent, and babies showing neonatal abstinence syndrome also decreased from 18.3 percent to 16.1 percent, she said.
These percentages represent real people,” Nefcy said.
These add up to 164 fewer overdoses, and seven fewer babies born addicted to opioids, from 2018 to 2019.
Within the traditional medical community, the “harm reduction” treatment philosophy has been a controversial one. Instead of abstinence, supporters advocate for health of people who use drugs, from clean needles to the use of opioids in treatment.
“The concept of harm reduction is not accepted in many places,” said Brunt. “There is hardly any harm reduction taught in nursing schools, and health care workers are the biggest stigmatizers out there.”
Here in northern Michigan, that may be changing. At the Munson press conference, when Nefcy said one goal of the grant is to reduce the stigma surrounding opioid use disorder, her comment drew enthusiastic applause.
Later, Partnership spokeswoman Lynda Zeller, a senior program officer with the Michigan Health Endowment Fund, listed harm reduction as a goal of the $5 million initiative.
When it comes to these two different ways of addressing the opioid epidemic, there’s at least one local healthcare provider who says he has an appreciation for both. Mac Beeker, a nursing instructor and member of Munson’s Bioethics Resources Advisory Committee, “gets” the hospital’s treatment philosophy and that of harm reduction’s “boots on the ground” workers.
Beeker also praised the way that Munson adapted to the opioid epidemic with an increasingly “nuanced approach.”
But those advocating both tactics need to work fast, he said.
“The goal of ending suffering is an endless human endeavor,” Beeker said, during the question and answer session following the panel discussion at Milliken Auditorium. “And when it comes to opioids, we’re really losing right now.”