Washtenaw United: Washtenaw County Health Department amps up its fight against the growing opioid epidemic
ABOUT JIMENA LOVELUCK:
Ms. Loveluck began her role as Health Officer on September 1, 2019 after serving two years as the Washtenaw County Health Department’s first Deputy Health Officer. Prior to joining the Washtenaw County Health Department, she was the President/CEO of the HIV/AIDS Resource Center in Ypsilanti and led the merger with AIDS Partnership Michigan in 2015, resulting in one of the largest HIV service organizations in Southeast Michigan.
Ms. Loveluck received her Master’s degree in Social Work from Boston College in 1990, with a concentration in Community Organizing/Social Policy and Planning. Her public health career has spanned 30 years with a focus on health equity, HIV prevention and care, harm reduction, community engagement and community-based participatory research.
David Fair: This is 89 one WEMU, and welcome to another edition of Washtenaw United. I'm David Fair. And while most of us have focused on the public health crisis of the COVID 19 pandemic, there was another growing worse right under our noses. The nation has been in the midst of an opioid crisis for a long time, but it has gotten worse since the start of the pandemic. A recent report from the Washtenaw County Health Department shows a 28% increase in the number of opioid overdose related deaths between the years of 2020 and 2021. In the 2018-2019 period, such overdose deaths had actually gone down 26%. That's a huge swing. Here to guide us through what is happening and what can be done about it is Jimena Loveluck. She is Washtenaw County's health officer. And thank you so much for joining us today.
Jimena Loveluck: Thank you for having me.
David Fair: The research clearly shows that substance use disorder increased through the pandemic, and as part of that, there were more opioid-related deaths. Does it tell us why?
Jimena Loveluck: Well, that's a great question. I think, in Washtenaw County, we are seeing certainly the impact of COVID in terms of other health issues, other mental health issues, and well-being among people. And we continue to really see the significant impact of fentanyl in the drug supply. And so, in addition to this increase that you mentioned in opioid-related deaths, 82% of those overdose deaths involved fentanyl.
David Fair: And fentanyl, it's often put into other drugs without the consumer knowing, usually making the overdose accidental and, unfortunately, all too often, fatal. That is primarily in street drugs, like cocaine and heroin, though. Are we still at crisis levels with prescription opioid addictions and overdoses?
Jimena Loveluck: Yeah, particularly because of the combination with fentanyl. This is why a report like this is so important. We want to notify the public about the increase in opioid overdose deaths, so that community members and professionals really understand the risks and are able to respond to the new information. Fentanyl, which is a synthetic opioid, can be up to 50 to 100 times more potent than morphine. And we're seeing that it is being mixed into cocaine, as well as methamphetamine and into counterfeit opioid pills and heroin. And so, when we talk about, you know, prescription opioids, certainly, there has been a tremendous effort to control the supply of those prescription opioids and really monitor what's being done on the provider level with prescribers. But we know that there are counterfeit pills that are being distributed, and these counterfeit pills are just, you know, as risky in terms of the inclusion of fentanyl in those pills. And, with fentanyl, it takes as little as three milligrams or the size of a grain of sand to kill an average adult male. So one pill--counterfeit pill--that someone takes, they may think it's something legitimate laced with fentanyl, unfortunately, can cause an overdose death.
David Fair: This is Washtenaw United on 89 one WEMU, and we're talking with Washtenaw County Health Officer Jimena Loveluck about increases in opioid-related deaths in our community. Now we continue to see all sorts of efforts to create greater equity in Washtenaw County and on a number of different fronts. When we talk about public health in the larger and more broad sense, we know outcomes are usually worse for people of color. If we get specific in this conversation and talk opioids, does that hold true as well?
Jimena Loveluck: Well, our report showed that we still do see a disparity in terms of the opioid overdose deaths. We see a disproportionate impact in the number of Black and African American residents who died of opioid overdoses, especially between the ages of 35 to 44 years. And so, yes, that is one of the things that, as we review data, we're always looking for that health equity perspective and looking and raising attention to those health disparities that we see in our communities, so that we and our service providers and our community members and organizations can engage in conversations about how to reduce those disparities.
David Fair: You know, all of these various issues all touch one another. It's so difficult to attack any public health issue as a stand-alone problem. What is the more comprehensive approach to the opioid and fentanyl crisis in our community?
Jimena Loveluck: Well, it certainly has to be comprehensive. We have, obviously, a very robust system of substance use disorder services and providers. We have now, thanks to additional funding from the mental health and safety millage and the work of the community mental health department at the county, we have a 24-seven cares line that people can access and help get connected to substance abuse services. And we also have much more information and evidence about the importance of harm reduction approaches. And so, as we recognize people that will not necessarily be ready for treatment may continue using, we want to ensure that they maintain their health and that they don't succumb to an overdose. And so, having naloxone, knowing how to use naloxone in our county health department here in Ypsilanti at the Towner building, where community mental health and the Washtenaw County Health Department are housed, we have a naloxone vending machine, where people can access naloxone for free. So, those are really important tools. And, of course, continuing to raise awareness and provide this kind of information, I think, is really important, so that all of us as providers, as prescribers, as community members and organizations, we have the tools to help prevent further increases in opioid overdose deaths.
David Fair: WEMU's Washtenaw United conversation with Jimena Loveluck continues. She is Washtenaw County Health Officer, and we've been talking about how the opioid crisis has only gotten worse as we've navigated through the COVID-19 pandemic. Private recovery centers can be sickeningly expensive and out-of-reach for a good portion of the population. In publicly-funded or subsidized treatment facilities, there's often criticism that there's no room. How significant is Washtenaw County's investment in treatment and recovery?
Jimena Loveluck: It is significant. I think that, certainly, there are challenges that remain, in terms of accessibility and the quickness in which people can access those resources. But I think there's been quite a bit of work to ensure that that access is as streamlined as possible, that we are able to respond as quickly as possible when people are ready and are seeking those treatment services. And, certainly, having a 24-seven cares phone number that people can call when they're in crisis or when they're seeking assistance is a tremendous addition to the resources that we have available in our community. And I think we also have many other efforts to coordinate care and coordinate services. So, there are lots of organizations that are working in collaboration together to not only promote access to substance use disorder services, but also to ensure that our county has robust harm reduction strategies in place as well.
David Fair: As you have mentioned, there are ongoing education efforts about fentanyl and opioids. There is free naloxone available to help people who are trying to help those who are overdosing. You've outlined some really comprehensive ways in which the crisis is being handled. As we look to the future, it's a problem that's not going away anytime soon. So, where do you find hope in our ability as a society to deal with this?
Jimena Loveluck: Well, I think that, certainly, the more information and education that people have, the more tools that will have to address this issue. I think that we've seen tremendous progress in terms of recognizing harm reduction as an evidence-based strategy that works and is effective, not only in reducing harm, but in also helping people access, ultimately, treatment services, so that they can move into recovery. And I think we also are seeing, you know, a robust recovery community that is involved and really leading a lot of the efforts around substance use disorders and addressing the opioid overdose situation in our county. So, I think that it continues to be certainly a challenge. But we know that it was just a few years ago where we were making significant progress in decreasing those deaths. So, we know that we were able to kind of have an impact in decreasing those deaths in previous years. And, I think, as we come together and focus on the health and well-being of all of our community members and really recognizing the impact of the COVID pandemic, hopefully, we will also see a reduction in the coming years.
David Fair: Thank you for the time and the conversation today. I appreciate the information.
Jimena Loveluck: Thanks so much for spending time talking about this important issue.
David Fair: That is Jimena Loveluck. She is Washtenaw County Health Officer. And for more information on opioids in Washtenaw County, visit our website at WEMU dot org, and we'll have the links there for you to take you everywhere you need to go. Washtenaw United is produced in partnership with the United Way of Washtenaw County. We bring it to you every Monday. I'm David Fair, and this is your community NPR station, 89 one WEMU FM Ypsilanti.
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