Opinion | Michigan needs more options to combat opioid overdoses amid rise in fentanyl

As Bridge Michigan conducts a series of reports on the scale of the opioid crisis in Michigan, the opioid lawsuit settlement funding, how the spending will be divided and spent, and resources to help with treatment and prevention of opioid addiction, the conversation needs to include how Michigan needs to expand its options for law enforcement to combat this growing epidemic. 

This crisis has significantly elevated with the shift to synthetic opioids such as fentanyl. Usage of fentanyl was implicated in 68% of the U.S. drug overdose deaths in 2022 alone. Up to 50 times more potent than heroin, fentanyl has infiltrated the supply of street drugs and is emerging as the primary cause of synthetic-opioid overdose deaths. In 2022 in Michigan, 2,993 people died of drug overdoses, with fentanyl being the leading cause of synthetic opioid related overdose deaths.

Illegally manufactured fentanyl is found in heroin, cocaine, methamphetamine and in counterfeit pills. As a result, first-time drug users, especially non-habitual and experimental drug users, may be trying a pill that they believe is a Xanax or an Adderall but it’s actually a counterfeit. They may not know they're ingesting fentanyl, leading to an accidental poisoning. 

Exacerbating the crisis, other synthetic drugs are hitting the markets and contributing to the looming number like Xylazine, a horse tranquilizer, and Nitazene, a drug developed in the 1950s that was never approved for human consumption (and is hundreds of times more powerful than fentanyl). Both Xylazine and Nitazene are becoming more frequently used or mixed with other opiates, drastically increasing the risk of overdose to unseen heights.

Michigan needs to expand life-saving treatment options to fight this crisis. A broader, more comprehensive approach to treatment is vital as the drug market has been bombarded by fentanyl and other synthetic opioids. First responders need more life-saving tools to reduce opioid overdose deaths. Narcan, which was a miracle when first introduced, was developed before the rise of synthetic and fentanyl-laced drugs. Victims often need multiple doses in order to be revived. Those overdosing on opioids need a second chance of life. If we can save your life, then we can worry about the next steps after. 

The Oakland County law enforcement lab found 80% plus of street drugs had some component of fentanyl. Last November in a pilot program, the Oakland County law enforcement department became the first agency in the nation to equip our deputies with a longer-acting, FDA-approved antagonist drug to treat opioid overdoses. It is more effective than the treatment currently used. Although similar to Narcan in that it blocks the effects of opioids in the brain, it stays longer in the body than others. This proved highly effective in restoring normal breathing and blood pressure during an overdose on synthetic opioids.  

Michigan enacted a standing order in 2017, which outlines medications readily available to first responders and community-based organizations. The standing order only includes Narcan. Michigan must update the standing order to ensure all FDA-approved reverse opioid agents are accessible to our frontline responders to combat the lethal grip of synthetic opioids. 

Other FDA-approved opioid antagonists have been deemed effective life-saving treatments against fentanyl.  Michigan first responders need to be equipped with every lifesaving weapon available to combat this growing opioid crisis. We need a balanced approach to responding to opioid overdoses with several options. 

It’s a matter of simple logic — equip our first responders with every tool in the toolbox, giving them every possible chance to snatch lives back from the brink. Every second counts in an overdose involving fentanyl. It is time to act.