After years of opioids agony, rural Michigan finds reason for hope

• Nearly 3,000 Michigan residents die each year from opioid-related overdoses
• Addiction services are expanding, thanks to increased funding
• Remaining roadblocks to recovery: transportation and affordable housing

GAYLORD — Something different was in the air Thursday at an annual gathering of northern Michigan addiction service providers. 

While their work battling the epidemic remains grim, and their needs are great, many in the recovery community say there are also signs of progress after years of heartbreak.

The number of ambulance runs because of overdoses is declining. The distribution of OD-reversing drugs like Narcan is up. After more than a year of frustration over the pace of distributing millions from a once-in-a-lifetime opioid settlement, money is trickling down to providers and services are expanding.

“I am so much more hopeful,” said Caitlin Koucky, executive director of Community Recovery Alliance, an organization providing services in five northern counties and based in Petoskey. 

Her service has grown from one to five employees since 2019 and is prepping a move to a new 4,000 square-foot recovery resource center.

“There are more grants and more funding coming in (for) recovery,” Koucky said. “There’s more help available, and that help is more visible. And the more people see other people in recovery, the more they realize that recovery is possible (for themselves).”

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The Rural Michigan Opioid and Substance Use Summit drew nearly 200 advocates and service providers, primarily from northern Michigan, to talk about an opioid epidemic that kills nearly 3,000 Michiganders a year, more than guns and traffic accidents combined.

Michigan is set to receive $1.6 billion over 18 years from a lawsuit settlement with opioid manufacturers, distributors and pharmacies. 

Half of the money is going to the state, while the rest goes to local governments, many of whom are still figuring out how to distribute the money. About half of counties haven’t spent any funds yet, even though they began receiving checks in January 2023. 

This year is the peak receipt for those funds, with $186 million coming in, Jared Welehodsky, a senior policy analyst at the Michigan Department of Health and Human Services, told the conference. 

Michigan already has budgeted $44 million of its settlement funds for the fiscal year that starts in October.

Among the signs of hope highlighted in the conference:

• A decade ago, Michigan was ranked among the 15 worst states in overdose rates, but has been below the national average for the past six years, now ranked 30^th.
• Non-lethal opioid ambulance runs fell 8% from 2022 to 2023.
• Narcan distribution by ambulance services nearly doubled between 2021 and 2023.
• The state has budgeted about $300 million to fund substance use disorder services in the upcoming budget year. Most of that is state or federal funds, separate from settlement dollars.
• There were 147,000 Narcan kits and 58,000 fentanyl test strips paid directly from state opioid settlement funds in 2023.

The money is beginning to make a difference, said Chancy Eastman, a peer recovery coach in Midland and Arenac counties for Bay City-based Peer 360 Recovery Alliance.

“Recovery is becoming more dynamic,” Eastman said. “It used to be there were fewer options.”

Numerous advocates and service providers told Bridge Michigan the biggest roadblocks for addiction help today are transportation and housing.

At Bay Mills Health Center in Brimley in the Upper Peninsula, some substance use disorder patients have no cars and no access to public transportation to get to the treatment center.

“We can give them one $25 gas card a month,” said Jennifer Cifelli, intensive outpatient therapist at Bay Mills. “Who do you know who only uses $25 a month in gas?

“It’s expensive getting clean.”

That expense can make recovery harder. Jean Talsma, medical director of Bear River Health recovery house in Boyne Falls, said some former residents relapse once they leave because they can’t afford a place of their own and they return to communities where they are surrounded by triggers of their addiction.

“Our biggest challenge is what happens to our people when we are done,” Talsma told the conference-goers. “If they go back to the same environment, how do we expect them to succeed?”

The state is ponying up $2.7 million from opioid settlement funds for transportation grants in the current budget year and another $2.5 million next year. 

MDHHS also budgeted $4 million to assist in recovery housing around the state.

“The biggest challenge is transportation and affordable housing,” said Dr. Rob McMorrow, chief medical officer and addiction medicine specialist at MidMichigan Community Health Services in Houghton Lake. “If someone has transportation, stable housing, we can get them in (for treatment) fast. But not only is that uncommon, “some of our patents don’t even have phones or internet” to make appointments, he said.

“Until you’re in it, you don’t understand it. It’s humbling.”