In a 2016 report, the U.S. Centers for Disease Control (CDC) announced the rate of deaths related to opioids increased 200 percent between the years 2000 and 2014. In 2015, more than 33,000 people died from the epidemic. No neighborhood is safe from the problem. Its reach stretches from the streets of crime-infested communities, where Oxy is traded for unseemly acts … to doctor’s offices, where painkiller prescriptions sometimes are offered like candy. Its victims range from homeless people opting for heroin over food … to parents passed out from overdosing in idle-running vehicles, their infant children still strapped to safety seats in the back. Bay City and its surroundings certainly aren’t safe from the opioid problem, as The University Clinic’s staff and associates discovered. And Hoxie is far from the first opioid addict — and likely far from the last — to seek help there.
F “I never thought I’d see the day when more people were dying from overdoses than automobile accidents,” said Joel Strasz, who began his health care career in Bay County in the late 1990s. “That’s what’s happened, though. It’s happening here.” Four years ago, Strasz was promoted to health officer — the top post — at the
Bay County Health Department, where The University Clinic now is housed in downtown Bay City. During his time there, he watched the opioid crisis develop both afar and near. The CDC in March 2016 issued recommendations to the nation’s doctors, urging caution when prescribing highlyaddictive painkillers. Since 1999, the amount of prescription opioids sold in the U.S. quadrupled. Medical professionals had lowered the threshold for deciding when patients needed painkillers and how long they needed the medicine, experts argued, and those increasingly lax standards resulted in more Americans growing dependent on — and eventually abusing — the pharmaceuticals. In many cases, those pills served as gateway drugs to cheaper alternatives with more potency and deadly potential such as heroin. Those national trends took an alarmingly local turn in recent years, Strasz observed. Michigan Department of Health and Human Services figures showed medical professionals in Bay County wrote more opioid prescriptions-per-person (1.9) than in any of the 82 other counties in the state in 2015. That figure represented a sizable spike from Bay County’s 1.2 opioids prescribed-per-person just six years earlier. The statistical surge seemed to coincide with other trends. Overdose deaths in Bay County jumped from five people in 2005 to 25 people in 2016. Of those 25, 23 died from opioids. Riverhaven Substance Abuse Services, a recently-defunct office within Bay-Arenac Behavioral Health, reported 15 percent of clients receiving treatment for substance abuse at the facility were seeking help for opioid abuse in 2005. That figure soared to 48 percent in 2014. “The numbers didn’t look good,” Strasz said. “We needed to do something.” In May 2015, he issued a public health advisory for Bay County regarding the opioid epidemic. The advisory remains in effect today. “I’m waiting for the problem to lessen significantly before ending the advisory,” Strasz said. “It doesn’t look like it’s going to do that anytime soon.” Raising public awareness is one approach taken by The Bay County HOPE (Heroin Opioid Prevention and Elimination) Project, an organization Strasz assembled as part of the public health advisory. Its members discuss the problem at community forums as well as middle and
high schools where opioid abuse also is on the rise in Bay County. HOPE members apply other strategies to curbing the epidemic, including referring addicts to treatment centers. “That’s where The University Clinic has become so important,” Strasz said.
F The clinic began as an experiment. No other county-run health department in the state housed primary care staff, which offer the sort of services patients often seek when visiting family doctors and physicians. Funded by a $1.5 million U.S. Health and Human Services grant, SVSU and Bay County Health Department officials opened the clinic’s doors in January 2015, providing a variety of health care resources to clients who were less likely to seek primary care at traditional facilities. “People suffering from chronic health conditions like hypertension and diabetes are who we targeted first,” said Kathleen Schachman, SVSU’s Randall Wickes Endowed Chair in Nursing and one of the clinic’s coordinators. Clients trickled in at a slow pace for months. Early efforts at promoting public awareness for the facility attracted relatively few people, Schachman said. Then the clinic redirected its outreach and began seeing results within its first year. “Things really started to pick up when our social workers and student interns reached out to homeless shelters in the area,” she said. “This just happened to be a population that had nowhere else to go.” Soon, positive word-of-mouth from clients attracted others. The office’s proximity to a bus station, the county jail and courthouse, and a park known as one where people abused drugs led growing numbers of individuals with limited resources to the clinic’s front door. “In some cases, these are people who don’t usually get the care they need until they are in a crisis, and don’t always show up for their appointments,” Schachman said. “A lot of places don’t want these people as patients, but we are willing to take them on, and to treat them with respect.” Serving the homeless, in particular, made Schachman acutely aware more resources were necessary. To meet those needs, Schachman applied for — and received — a trio of grants in 2016 worth a total of $2.9 million
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