JULIA MONTAG| COLUMN
A
s covered in Part 1 of this
three-part series, a look at
nationwide opioid overdose
data led me to question the presence
of an epidemic here at the University
of Michigan, and, upon investigat-
ing, I was confounded by shockingly
low numbers. The 2016 University of
Michigan National College Health
Assessment shows 98.5 percent of
respondents answering “never” when
asked about the frequency of their
opiate use. Michigan is not the only
campus that the opioid epidemic has
skipped, Grace Bird says for Insid-
erEd. University of Wisconsin-Madi-
son recently instituted an agreement
with pharmacy chain Walgreens to
allow students to buy overdose-coun-
tering Narcan, even though opioid
misuse at the school is “exceptionally
rare,” Bird writes. Like the University
of Michigan, the University of Tennes-
see-Knoxville has a police department
that stocks Narcan; U-M officers have
only needed to administer it twice,
which is two more times than needed
in Knoxville.
“I would agree with the general
observation, one supported by the
NCHA data, that the campus com-
munity has largely been spared by the
dramatic rise in opioid use compared
to the general population,” Robert
Ernst, medical director of U-M Uni-
versity Health Service, says. But if
the entire country is being hit with
the serious crisis that is addiction to
prescription pain relievers, what’s
keeping the numbers so low on many
campuses?
Colleges have avoided the rise in
drug use, Bird claims, because the
epidemic “discriminate[s] in terms
of education, as it disproportionately
affects poorer, more rural and less-
educated communities.” She explains
the research that connects individuals
with lower educational attainment to
scarce, dangerous job opportunities —
opportunities that increase the risk of
workplace injuries and make use of an
opioid painkiller likely.
Now, I am no doctor, but my
extensive digging within the drug
discussion showed me one important
factor that college campuses have in
common: Schools across the country
are continuously pumping out novel,
influential studies that work to com-
bat the crisis. An immense amount
of research takes place at these edu-
cational hubs, including Ohio State
University, University of Miami,
University of Maryland — the list
goes on — and I’d go as far as to say
that this research is what’s suppress-
ing addiction within this subpopula-
tion. Universities are assembling vast
resources to prevent and intervene
upon addiction, as well as promote
treatment and recovery. Perhaps sheer
proximity to this information is what’s
subduing addiction at the student level.
To corroborate this theory, I took a
look into Michigan Medicine through
a specific and inquisitive lens: What
exactly is it about our university that
keeps us from misusing? I found
that the University of Michigan has
assembled some brilliant minds, and
they’re at the forefront of the crisis
with power, intelligence and innova-
tion. Schools around the country are
citing the University’s groundbreak-
ing studies to create the foundations
of their programs. We have the safety
nets and safety blankets of Wolverine
Wellness and the CRP, just as we have
the recovery-safe housing and medica-
tion disposal programs; we also have
some of the country’s leading experts
on drug misuse, and they’re working
to revolutionize the way that the entire
country tackles the crisis.
Among those professionals is Sean
Esteban McCabe, an “internation-
ally recognized scholar” and former
director of the University of Michi-
gan Substance Abuse Research Cen-
ter. McCabe is rolling out studies that
focus on the trends of prescription
opioid use among U.S. adolescents and
college students by analyzing motives,
methods of administration and symp-
toms of disorder. In his study that
attempted to clarify when and why
people begin to misuse drugs, McCabe
found that “most adolescents become
fully responsible for their own medi-
cation management for the first time
in their lives during college and are
presented with more opportunities for
— and a higher expectation of — sub-
stance use.” It’s possible that his work
has so powerfully aided in our under-
standing of why this crisis began that
it sparked other campus programs and
projects that mitigate concerns and
take control of addiction.
Exhibit A: the Opioid Overdose
Summit in 2015, hosted by the U-M
Injury
Prevention
Center,
which
assembled folks around the com-
munity and started important con-
versations surrounding the growing
epidemic. The University also par-
ticipated in the 2018 Opioid Abuse &
Heroin Overdose Solutions Summit,
where various doctors and residents
presented on their specialties within
the field. We have invaluable tools
manufactured by our medical profes-
sionals and students, including the
Michigan-made Opioid Prescribing
Recommendations for Surgery. The
website, of use to all patients in any
hospital, provides new, lower recom-
mended dosages of different pain-
killers for different surgeries and
procedures. “(W)hen patients are
prescribed fewer pills, they consume
fewer pills with no changes in pain
or satisfaction scores,” the site reads.
The suggestions were developed by
Michigan OPEN, or the Opioid Pre-
scribing Engagement Network, which
was established in 2016 with support
from the Institute for Healthcare Pol-
icy and Innovation at the University
of Michigan. Using patient-reported
data, researchers found that previ-
ous recommended dosages swamp
patients by meeting and oftentimes
exceeding self-reported use, as dis-
cussed on the website.
Ernst explained to me yet another
feature of our health system that
fortifies proper prescribing efforts:
changes implemented to the pre-
scribing functionality of the com-
mon electronic health record system
shared between UHS and the aca-
demic medical center. The advan-
tages of those changes, rolled out just
over the past few months, include a
“single-click sign-on to the Michi-
gan Automated Prescription Sys-
tem which provides for review by
the prescriber a detailed report of
all previously filled controlled sub-
stance prescriptions by that patient,”
Ernst explained. “… No prescrip-
tions for controlled substances, new
or renewal, can be completed now
without the provider first attesting
to the fact that the MAPS report has
been reviewed.” In addition to this
detailed list, information packets
that outline risks of overdose and
dependence are now automatically
provided for patients filling new pre-
scriptions. Additionally, “for acute
pain, the duration of prescribed opi-
oids is limited to a maximum of seven
days in order to prevent the occur-
rence of leaving unused pills,” Ernst
said. Together, these novel features
are paving the way for other medi-
cal centers to counter the norm and
make new rules.
So what is it that keeps campus-
es from misusing? I believe it’s the
McCabes, the Injury Prevention Cen-
ters, the thought-provoking summits
and recommendations, and the con-
sequential organizations that marshal
vast troops of affiliates to exchange
ideas and confront community issues
head-on. I believe we fortunately live
in a community where these influ-
ences are within reach.
5
OPINION
Thursday, August 2nd, 2018
The Michigan Daily — michigandaily.com
By
polarizing
the
debate over Trump’s most
blatant
disregard
for
national concern yet, his
coterie of supporters has
ensured any full-throated
defense
of
American
sovereignty will be met
with substantial outcry,
thereby redirecting GOP
politicians
toward
the
path of least of resistance.
As they have repeatedly
made
clear,
Republican
lawmakers
have
heard
the message and will not
hold Trump accountable
if
it
means
upsetting
constituents — even if
impeachment (or at least
moving toward it) will
mitigate future damage
to American international
standing.
In light of unending
congressional deference to
Trump’s ignobility, there
seems to be little hope for
recourse, a prospect even
more disconcerting given
the momentum of Russia’s
continuing
campaigns
against
American
domestic
security
and
overseas interests. Just
as it is futile to hope that
Trump will change his
predispositions, it is naïve
to call upon Republican
members
of
Congress
to
sacrifice
their
own
electoral security for some
higher
cause
(perhaps
a justification in and of
itself for doing away with
the
two-party
system
and its many maladies).
Republican
lawmakers’
predictable
and
demonstrated preference
for political expediency
speaks to an era where
reminiscing on the days of
“bipartisanship” is hokey
at
best,
and
deceptive
at
worst,
demanding
a
Congress
capable
of
pushback.
As Trump’s rhetoric has
moved beyond bombastic
to outright terrifying, he
has proved himself beyond
deserving of impeachment
and possible removal from
office. Deliberation on the
true nature of his historic
missteps will not become
a reality as long as those
lawmakers poised to forgo
the nonpartisan duties of
the legislature remain in
power. Accommodation
of Trump and his ever-
flirtatious
dance
with
outright
treason
can
therefore come to a close
only under a Congress
headed by the Democrats,
necessitating widespread
electoral
support
for
blue House and Senate
candidates come this fall.
To
be
clear,
this
is
not a partisan call for
a
Democratic
takeover
of
Congress
predicated
on liberal policy toward
health
care,
abortion
access,
gun
control
or
any
other
hot-button
political issue – it is a
straightforward
demand
for Congress to put its
allegiance
to
America
first, and act deliberately
when the man elected to
the nation’s highest office
so clearly fails to do so.
No longer answering to
Trump’s steadfast base,
maybe a new majority of
Democratic
legislators
can, as Mason envisioned,
contain
our
unfit
magistrate.
What we’re doing and where we’re going
Julia Montag can be reached at
jtmon@umich.edu
Ethan Kessler can be reached at
ethankes@umich.edu.
CONTRIBUTE TO THE CONVERSATION
Readers are encouraged to submit letters
to the editor and op-eds. Letters should
be fewer than 300 words while op-eds
should be 550 to 850 words. Send the
writer’s full name and University affiliation to
emmacha@umich.edu
Defaulting on leadership by Ethan Kessler continued below: