Medical Examiner Drug Report
Michelle A. Fox, D-ABMDI, is the Sparrow forensic pathology supervisor & chief investigator of the Office of the Medical Examiner, which tracks drug-related deaths in Eaton, Ingham, Ionia, Isabella and Shiawassee counties.
For 2019 Q3 (July 1 – Sept. 30) in Ingham County, there were 23 drug-related deaths, of which 13 included some form of fentanyl, though all but three cases were a combination of drugs.
Fox says it is helpful to look at the whole year. In 2018, in Ingham County there were 101 drug-related deaths, 84 of them opioid related. In most cases, multiple drugs were involved.
Drug deaths and drug deaths where opioids were involved are slightly down in 2019.
“We had a general decrease in overall drug deaths from quarter three of ’19 to quarter three of ’18,” said Fox. “Amphetamines are a little bit more on the rise,” said Fox.
However, Fox cautions against making too many inferences with a small sample size. “You have to look at a whole lot more (information) than that to be able to determine exactly what direction we’re headed in.”
Fox says one possible reason for the reduction could be because fentanyl analogs have been reclassified as a schedule one, a category meaning there is no deemed medical use and they are illicit.
A Public Health Issue
“A lot of what we’re seeing mirrors what’s going on nationwide,” says Linda Vail, MPA, health officer at the Ingham County Health Department.
“People get addicted to drugs,” she said. “It is not a moral failing.”
“It’s a chronic disease no different than diabetes or high blood pressure,” she added.
Vail said many people say our society spends too much money on fentanyl – that people should just die because they’re not smart enough to stop taking drugs.
“This is a complete misconception,” said Vail.
For example, Vail says most of society wouldn’t advocate denying emergency medical care to someone with diabetes who forgot to take their insulin.
“The stigma associated with addiction and other behavioral disorders is more blaming and shaming of the person than recognizing that they have a disease. And, to the extent that we do this, we create a system that has barriers,” she said.
To help curb the opioid crisis Vail would like to see a health care system that doesn’t bifurcate treatment systems into medical and behavioral health. Vail says bifurcation “makes it more difficult to get treatment.”
“Then why do we continue to treat people who have this disease differently? … Then, that stigma literally becomes discrimination,” she said.
The Evolving Role of Law Enforcement
“Opioids are an epidemic,” said Daryl Green, chief of police for the City of Lansing Police Department. “It continues to rear its ugly head throughout many communities, not just the city of Lansing.”
Green says the department will see spikes in overdoses in a specific area.
“We’ve seen some of the most potent heroine in the nation,” said Green.
Green says his department is working with area partners to share information, make referrals, and approach the issue in a holistic way.
In the past couple of years, all of the patrol officers have been trained and equipped with naloxone, a medication designed to rapidly reverse opioid overdose.
“One of the things we’re doing really differently in the city of Lansing is we try to directly intervene to help overdose victims,” said Green. “And how we do that is we’re one of the only police departments in the state of Michigan that has a fully embedded social worker.”
“If you can get them stable, you don’t see them anymore in the criminal justice system,” said Green.
“It’s complex,” he said. “You have a drug issue, a housing issue, you have some mental health issues. A lot of times you’re dealing with all three.”