State systems for tracking heroin deaths flawed, advocates say

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NOTE — THIS IS PAIRED WITH ANOTHER STORY: Heroin problems outpace Michigan’s solutions
Capital News Service
LANSING — Those in the fight against heroin and opioids say one of their biggest problems is the absence of up-to-the-minute information on drug cases.
A lack of official communication, outdated statistics and inconsistent reporting practices have slowed Michigan’s attempts to combat the continuing heroin and opioid problem, advocates say.
They call for better reporting and recordkeeping of heroin deaths, along with legislation to increase the availability of the overdose-reversing drug naloxone.

Jennifer Smith, public information officer for the Michigan Department of Health and Human Services, said addressing the state’s heroin and prescription drug abuse problem is a priority — and this includes looking at the problems with current reporting systems.
It is difficult to get an accurate read on the scope of the problem due to inconsistencies in the way drug-related overdoses and fatalities are reported in the state.
“A perfect example is the year that our organization started (in 2007), it was reported that there were no overdose deaths in Macomb County,” said Linda Davis, a district judge in Clinton Township and president of Families Against Narcotics. “And yet we had nine parents sitting at our meeting who had lost their children to heroin that year.”
Michigan relies on local medical examiners and coroners for data on heroin-related deaths. Death certificates are the sole source for mortality review at the state level. At this time, there is no code assigned for heroin laced with fentanyl, which means even when the drugs are both known to be present they are not always reported, Smith said.
This makes it difficult to know where the contaminated heroin is and limits the department in its ability to comment on the current rash of calls to the Michigan Poison Control Center since January.
Local examiners and coroners, Smith said, have real-time data and can provide more detailed information to those who ask, but the State Health and Human Services Department’s use of death certificate data creates a two-year time lag between a death its inclusion in a report.
Smith said this is the time it takes to collect in-state death records, wait for out-of state death records, and review and finalize the file.
The only publicly available data on hospital emergency room visits in Michigan are from the Drug Abuse Warning Network for the Detroit, Warren and Livonia Metropolitan area. The most recent tables, provided by Smith, are from 2004 through 2011 and provide almost no data on heroin-related admissions.
A fact sheet from the state tracks a rise in the number of heroin and opioid related deaths between 2009 and 2013. The most dramatic increase was from 2012, with 648 deaths, to 2013, with 840.
“Our organization has several different chapters all over the state, and all of them are struggling with it,” Davis said. “I know Waterford recently had 10 deaths in a two-week period of time; we’ve had numerous deaths in Macomb County.”
Davis is calling for a standardized, statewide approach to reporting overdose deaths. Better reporting and tracking of heroin-related health issues could lead to expanded legislative efforts to tackle the problem, advocates say.
Kevin McFatridge, director of marketing, communications and public relations for the Michigan State Medical Society, agreed that heroin and opioid abuse is a major problem. He said the society is working with the governor and legislators to address it.
Davis said she is encouraged by the legislature’s attempts, but more still needs to be done.
“This problem has gotten so big, so fast,” she said. “This is a real problem and we are losing a lot of young people because of it.”

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