Published in Health Care
Steve Alsum Steve Alsum PHOTO: KATY BATDORFF

Solving opioid crisis requires employers, society to think differently about addiction

BY Sunday, October 27, 2019 01:16pm

A Q&A with Grand Rapids Red Project Executive Director Steve Alsum

For more than a decade, the Grand Rapids Red Project has been a leading organization in combating the opioid epidemic in Michigan. 

During that time, it has run a syringe access program as well as distributed and provided extensive training in the overdose-reversing drug Naloxone. The organization now operates in seven West Michigan counties and has increased its budget from $70,000 six years ago to about $1.5 million. 

Red Project Executive Director Steve Alsum says the opioid epidemic has come in multiple phases, and emerging issues involve removing the stigma around drug users and proven treatments, such as medication-assisted treatment.

Alsum recently spoke with MiBiz to discuss the trends and emerging concerns about the opioid crisis, as well as misleading portrayals in the media about opioid addiction. (This interview was edited and condensed for length.)

How have you seen the opioid crisis evolve over the past decade?

There really has been three phases of the opioid epidemic. The bulk of fatalities from 2008 to 2012 were caused by prescription opioids. The medical community started recognizing the role prescription opioids were playing in fatalities, and they started limiting access to prescription opioids. However, they weren’t providing the same level of evidence-based treatment for people already addicted to prescription opioids. A lot then transitioned to heroin use. We’re now in the third phase of this, and deaths are primarily being caused by illicit heroin cut or adulterated with fentanyl.

Why has an organization like Red Project, which supports often stigmatized programs like needle exchanges and medication-assisted treatment, been successful in politically conservative West Michigan?

Initially, we were fortunate to have support from some city leaders. Red Project really got off the ground partially as a result of former Mayor Logie putting together a task force on drug reform in Grand Rapids. We have been really fortunate to have a lot of dedicated people who are interested in working on this issue in Kent County.

What’s been the response to your programming from institutional players like insurance companies or physicians?

There’s a lot of stigma around people having an opioid use disorder, and also a lot of stigma around interventions that are there to help people. Some of the major players are catching on more now because they have to. I think there’s still a really long way to go. At this point in time, syringe access programs have been around for 20 years. Now we need to be moving forward with more innovative programming.

Does the Red Project work with employers to address opioid use among employees?

Most employers nowadays are going to have employees who are using opioids, whether they know it or not. Typically, the work we’ve done with employers happens after a fatal overdose of an employee. Some employers have reached out to us and request we train their staff on Naloxone. 

A lot of times, employers have policies around drug use that make it very unlikely that their employees would ever disclose (opioid use) to them. We’d love to see employers be more accepting around the issues some of their employees are struggling with. At a lot of these places, their first response is it’s not their problem — until someone they care about actually overdoses.

Is the opioid crisis — the cause and response — a uniquely American problem?

It absolutely is. The way we deal with drug use by criminalizing it has been a uniquely American way of dealing with this health issue. We talk a lot about addiction being a disease, but that’s not really how we deal with it as a society. The primary treatment most people get with opioid addiction is jail and the criminal justice system. We give lip service to this being a disease and a medical issue, but it’s primarily a criminal justice issue.

What do you feel have been under-reported or mis-reported aspects of the opioid crisis?

It’s portrayed as either people being abstinent or at their worst. The reality is there’s a whole spectrum of behaviors people can fall into. The media loves the story of an addict who’s doing really well right now. The narrative that’s pushed a lot of times is that people’s lives do not have value while they’re using opioids, and their lives begin to have value when they’re abstinent or when they pursue abstinence. A key thing the Red Project does is we affirm the value of people’s lives wherever they’re at in their substance use.

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