As we talk about the complexities and challenges within an urban city, several adversities rise to the surface, such as poverty-stricken homes, blight, crime, environmental injustices, poor educational systems, and the list goes on. Though all instances of community neglect are crucial to address, when it comes to the reality of ongoing decades of drug abuse within these communities, mediation must come into play immediately. The above list of obstacles one may face being a product of an urban and underserved community is, in most cases, out of their hands, but drug usage is a choice; though this is true, most people who become addicted to drugs often think the addiction bug wouldn’t bite them, the “couldn’t be me” mentality. Unfortunately, it always does, and that is when the abuse and neglect of one’s quality of life is born.
“Our brains are wired where we have four major chemicals in the brain that are there for a purpose but when you can get external substances that mimics the same activity it highjacks that purpose and people can get addicted to those chemicals pretty quickly,” said Dr. William Beecroft, Medical Director of behavioral health, Blue Cross Blue Shield of Michigan as he shared the impact of transfer addiction, essentially the driving force of overdoses on opioids, pain medication, fentanyl, and things alike. “When you look at the substances that people can get a hold of to use and when they have the inability to get their preferred substance that’s when they’ll use other alternatives or transfer to a different but similar substance that does the same thing.”
Being that Detroit was an entertainment scene and big in the auto industry, drug abuse can date back to the late 50s, bringing forth heroin and cocaine, and in the 1980s, the drug scene highlighted the addiction to crack cocaine. Although these drugs are still prominent throughout, opioids have now entered the conversation surfacing in 2018. Detroit’s ongoing battle against opioid addiction has reached a critical juncture. The city, grappling with alarming overdose rates, is now poised to receive significant financial support from the very pharmaceutical companies that played a role in fueling this crisis. While this move marks a significant step toward addressing the epidemic, the path forward remains fraught with challenges.
Recent data from Wayne County, encompassing Detroit, reveals a disturbing trend: the county’s overdose death rate stands at 35 per 100,000 people in 2023, surpassing the national rate of 32 per 100,000 in 2021. This alarming statistic is part of a broader narrative of suffering and loss, with an estimated 871 provisional drug overdose deaths in 2022 in the county alone, the majority involving opioids.
The impact of this crisis transcends numbers, devastating communities across Michigan. In 2022, overdose deaths statewide exceeded those from suicides and homicides combined. While the majority of these fatalities involve white individuals, Black communities are bearing a disproportionate burden, reflecting a troubling disparity in the crisis. The opioid overdose rates among Black individuals surpassed those of White individuals by a factor of four to six, with substances like fentanyl and heroin disproportionately affecting Black communities. This gap was further exacerbated during the intersection of the opioid crisis with the COVID-19 pandemic in 2020. African Americans, particularly those residing in urban areas, represent vulnerable groups that urgently require both social and political support to tackle the opioid epidemic in communities that are often lacking in resources.
Economically, the opioid epidemic has inflicted a staggering toll. In 2020, the U.S. economy lost nearly $1.5 trillion as addiction displaced workers and strained medical resources. This backdrop set the stage for legal action, with states and local governments suing about a dozen companies responsible for perpetuating opioid addiction through the production and distribution of painkillers. These lawsuits are expected to funnel $1.54 billion to Michigan over 18 years.
Of this sum, half is earmarked for statewide opioid remediation, leaving approximately $770 million for cities and counties. Detroit is set to receive at least $40 million over 18 years, while Wayne County is expected to get over $95 million. Under the agreement, a minimum of 85% of these funds must be allocated to treatment and prevention strategies.
“Detroit is one of the main markets for these substances even though the population isn’t the same as it used to be. Detroit is still a big popular city,” said Beecroft. “When you have populations that have dispensable income there’s a market that the others will seek and manipulate. It’s the ability to manipulate that purchaser that is a huge problem. Opioids are very available at this point especially synthetic ones like fentanyl and Carfentanil. Fentanyl is about 170 times more potent than a similar amount of morphine – it’s way more powerful than anything else.”
Detroit’s initial steps with its settlement funds include setting aside $4 million to pay for a team of social workers and peer recovery coaches. These professionals will engage with individuals post-overdose treatment, extending support to those without housing referred by homeless service providers. The city’s approach emphasizes counseling, treatment connections, and syringe service programs, although the contractor to administer these services is yet to be determined.
However, concerns arise over the city’s focus on post-overdose interventions, with critics advocating for a more robust prevention strategy. This includes medical treatments for addiction grounded in scientific evidence and support for community organizations practicing harm reduction. The city also plans to enhance behavioral health support in homeless shelters.
“There are some miraculous medications that we have that are truly lifesaving. In the past all you had as tools is primarily methadone but today there’s new tools that decrease the craving from the drug and decrease from the withdrawal symptoms that pushes people to use more and more,” Beecroft shared. “The use of these medications which is called Medical Opioid Use Disorder treatment are really the best way to use those funds. To be able to help save people’s lives.”
Further, settlement funds will augment recovery housing in Detroit, adding 40 treatment beds to an existing project. Recovery housing, offering low-cost or free accommodations, is a critical resource for those overcoming substance use disorders, providing a substance-free environment coupled with counseling and social services.
The City Council’s agenda recently included a request to Accept and Appropriate the FY 23 Comprehensive Opioid, Stimulant, and Substance Use Site-based Program. This program, backed by a $1.6 million grant from the U.S. Department of Justice, aims to confront the opioid crisis head-on. With no match requirement, the grant represents a major influx of resources toward combating this public health emergency.
The grant’s primary objective is multifaceted: to prevent fatal drug poisonings, create sustainable pathways to permanent housing, and foster holistic wellness opportunities. These goals are particularly crucial for participants in the city’s Specialty Courts, who are often at the intersection of the legal system and substance use recovery.
“This money can give a hand-up to those affected by addiction, when they’re not high, to be able to go to counseling and peer support while being able to help them recognize that they have value in their life that is beyond the drug,” Beecroft said. “Those are the things that can be the cascade in doing this and though this is a multiple part system to do the first is, stop people from dying in the first place. Get people into treatment, meet them where they are, invest in resources and highlight the resources that are already out there. That is how we can get the most out of this money.”
The Detroit Housing & Revitalization Department, upon approval, plans to utilize this funding to engage participants and stakeholders through comprehensive wraparound care. This includes training, education, and strategic development, all under the umbrella of the Detroit HOME Project. Notably, this grant operates on a reimbursement basis, ensuring accountability and effective use of funds.
The request, which has already received a nod from the Office of Budget, is waiting for the green light from the City Council. If approved, it would authorize the department head to execute the grant agreement and allow the Budget Director to manage the funds, designated as Appropriation #21363.
This project comes at a critical time for Detroit. In the past decade, the city has lost over 2,000 residents to fatal drug overdoses, and more than 7,000 have faced opioid-related emergencies since the COVID-19 pandemic began. The economic burden of illicit drug poisonings is staggering, costing the United States an estimated $193 billion annually, with Detroit’s share nearing $1 billion. These figures account for healthcare, treatment programs, and associated societal costs, yet the true cost, including grief and social impact, remains immeasurable.
The pandemic has further deepened housing inequalities, particularly affecting young Black and Brown adults under 34 who are precariously housed or homeless. The Detroit HOME Project (Housing, Overdose Prevention, Managed Care, and Empowerment) aims to address these issues by marshaling the resources of various city departments and community organizations. The project’s ambitious goal is to engage 500 participants in wraparound care, training, education, and strategy development, striving to advance behavioral health equity and provide effective care strategies.
This initiative is a beacon of hope, signaling a robust response to the dual crises of drug addiction and housing insecurity plaguing Detroit’s communities.
For those seeking recovery housing, resources are available through the Michigan Association of Recovery Residences Inc. or the Detroit Wayne Integrated Health Network 24/7 hotline at 800-241-4949.
While the influx of settlement funds offers a beacon of hope, Detroit’s journey to overcoming its opioid crisis is complex and multifaceted. It demands a balanced approach that addresses the immediate needs of overdose survivors while also tackling the root causes of addiction, ensuring a healthier, more resilient community for all its residents.
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