Revised March 2019
Opioid-Related Overdose Deaths
In 2017, there were 2,033 overdose deaths involving opioids in Michigan—a rate of 21.2 deaths per 100,000 persons, which is higher than the national rate of 14.6 deaths per 100,000 persons. The greatest increase in opioid deaths was seen in cases involving synthetic opioids (mainly fentanyl), from 72 deaths in 2012 to 1,368 in 2017. Deaths involving heroin increased from 263 to 783 deaths in the same 5-year period. Prescription opioid involved deaths also rose from 378 deaths in 2012 to 678 deaths in 2016 but saw a recent decline to 633 deaths in 2017 (Figure 1).
Opioid Pain Reliever Prescriptions
In 2017, Michigan providers wrote 74.0 opioid prescriptions for every 100 persons (Figure 2). This represents a 25 percent decline in Michigan opioid prescriptions since 2013 (CDC).
The rate of overdose deaths involving opioid prescriptions has not followed this trend and steadily rose to 7.0 deaths per 100,000 persons through 2016 (Figure 2). In the past year, however, the rate decreased to 6.5 deaths per 100,00 persons.
Neonatal Abstinence Syndrome (NAS)
NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study showed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. That is one baby born with NAS/NOW every 15 minutes in the United States. During the same period, hospital costs for NAS/NOWS births increased from $91 million to $563 million, after adjusting for inflation (Figure 3). In Michigan, the NAS/NOWS rate increased eightfold from 0.9 cases per 1,000 births in 2004 to 7.1 cases per 1,000 births in 2014 (Michigan Inpatient Database).
HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)
- U.S. Incidence: In 2016, 9 percent (3,480) of the 39,589 new diagnoses of HIV in the United States were attributed to IDU. Among new cases, 6.3 percent (2,530) were transmitted via IDU or male-to-male contact and IDU among men, and 2.3 percent (950) were transmitted via IDU among women (CDC).
- U.S. Prevalence: In 2016, 991,447 Americans were living with a diagnosed HIV infection—a rate of 306.6 cases per 100,000 persons. Among males, 19.9 percent (150,4661) contracted HIV from IDU or male-to-male contact and IDU while 21 percent (50,154) of females were living with HIV attributed to IDU (CDC).
- State Incidence: Of the new HIV cases in 2016, 747 occurred in Michigan. Among males, 7.0 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 20.5 percent of new HIV cases were attributed to IDU (Figure 4) (AIDSVu).
- State Prevalence: In 2015, an estimated 14,615 persons were living with a diagnosed HIV infection in Michigan—a rate of 174 cases per 100,000 persons. Of those, 12.8 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 21.4 percent were living with HIV attributed to IDU (AIDSVu).
Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use1
- U.S. Incidence: In 2016, there were an estimated 41,200 new cases of acute HCV2 (CDC). Among cases reports that contain information about IDU, 68.6 percent indicated use of injection drugs (CDC).
- U.S. Prevalence: An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual averages (CDC).
- State Incidence: There were approximately 107 new cases of acute HCV (1.1 per 100,000 persons) reported in Michigan in 2016 (CDC).
- State Prevalence: In Michigan, there are an estimated 70,000 persons living with Hepatitis C (2013-2016 annual average), a rate of 910 cases per 100,000 persons (HepVu).
- Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
- Actual acute cases estimated to be 13.9 times the number of reported cases in any year.
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NIH HEAL (Helping to End Addiction Long-term) Initiative
New Opioid Overdose Materials for Patients
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