The state Senate recently passed a package of bills designed to combat the opioid-use epidemic by expanding access to support services thereby reducing the risk of overdoses and improving both short- and long-term treatment outcomes.

The seven bills in the package, spearheaded by state Sen. Kevin Hertel (D-St. Clair Shores) and sponsored by he and five other Democrats, had bi-partisan support as each passed by an overwhelming margin.

“Too many Michigan families have felt the pain of losing a loved one to opioid addiction — and they deserve more than sympathy. They deserve action,” said Hertel, chair of the Senate Health Policy Committee, in a press release. “These bills aim to deliver real, immediate solutions that reflect what we’ve heard from medical professionals, recovery advocates, and families on the frontlines: we need fewer barriers, more access to care, and stronger tools to prevent overdose deaths. With this legislation, we can turn the tide on this epidemic and ensure help is available when and where it’s needed most.”

The package has gone to the state House of Representatives for consideration.Dunya Kilano, operations director of Clinton Township-based nonprofit Face Addiction Now, praised the package’s practical proposals to break down barriers for substance abusers to receive treatment.

“They’re practical solutions to some of the barriers that exist in how people access substance-abuse treatment and how we tackle this as a community,” Kilano said. “Our health systems are just not equipped to help people with substance-abuse disorder because some of these barriers exist.”

FAN, which operates over 20 chapters in Michigan, provided input to lawmakers while the package was in development, she said.

“Most of the things in the package are barriers that we work to break down, things that people struggle with every day,” she said.

“Expanding access to proven substance use treatment is the most effective way to address the overdose crisis in Michigan,” said Andrew Whitacre, a senior officer with Pew Charitable Trusts’ substance use prevention and treatment initiative. “The reforms in this bipartisan bill package will save lives.”

Kilano called the bills “common sense solutions.”

“It feels like we’ve been dealing with this opioid for a really long time,” she said, “but in the grand scheme of things it takes a long time for things to change” in the bureaucracies of health and insurance systems, including as well as in Medicaid and Medicare.

Increased abuse of opioids initially began nationally in the 1990s and rose dramatically in the 2000s. The number of opioid-related drug overdoses in Michigan hit 1,000 for the first time and peaked in 2021 with 3,096 total drug overdoses, as illicit drug producers mixed fentanyl with other illicit drugs such as cocaine and methamphetamine.

The mixing of fentanyl, an extremely potent opioid, with other substances and illicit drugs such as cocaine and methamphetamine has caused a skyrocketing of deaths in the past decade.

Fatal drug overdoses, however, have started to decline in Michigan and the nation. The number of deadly overdoses in Michigan decreased by a whopping 34% last year, from 2,931 in 2023 to 1,927. Nationally overdose deaths involving opioids decreased by nearly 27% last year, from an estimated 83,140 in 2023 to 54,743 in 2024.

The recent decrease has been largely attributed to the heightened use of naloxone, known by its brand name, Narcan, an opioid antidote. Narcan has been widely distributed in recent years by FAN and other public and private organizations in Michigan.

Kilano said the vast majority of overdoses are accidental as unsuspecting users are often killed by the potent fentanyl.

The distribution of fentanyl test strips for users to check for the highly-potent drug have also helped reduce deaths.

Hertel said the bill package was developed via conversations with care providers, researchers and policy experts in Michigan and the nation. Officials are seeking to “leverage best practices seen in other states, as well as research findings from leading institutions and input from those on the frontlines of the crisis,” according to Hertel’s release.

The legislation would:

• Remove dosage maximums. SB 397, sponsored by Hertel, requires the Michigan Department of Health and Human Services to remove prior authorization by private insurance, Medicare or Medicaid for any prescription drug used for the treatment of opioid withdrawal symptoms or opioid-use disorder.

• Expand access to addiction medications. SB 403, sponsored by Sen. Sam Sing (D-East Lansing) requires pharmacists to make a good-faith effort to fill the order of a lawful addiction medication prescription without undue delay.

• Allow for the co-prescribing of naloxone. SB 401, sponsored by Sen. Sylvia Santana (D-Detroit) allows for the co-prescribing of an opioid antagonist such as Narcan with an opioid or narcotic to help prevent overdose deaths resulting from unintentional misuse of prescription medication.

• Break down insurance barriers to treatment. SB 400, sponsored by Hertel, prohibits prior authorization on medications for opioid- and alcohol-use disorder in commercial insurance plans.

• Reduce overdoses among adolescents. SBs 404 and 405, sponsored by Sen. Darrin Camilleri (D-Trenton) require school nurses to carry naloxone.

• Expand treatment at critical access points. SB 402, sponsored by Sen. Paul Wojno (D-Warren) allows Medicaid to cover “street medicine” services, including prescribing and dispensing of medications at rural health clinics, certified community behavioral health centers, and more. Street medicines are those provided to homeless people.

• Prevent fentanyl deaths: SB 399, sponsored by Sen. Jeff Irwin (D-Ann Arbor) removes fentanyl testing strips’ classification as drug paraphernalia. The test strips allow users to test their illicit drugs for the deadly fentanyl.

“By streamlining access to medication and strengthening harm reduction efforts, some believe the bills could reduce overdoses in Michigan,” legislative analyst Alex Kravill of the Senate Fiscal Agency says in his summary of the bill.

A financial review of the package by a group of five analysts from the agency determined that most of the bills will have minimal or no impact but that SBs 401 and 401 could have significant impact.

SB 401 could cost over $22 million, according to the analysts. The bill would amend the Pharmacy Practice and Drug Control section, part 177, of the Public Health Code, to require a prescriber for an opioid to also offer the patient a prescription for an opioid antagonist, Narcan, “under certain circumstances.”

“The resulting additional prescription costs could affect the State’s Medicaid program through fee-for-service payments and increases to Medicaid health plan managed care rates, as well as the State’s employee and retiree healthcare expenses,” the analysis says.

Based on a “100% fill rate” for the opioid antidote of 781,700 prescriptions at a cost of $57.40 per prescription, the total cost would be $44.9 million, the analysts say. The estimated match by traditional Medicaid and the expanded Medicaid, aka Healthy Michigan Plan, is approximately 24.25%, translating to a $10.9 million hit to the state’s general fund, analysts said.

The increased cost to the state for its self-funded health insurance plans could be about $11.5 million paid by the general fund, according to the analysis.

SB 402, which would amend Section 109 of the Social Welfare Act, also could have “significant fiscal impact” due to increased costs depending on the definition of street medicine services” that would be provided directly to homeless people “in their environment,” according to the analysis. The bill fails to define “health and social care,” which could allow for “a broad interpretation that could mandate extensive provisions of such services,” it says.

“Depending on the scope and types of health and social care that would have to be provided, this definition would have the potential to result in a significant fiscal impact,” the analysts say.

In 2024, there were 9,739 homeless people in Michigan, according to the 2024 United States Department of Housing and Urban Development Annual Homelessness Assessment Report, the analysts say.

“Providing care to approximately 9,700 individuals in their own environment, instead of in a facility or mobile health clinic setting, could result in significant costs for the Medicaid program,” it says.

Kilano noted FAN participates in two programs in which mobile medical units already go to low-income areas where homeless people are located to provide services.

Medicaid in Michigan is about 76% funded by the federal government. The program is subject to a $15 billion cut over 10 years as a result of President Trump’s tax and spending law passed this month by Congress. Some 300,000 people of 2.6 million Medicaid recipients in Michigan will lose coverage starting in 2027, according to a state Department of Health and Human Services report.