MSU Extension Food & Health

IMPACTS

Through MSU Extension’s opioid misuse and prevention programming, Michigan residents and healthcare providers alike gained crucial knowledge about preventing opioid misuse, understanding the signs and symptoms of opioid use disorder and learning how to support those struggling with opioid use disorder.

PRIORITY AREAS

◦ Preventing substance misuse through education focused on using mindfulness techniques and modifying lifestyle behaviors to manage chronic pain
◦ Promoting self-management of chronic disease symptoms and improving problem-solving and communication skills
◦ Helping people deal with pain, discomfort and fatigue
◦ Teaching people about alternatives to taking prescription opioids
◦ Connecting community resources to those who need help
◦ Supporting persons in recovery and their families and neighbors

MISUPER: MICHIGAN SUBSTANCE USE, PREVENTION, EDUCATION AND RECOVERY PROGRAM

In response to the rural opioid epidemic in Michigan, MSU Extension, the MSU Department of Family Medicine in the MSU College of Human Medicine, and the Health Department of Northwest Michigan collaborated to develop a rural community-based education project called MiSUPER. The overall goal of the MiSUPER collaboration is to increase awareness of opioid misuse in rural communities regarding prevention, treatment options and recovery support so that community members and health care professionals could recognize signs of misuse, suggest options for professional treatment and support those in recovery. The MiSUPER rural community opioid misuse prevention education program targeted healthcare workers and community members throughout rural Michigan.

The MiSUPER team created and delivered multiple presentations explaining the physiology and psychology of opioid misuse as well as prevention, treatment and recovery options, with both professional and community audiences in mind. Presentations were tailored for each rural Michigan region by including local services, treatment providers and resources. In addition, rural medical students and AmeriCorps VISTA members received training, including Medication-Assisted Treatment (MAT) Waiver training for medical students to obtain a MAT waiver.

When the COVID-19 pandemic occurred in early 2020, the MiSUPER team quickly pivoted to convert what had been planned in-person community and provider education sessions to virtual platforms. This included the development of a website with enhanced educational resources as well as community recruitment through targeted social media and digital advertisement campaigns. Evaluation of the MiSUPER project includes descriptive statistics, comparison of educational outcomes using pre-post testing of participant’s knowledge and online metrics to measure digital outreach efforts.

From June to October 2020, the MiSUPER team held 18 virtual community education events reaching 268 participants, about half of whom were rural residents. Most participants (76.1%) were between 18 and 54 years old; 23.9% were 55 or older. Most (95.7%) were female, and 84.8% identified as White/Caucasian, 8.7% American Indian/Alaska Native and 6.5% mixed race/ethnicity. Participants were from 20 rural counties throughout Michigan. Additionally, 30 medical students received MAT waiver training and 10 AmeriCorps VISTA members received training on the opioid crisis in communities before they began their service project work.

To measure the change in knowledge as a result of the trainings, 46 participants in a training were asked to complete an eight-question opioid misuse knowledge survey before and immediately after the event, as well as 30 days after the event. The proportion of correct responses increased from 75% before the event to 88.7% after the event. At the one-month follow-up, 94% of responses were correct. Participants also reported more familiarity with local resources for prevention and treatment of opioid misuse.

Using a collaborative model, the MiSUPER team reaches rural residents and healthcare providers with education on opioid prevention, treatment and recovery services despite challenges presented by the COVID-19 pandemic. Rural residents were willing to attend virtual presentations, and knowledge about opioid misuse consistently increased following sessions.

USDA NIFA RURAL HEALTH AND SAFETY EDUCATION GRANT

The grips of opioid addiction can cross boundaries of socioeconomic class, age and everything in between. Underserved adults in rural areas often face additional risk factors for opioid use disorder such as isolation, unemployment and a lack of access to healthcare providers. A team of MSU researchers aims to help change that through a new project, funded by a two-year grant from the U.S. Department of Agriculture’s National Institute of Food and Agriculture, Rural Health and Safety Education program.

The core team is led by MSU Extension senior health specialist Dawn Contreras and includes Cheryl Eschbach, director of MSU Extension’s health and nutrition programming; Lauren Kennedy, MSU Extension community behavioral health specialist; Judy Arnetz, professor and associate chair for research for MSU’s Department of Family Medicine; and Courtney Goetz, research assistant from MSU’s Department of Family Medicine. Eleven MSU Extension county-based staff are also part of the effort.

The two-year project, which kicked off in September 2020, will take a multifaceted approach to helping combat the opioid crisis in rural communities. Specifically, the initiative aims to:

• Work with coalitions in rural counties of Michigan’s Upper Peninsula to build awareness and make collaborative plans to implement evidence-based opioid misuse prevention programs.
• Cross-train these coalition members, as well as recovery coaches, so they can facilitate evidence-based opioid misuse prevention programs.
• Equip physicians and mid-level healthcare providers in rural counties throughout the state with tools and training to make electronic patient referrals into prevention programs.
• Implement evidence-based opioid misuse prevention programs with residents in all Michigan’s rural counties and empower them through nonpharmacological approaches to pain management.

Throughout the course of this work, the project team will collaborate with several key partners, such as the Michigan Department of Health and Human Services, the Michigan Center for Rural Health, the College of Human Medicine Family Medicine Residency Network and NorthCare Network.

STATE OPIOID RESPONSE

In 2018, the Michigan Department of Health and Human Services (MDHHS) reached out to MSU Extension to provide community-based substance use disorder prevention education to Michigan’s older adults, aged 55 and older. This effort was funded by two State Opioid Response (SOR) and SOR supplemental grants. To date, this initiative has helped educate over 2,200 older adults in nonpharmaceutical approaches to pain management. Evaluation results show positive changes in appropriate use of pain medication and nonpharmacological approaches to pain management.

The urgent need to support older adults and adults with disabilities living with substance use disorder, chronic pain or both was first noted by the MDHHS Office of Recovery Oriented Systems of Care, which established a robust Older Adult Substance Misuse Prevention Partner Network to create a plan and address the issue. MSU Extension has been an active member of this network since its inception. This network has been meeting regularly since 2019 and supports MSU Extension in delivering these evidence-based substance use disorder prevention programs, with topics such as chronic pain self-management education, chronic disease self-management education and mindfulness