MSU Extension Food & Health

Impacts

Using an opioid medication for a use other than what the provider intended, or taking the medication for longer than prescribed, can lead to misuse of the drug and other serious health consequences. Opioid use disorder (OUD) changes the structure and function of the brain. If people develop an addiction to opioids and are unable to access prescription opioids, they may seek out other harmful substances. Many people who misuse opioids or develop OUD will need harm reduction supports to lessen consequences. Michigan State University Extension’s opioid misuse prevention and education programming centers around a message that recovery is rarely a straight line but is possible. After participating in a MiSUPER program or presentation offered by MSU Extension:

• 77% of participants reported improving their understanding of community resources for opioid misuse prevention, treatment and recovery.
• 75% of healthcare providers said they improved their knowledge of local resources for patients who cannot afford opioid misuse treatment.
• 77% of providers reported increased comfort in discussing opioid misuse with patients and  their loved ones.
• 99% of participants and 100% of providers would recommend the MiSUPER educational webinar and training to others.
• 4,493 rural and older adults reached through direct educational efforts designed to prevent opioid misuse and to decrease stigma surrounding substance misuse.
• 803,603 impressions of MiSUPER (Michigan Substance Use, Prevention, Education and Recovery) digital media campaign materials.

Priority Areas

• Teaching people about alternatives to taking prescription opioids for pain.
• Contributing to local coalitions and investing in community members to build capacity and strengthen partnerships.
• Promoting self-management of chronic disease symptoms and improving problem-solving and communication skills.
• Preventing substance misuse through education focused on using mindfulness techniques and modifying lifestyle behaviors to manage chronic pain.
• Establishing referral pathways between healthcare and community-based programs.
• Supporting people in recovery and their families, neighbors and employers.

To learn more about opioid misuse prevention and education programming, contact Cheryl Eschbach (cheryl@msu.edu), Dawn Contreras (contrer7@msu.edu), Lauren Kennedy (Kenne552@msu.edu) or Liz Williams (josaitis@msu.edu).

Year 3 Efforts of the MSU Extension State Opioid Response Team

Older adults are at a higher risk of developing chronic pain or other chronic conditions than are younger adults, making them particularly vulnerable to opioid misuse. Between 2018 and 2021, MSU Extension’s State Opioid Response program, or SOR, received just over $391,000 in grant funding to help prevent opioid misuse among Michigan adults ages 55 and up. The program focuses on educating older adults on how to manage pain without opioid drugs.

During the three-year period, a team of 20 MSU Extension health educators and program instructors provided educational programming to more than 3,000 older adults across Michigan. The project uses three educational program delivery methods: face-to-face programming, virtual programming, and mailed toolkits combined with conference calls. Participants report that they have developed their skills and confidence in using self-management strategies to overcome pain and manage their chronic diseases. These strategies include mindfulness techniques, medication management, health literacy and communication skill development.

IN 2020, the U.S. Department of Agriculture's National Institute of Food and Agriculture (Rural Health and Safety Education) awarded the SOR team a $350,000 grant to continue and expand their successful opioid misuse prevention education to rural Michigan residents of all ages, with a focus on telehealth strategies and the impacts of distance education on rural adults. 

For this work, MSU Extension collaborated extensively with the Michigan Department of Health and Human Services' Office of Recovery-Oriented Systems of Care and the prevention networks that receive funding from that office. These networks helped promote the programs for older adults in their regions. Many prevention network members became certified to implement opioid misuse education programs, which will help sustain the programming beyond the grant period. Before this initiative, no other entity in Michigan was providing opioid misuse education specifically geared to older adults. 

The top chronic conditions experienced by program participants were arthritis (34%), hypertension (31%), diabetes (31%), high cholesterol (29%), chronic pain (28%), depression (19%), asthma/emphysema (17%) and anxiety disorder (15%). Participants who completed self-management classes received a locked medication box after completion, an incentive item intended to encourage them to keep their prescription opioids secure.

Over the course of this three-year grant, MSU Extension increased the number of instructors able to teach chronic disease and chronic pain self-management classes for older adults by holding online and in-person train-the-trainer sessions. Nineteen new instructors attended training sessions in Gaylord, Novi and Lansing, and 12 attended online sessions. All completed the course and became certified to teach Chronic Disease PATH (Personal Action Toward Health) and Chronic Pain PATH classes in support of this grant. As part of their training, new instructors completed volunteer applications (including criminal background checks) and signed letters of commitment to teach in the program. They are now part of a team of educators teaching older adults in Michigan about preventing substance misuse.

• 145 & 136 class series and single-day workshops, respectively, for older adults delivered through MSU Extension's State Opioid Response (SOR) project.
• 31 new instructors gained from the SOR in-person and virtual train-the-trainer sessions.
• 7 people who shared their experiences with substance use disorder(s) in their own lives through the Stories of Hope (https://bit. ly/3DnqNyx) MiSUPER video series.  

"The COVID-19 pandemic has intensified the impact of the opioid crisis in Michigan. Data reveals disturbing racial disparities in opioid-related overdose deaths that may be attributable to certain aspects of the pandemic (for example, unstable access to harm reduction services, increased fentanyl in the drug supply, etc.). While the relationship between opioid misuse and COVID-19 continues to emerge, both public health crises have disproportionate effects on Black people, Indigenous people, and other racialized people, warranting prevention approaches that take equity into account. In Michigan, future MSU Extension efforts should: provide education and resources for harm reduction approaches and treatment options (for example, MOUD); partner with Black families, particularly Black rural families and other minoritized subpopulations; adopt an approach that includes a deeper level of engagement with community members; and work alongside people who use drugs, and those in recovery to strengthen our outreach efforts." -Lauren Kennedy, PhD, Specialist in Community Behavioral Health, MSU Extension

"For me, it was like trying to figure out a combination lock. I might get one issue addressed like my substance use, but having that one number wasn’t enough to set me free. What I really needed was a more holistic approach: treatment for occupational issues, educational issues. I needed housing and transportation. And until I could get all of those variables addressed at once, I wasn’t successful . . . [Today] I love recovery because it has given me a purpose in my life and hope for the future." -Amanda, person living in recovery in rural Michigan, Stories of Hope

"Opioid misuse and overdose are at an all-time high and the stigma around addiction remains. Education plays a vital role in creating more awareness around substance use disorders and viewing them as chronic conditions. Providing people with foundational information about addiction, treatment and recovery is one way to support communities as they address the opioid crisis at the local level. Opioid misuse can happen to anyone and understanding how to recognize the signs of misuse, or an overdose could save someone’s life." Liz Williams, MSU Extension Educator

MiSUPER Program Achievements

MiSUPER, the Michigan Substance Use, Prevention, Education and Recovery program, is funded by grants from the federal Substance Abuse and Mental Health Services Administration. The collaborative effort includes MSU Extension, the MSU College of Human Medicine’s Department of Family Medicine, and the Health Department of Northwest Michigan. The project has gathered a team of 15 medical science faculty, public health professionals and community-based educators. MiSUPER’s goal is to increase awareness in rural communities of opioid misuse and of prevention, treatment, and recovery support options.

When the COVID-19 pandemic reached Michigan in March 2020, the project was affected by the state’s “Stay Home, Stay Safe” orders. All planned educational outreach quickly pivoted to a virtual format and the project website was expanded, adding new features such as an online event calendar, news articles, a link to request community presentations, information on how webinar attendees could apply for continuing education credits, seven online community resource guides and a video series called “Stories of Hope.”

The Stories of Hope video series (https://bit.ly/3Kyhe2H) collected video testimonials from rural Michigan residents sharing their pathways to recovery. Seven stories that were produced in 2021 are posted on the project website and the MSU Extension YouTube channel. In June and October 2021, members of the MiSUPER team presented virtually on the Stories of Hope project at two statewide conferences hosted by Michigan’s Center for Rural Health.

The MiSUPER project team’s successes in 2021 included:

• Delivering 26 community slide presentations of 45 to 60 minutes and 13 project overview presentations of 10 to 20 minutes that reached 1,331 participants. Nine of the 26 community slide presentations were statewide webinars. Other community trainings were before closed groups that invited the MiSUPER team to meetings.
• Presenting to 159 healthcare professionals and providers in April. Continuing education credits and attendance certificates were emailed to participants who requested them.
• Using an incentive process to gather pre-, post-, and 30-day follow-up evaluations on awareness and knowledge gain to participants in 17 community trainings and one provider presentation.
• Running a digital media campaign from November 2020 through April 2021 in rural areas of Northern Lower Michigan and the Upper Peninsula highlighting positive messages about opioid misuse prevention, treatment, and recovery. The six-month campaign averaged 3,000 impressions a day and had a total of 803,603 digital impressions.
• Updating an MSU Extension fact sheet titled “Opioids in Rural Farming Communities” in June. The fact sheet’s audience is professionals such as Michigan Department of Agriculture and Rural Development staff who work in rural communities.
• Posting a Spanish-language article providing readers alternatives to medication for chronic pain management.
• Creating community resource guides targeting seven geographic regions of the state, based on requests from community partners and program participants.