White pills spread on a black table with a blurry orange pill bottle and safety cap in the background.
Wayne County, which contains Detroit, has one of the highest rates of overdose death in Michigan this year so far at 35 per 100,000 people. Nearly 900 people died of overdose deaths in Wayne County last year, and most overdoses involve opioids. Credit: Photo credit: BackyardProduction

Pharmaceutical companies that fueled the opioid crisis in Detroit and nationwide are helping to foot the bill for treatment and crisis intervention in the city. But overdoses are still common, and it’s not clear that these measures will get to the root of the problem.

Suspected overdose deaths in Wayne County, which contains Detroit, are among the highest in the state at 35 per 100,000 people this year and above the national rate in 2021 of roughly 32 overdose deaths per 100,000. An estimated 871 people died of provisional drug overdoses in Wayne County in 2022, and those overdoses almost always involved opioids.

The personal consequences of so much addiction and death are vast, touching communities everywhere in Michigan. Statewide, there were more overdose deaths than deaths by suicide and homicide, combined, per provisional 2022 data. While white people account for the majority of opioid overdose deaths, Black communities are disproportionately affected.

The economic toll of the crisis piled up as addiction pushed people out of work and into the medical system. The crisis cost the U.S. economy nearly $1.5 trillion in 2020, according to a congressional study released last year.

To recoup some of that cost, states and local governments across the country sued roughly a dozen companies that fueled opioid addiction nationally through the manufacturing, advertisement and distribution of painkillers. The settlements are expected to bring $1.54 billion to Michigan over 18 years according to the latest figures provided by Danny Wimmer, spokesperson for Attorney General Dana Nessel. 

Half of that money will go to statewide opioid remediation efforts, leaving roughly $770 million for cities and counties, according to data from Nessel’s office.

The money is available to every Michigan county, plus cities and other municipalities that joined the lawsuits or have populations of at least 10,000. It will be divided using a formula that takes into account overdose deaths and the number of pills prescribed in each municipality.

Detroit is set to receive at least $40 million from the various settlements over 18 years, while Wayne County will get more than $95 million, according to data from Nessel’s office.

Search for your county or municipality to see how much funding it is set to receive as part of opioid settlements as of September:

Under the settlements, at least 85% of the funds must be spent on a menu of strategies for treatment and prevention.

Detroit has begun spending its settlement funds after City Council set aside the first $4 million in May, and a city spokesperson shared details of how it will spend the money.

Officials for Wayne County did not provide details of its spending plan.

Here’s what you need to know.

Expanded naloxone supplies

Naloxone — also known as Narcan — is a nasal spray that works to reverse an overdose in progress.

The City of Detroit will use some of its settlement funds to expand its supplies of the drug and to add to an existing network of naloxone vending machines, which dispense free doses of the drug, said city spokesperson John Roach. There’s already a vending machine at the Wayne State University undergraduate library.

The drug has become more widely available in recent years, as have trainings for its use.

Basic training is available online, and various groups in southeast Michigan, including Families Against Narcotics and Detroit Wayne Integrated Health Network, provide free training and Narcan kits.

Michigan pharmacies are expected to begin offering Narcan over the counter this fall.

Individuals can request naloxone kits by calling the Detroit Health Department at 313-876-4000 or by emailing 313hope@detroitmi.gov.

Overdose follow-up

What happens when a person survives an overdose?

The City of Detroit expects to use its share of the settlement to pay for a team of social workers and peer recovery coaches who will follow up with individuals who’ve recently received treatment for an overdose, Roach said.

Referrals from the program won’t just come from first responders. Social workers will also reach out to opioid users without housing who are referred by homeless service providers.

These teams will offer counseling and connections to treatment, syringe service programs and other social services. The city hasn’t yet chosen a contractor to run the program.

The city also plans to hire additional behavioral health specialists who will work at homeless shelters to help connect people with counseling and other resources to address substance use disorders, including addiction.

Expanding recovery housing

Settlement funds will cover the cost of 40 new long-term treatment beds at an existing recovery housing project in Detroit, Roach said. It’s not yet clear which recovery housing organization will receive the additional money.

Recovery housing offers low-cost or free housing for people recovering from substance use disorders. The facilities are designed to be substance-free and to provide resources for counseling and other social services.

To apply for recovery housing, reach out to programs listed in the online directory provided by the Michigan Association of Recovery Residences Inc., or call the Detroit Wayne Integrated Health Network 24/7 hotline at 800-241-4949.

What’s missing?

Addressing the opioid crisis in Detroit is especially important because of the disproportionate, growing impact of these drugs on the Black community. Opioid overdoses among Black people have increased faster than among white people in recent years, and occur at a higher rate per capita.

Still, some worry that Detroit’s settlement spending is too focused on opioid overdoses and their aftermath, and not enough on prevention.

Cities should consider using the funds to address addiction before overdoses take place, said Oona Krieg, chief operating officer for Brave Technologies Cooperative, a company that makes digital overdose detection tools and has operations in Dayton, Ohio, and Vancouver, British Columbia.

“Expanding access to recovery housing and Narcan is important and necessary,” she said. “But those are just tiny pieces of a more comprehensive mechanism.”

That could mean facilitating medical treatments for addiction, which are well-grounded in scientific evidence, and providing funds to community organizations that practice harm reduction strategies including opioid cessation counseling and safe injection sites, she said.

Editor’s note: The settlement table has been updated to include payment estimates from the Distributer and Janssen settlement for counties, townships and cities. The table previously aggregated these payments at the county level.

Koby (he/him) believes that love drives people to fight for their communities, and that curiosity is food for love. He enjoys the many moods of the Detroit River.

Malak (she/her) believes in local journalism that provides people with verified and comprehensive information. Her favorite places to unwind and pick up a new read are at Detroit’s bookstores and libraries.