People are People No Matter..‪.‬ This Rural Mission

In our effort to cover the issue of opioid use in rural Michigan, we took to the hospitals, providers, and persons who are trying to have an impact on opioid use and overuse in our state. 
This Rural Mission is a podcast brought to you by Michigan State University College of Human Medicine. The podcast is produced with funds from the Herbert H and Grace A Dow Foundation and the Michigan State University College of Human Medicine Family Medicine Department. Welcome to season two. I'm your host, Julia Terhune, and I hope you enjoy this episode.
I'm sure none of you listening are surprised that we did an episode this season on the opioid crisis. The issue of opioid use, overdose and related deaths has been in the news media for several years now and at this point it seems to be synonymous with rural. But that is because this is a tremendous issue concerning rural populations. It affects every facet of life for many rural communities, from the healthcare system to schools to industries. Rural healthcare facilities are dealing with people addicted to opioids and the legislative policies tied to combating drug-seeking behavior every day. School systems are seeing younger and younger students either becoming addicted to opioids, dying from overdose, or living in homes where families have been impacted by drug addiction.
US census data shows that unemployment rates are highest in rural areas and the opioid crisis has done nothing to help. Poverty is a contributor to drug use, and yet if you can't stay clean, you can't get a job. But this episode is not about these distressing realities. Instead, we're talking about the people who are doing something to combat this crisis. I'm going to spoil the theme of this podcast and let you know in a word what we are hoping you get out of this. People.
We hope you understand that people need people, meaning if we are to make an impact in these communities concerning opioid use and overuse, we have to put people first. Today our stories are going to have a tiered effect. We're going to start at the top and talk about community impact, then we're going to take it down to the practice level, talking about what individual doctor's offices are doing. We're then going to get personal.
So starting off our conversations, we're going to talk about system policies that have made an impact on getting access to opioids. I spoke to Steve Barnett, the CEO of the McKenzie Health System in Sandusky, Michigan, a rural hospital in the thumb. In 2012, his hospital started an Oxy-free ED policy that stopped providing opioids for non-acute medical concerns.
You have people that are accessing the emergency department for real, acute reasons, and yet there's also people accessing the ED because they've run out of whatever substance they prefer and this is an easy way to come in and probably get a couple days worth or maybe even a month's worth of prescription to get them in and out of there. Rather than wasting resources in the ED and being part of the problem, we decided we wanted to try and at least provide some solution. It's just one door of multiple doors, you know, but it's at least taking a position that we're not going to be that place that pushes drugs.
Were you concerned about any unintended consequences of making this change in your ER?
Sure, we were. Our primary concern was that once they figured out, those patients that are seeking drugs through the emergency department, that we're not going to support that, then they'll simply move to other emergency departments locally and then we won't be viewed very kindly by those other hospitals who have an uptick in volume, but it's really drug-seeking volume. So we presumed, we assumed that that would happen and we talked to everybody, let them know that we were implementing this Oxy-free ED and they may see an uptick and we'd like to hear about it if that in fact occurs.
The other things that we were concerned about is how the patients would react that