WMed professor looks to help stem Michigan opioid crisis with state-funded surveillance project

Prentiss Jones, PhD
Prentiss Jones, PhD

The figures can be dizzying to consume, but they tell the story of the opioid crisis in Michigan.

Since 2007, the number of heroin-related deaths in the state have risen nearly seven-fold. Of the 2,335 overdose deaths reported in 2016, more than seven out of 10 were opioid-related. Overall, the number of opioid-related deaths rose more than 32 percent from 2015, according to the Michigan Department of Health and Human Services (MDHHS).

In the face of those sobering numbers, a WMed professor has been awarded a $125,000 grant from MDHHS that will fund the Opioid Surveillance project, a one-year initiative that aims to provide a rapid turnaround time of laboratory test results to constructively impact real-time responses to emerging opioid crises in Michigan communities and, potentially, other parts of the country.

“This is a nationwide crisis,” said Prentiss Jones, PhD, an associate professor in the medical school’s Department of Biomedical Sciences. “We were drawn to this because the state of Michigan really wants to get its hands around this problem. This is a multi-faceted problem.”

Dr. Jones is the principal investigator for the opioid surveillance project and Joyce deJong, DO, chair of the Department of Pathology, is a co-principal investigator. Dr. Jones also credited Dr. Bill Fales, associate professor for Emergency Medicine, Division Director for EMS and Disaster Medicine, and EMS Fellowship Program Director, with playing a pivotal role in the surveillance project. Dr. Fales is also medical director for the MDHHS Bureau of EMS, Trauma, and Preparedness.

As part of the project, Dr. Jones and his team are developing and validating an analytical method that is capable of rapidly identifying and quantitating up to 50 different opioids and opioid analogs via the analysis of postmortem blood taken from individuals who are suspected of dying from a drug overdose.

Dr. Jones said test results in suspected overdose deaths currently take up to 10 to 14 days, a lengthy period that he said can prove detrimental to public health and public safety. The opioid surveillance project will seek a more rapid turnaround and present more “real-time” test results that will be available in 48 to 72 hours.

“From a postmortem perspective, getting test results back in 10 to 14 days may not be as helpful in tracking or stemming some of the potential problems that could come about if there’s an opioid or synthetic opioid that’s new or novel,” Dr. Jones said. “We’re hoping that our findings demonstrate that having these results in real-time, if you will, will allow the healthcare community to react faster and law enforcement, as well. It may be that we can track the movement of this plague, if you will, see where it’s headed and head it off.”

The surveillance project officially began on September 1, 2017, and goes through August 31, 2018. Initially, Dr. Jones said his team is getting postmortem blood samples from nine counties in Michigan – Kalamazoo, Allegan, Calhoun, Grand Traverse, Leelanau, Mason, Muskegon, St. Joseph and Van Buren – where members of the medical school’s Department of Pathology also are pathologists for the Office of the Medical Examiner. He said work is underway to extend the testing to other medical examiner offices in Michigan later this year.

Dr. Jones said that through the testing that will be done as part of the project, he suspects that he and his team will find overdose deaths related to classic opioids like heroin and OxyContin. However, he said it’s likely that the testing will reveal a large number of the deaths are related to synthetic opioids such as Fentanyl.

“Why now are we having this rash of fatalities?” Dr. Jones said. “Perhaps it’s because they believe they’re using heroin, but what we’re finding in our cases, at least here, is that not only do we see heroin, but it’s mixed with opioid analogs and therein lies the problem.”

If the project proves successful, Dr. Jones said he is hopeful that the rapid, more specific opioid testing will be used by more medical examiners and healthcare providers who are increasingly confronted with overdose deaths in Michigan and across the U.S.

By facilitating an epidemiologic analysis of the opioid problem in Michigan, these efforts could potentially result in improved public health policy and an approach to help mitigate the opioid crisis.

“We’ve got to address it and this is just one way that our lab and others might look at doing that,” Dr. Jones said. “We have to somehow stem the tide and we have to get in front of this. Right now, we’re playing catch-up, we’re so far behind.”