MICHIGAN — Michigan has achieved a significant reduction in its opioid overdose death rate, which has fallen by more than 35% since 2023. Preliminary 2024 data project fewer than 2,000 overdose deaths in the state, a decrease from nearly 3,000 deaths annually in the past. This progress is attributed to sustained investments in evidence-based strategies and strong coordination among state and local partners.
The state’s efforts are supported by nearly $1.8 billion in opioid settlement funds secured by Michigan Attorney General Dana Nessel and a bipartisan coalition of attorneys general. These resources, from major manufacturers and distributors, are managed with guidance from the Michigan Opioids Task Force to strategically, equitably and transparently address the opioid epidemic.
The Michigan Department of Health and Human Services estimated that harm reduction efforts are preventing overdose deaths, reducing emergency department visits, hospitalizations and the spread of infectious disease. Since 2020, almost 1.7 million naloxone kits have been distributed statewide through programs like the NARCAN Direct portal. From 2018 to 2024, expanded access to naloxone and other harm reduction services saved more than 1,600 lives, prevented more than 13,000 hospitalizations and averted approximately 13,200 emergency department visits, in addition to avoiding thousands of hepatitis C infections.
Natasha Bagdasarian, M.D., MPH, FIDSA, FACP, Chief Medical Executive for the State of Michigan, noted the significance of these findings. “These findings reinforce what communities and providers have long observed — harm reduction is a critical component of a comprehensive public health response and a sound investment in community well-being,” Dr. Bagdasarian said. She also highlighted the ongoing challenges, such as disparities across race and geography, workforce shortages and housing instability.
The opioid settlement funds for Michigan governments are issued more than 15 years, with half directed to local governments and the remaining half entering the state’s Opioid Healing and Recovery Fund. The Michigan Opioids Task Force, established in 2019 via Executive Order 2019-18 and updated in 2022 via Executive Order 2022-12, advises on the use of these resources.
The task force guides the state’s strategy, ensuring a coordinated, data-driven and equitable response. It includes state agency leaders and regional representatives with expertise in prevention, harm reduction, treatment, recovery, criminal-legal system involvement, maternal health, education and community engagement. The task force is structured with four standing subcommittees: Prevention, Harm Reduction, Recovery and Treatment, which are co-led by a task force member and an MDHHS employee and include community experts.
Michigan’s Substance Use Response Framework is central to the task force’s work, built around four pillars: Primary Prevention, Harm Reduction, Treatment and Recovery Support. The framework emphasizes equitable access, community partnership and the use of evidence and real-time data to shape decisions. Racial equity is embedded throughout every component of the response, recognizing that disparities in overdose death rates, access to care and recovery outcomes must guide all program design, investment decisions and metrics.
In 2025, the task force met five times to review data trends, discuss policy priorities and guide settlement-funded investments. They tracked emerging contaminants in the unregulated drug supply, including carfentanil and medetomidine. The task force also strengthened partnerships with organizations like the Michigan Association for Local Public Health, the Michigan State Police and License and Regulatory Affairs.
The MDHHS contracted with Michigan State University, University of Michigan and Wayne State University from 2023 through fiscal year 2025 to offer technical assistance in planning and investing opioid settlement funds. These universities worked with the Michigan Association of Counties, delivering services to more than 20 counties and reaching more than 2,000 community leaders through Learning Series webinars.
Despite overall progress, significant challenges remain. Black men ages 60–69 have the highest overdose-related emergency department visit rate of any demographic group in Michigan, with fatal overdose rates up to 100 times higher than other groups. These individuals are less likely to access harm reduction and treatment services, refuse EMS transport after an overdose, are less likely to be screened for substance use in medical settings and are 35 times less likely to be prescribed buprenorphine than white patients.
In fiscal year 2025, $48,202,300 in new investment was allocated from the Opioid Healing and Recovery Fund by the legislature and governor. This brought the total allocated from settlements to $110,602,300. The state spent $41,503,461 in fiscal year 2025, funding over two dozen projects. Largest allocations included $6,530,263 for syringe service programs and $2,930,856 for naloxone distribution. Additionally, $3,800,000 went to expand recovery and permanent supportive housing options, $3,620,000 supported a new treatment center in the Upper Peninsula and $1,500,000 expanded treatment services in jails.
While Michigan youth substance initiation rates have trended downward, with alcohol initiation at roughly 5% (21% lower than the national average), challenges persist. Public awareness surveys show 67% of respondents view substance use disorder as a crisis, 84% believe effective treatments are available and 65% are willing to carry nasal spray naloxone. However, disparities for young women and girls, particularly Black young women and girls, who experience higher rates of emergency department visits for nonfatal overdose, highlight the need for targeted prevention strategies.
The state continues to face a severe behavioral health workforce shortage, with only 7.6 substance use disorder counselors per 1,000 persons (age 12 and older) who met the criteria for a substance use disorder in 2024. This rate is 22% below the national average, though it represents an improvement from 29% below in 2023. Michigan ranked 34th among all states in the ratio of total substance use disorder-related providers per 1,000 people with substance use disorder in 2024, with increases lagging national trends.
Housing instability remains a barrier to long-term recovery, as one in five individuals who exited publicly funded substance use disorder treatment in 2024 lacked stable housing. Through programs like the Recovery Housing Investment Program has supported the creation of 100 new recovery beds and 110 permanent supportive housing units, including an expansion at Andy’s Place that added 26 new units.
Looking ahead to 2026 and beyond, the Michigan Opioids Task Force will focus on strengthening prevention and early intervention, sustaining and scaling harm reduction, expanding treatment access and workforce capacity, reinforcing recovery infrastructure and advancing data and accountability systems. This includes enhancing the state’s ability to measure progress by improving metrics, setting clearer statewide benchmarks, conducting regular treatment access surveys and supporting counties as they evaluate and refine their local strategies.
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