Policy 2021-07: Policy Regarding Buprenorphine
America is in the midst of a devastating opioid epidemic—and Michigan has been particularly hard-hit. Since 1999, the number of opioid deaths in Michigan has increased by more than 17 times. In Michigan, moreover, opioid overdoses account for nearly 80% of all drug-related deaths.
Because opioids cause a physical chemical dependency—and often result in permanent changes to neurochemical balance—recovery from opioid dependency can be particularly difficult. Abstinence-based treatment approaches, under which a person is expected to completely abstain from substance use, have been successful for many people. But abstinence does not work for everyone. For many, a more viable path to recovery involves medication for addiction treatment (“MAT”). Under a MAT approach, abstinence from illicit opioids is aided by longer-acting opioid medications that help to normalize brain chemistry, relieve physiological cravings, and block the euphoric effects of opioids.
One particularly effective medical treatment for opioid addiction is buprenorphine (often known by the brand name Suboxone). Though buprenorphine is technically an opioid, it does not cause the same physiological effects as drugs like heroin that fully activate the brain’s opioid receptors. Patients who use buprenorphine do not generally become intoxicated. They demonstrate significantly improved cognitive function. And they are generally safe to drive.
Because buprenorphine is a tremendously effective medication that can aid in recovery—and prevent people from using more dangerous drugs such as heroin or fentanyl—other communities have effectively decriminalized buprenorphine. In 2018, for example, the State’s Attorney in Chittenden County, Vermont announced that she would no longer prosecute misdemeanor buprenorphine crimes. The observed effects were unambiguously positive. In the year after buprenorphine was effectively decriminalized, overdose deaths in Chittenden County fell by 50%.
Accordingly, in light of the observed experience of other communities and the nature of buprenorphine itself, the Washtenaw County Prosecutor’s Office will no longer prosecute the use or possession of buprenorphine. The Prosecutor’s Office, however, will continue to file charges against large-scale manufacturers or distributors of buprenorphine who are engaged in the black-market sale of buprenorphine for profit, as well as those who sell buprenorphine as part of a “designer drug” that includes other dangerous drugs (such as heroin or fentanyl).