by Isiah Holmes, Wisconsin Examiner

“The scope and impact of this issue is really immense,” Dr. Ben Weston, chief health policy advisor for Milwaukee County and medical services director of its Office of Emergency Services, said during a virtual briefing Tuesday. A fatal overdose occurs every 16 hours in Milwaukee County. The loss of life is higher than homicide, suicide, and car accidents combined. Weston and other county officials are emphasizing the importance of harm reduction approaches and tolerance in the community.

Over just 72 hours last week, as the weather began to warm,17 people in Milwaukee County died of overdoses. The spike fueled concerns that a “bad batch” of drugs was in circulation. Weston said that although overdose trends have normalized since last week, “it’s important to remember that ‘normalization’ still means a member of our community is dying every 16 hours from an overdose.” The medical examiner is still analyzing those deaths to determine what substances may have been involved.

Weston called the idea of a bad batch “one of many possibilities.” He went on to explain, “certainly when you see a spike like this — 17 cases in 72 hours — something has changed in the community. Whether it’s the frequency of use, the type of substance, whatever it is. Something changed in the community over that weekend that led to that high number of overdoses.”

All sorts of data is considered before making a decision to alert the community of an overdose spike, including medical examiner data, EMS and 911 information, opioid alerts which notify hospitals that an overdose patient is being transported, pre-hospital data and other information. “There’s a number of different areas that we’re looking at that can serve as triggers to warn the community, in a similar way that we did last week,” Weston told Wisconsin Examiner.

While data may help the county develop better overdose spike warning systems, harm reduction strategies are also being emphasized. The distribution of Narcan, which can reverse an opioid overdose, fentanyl testing strips and other supplies are being made more widely available. Narcan, however, won’t work on increasingly common non-opioid drugs including xylazine. County officials are working “upstream” on long-term plans to prevent fatal overdoses, as well as “downstream” on harm reduction for the short term. Stigma and intolerance are stubborn hurdles for the community to overcome. As the overdose spike played out last week, Weston heard “from all sorts of folks the word ‘junkie.’”

Everyone who dies of an overdose, he stressed, has a  family and a story. “One was a husband coming up on his 40-year wedding anniversary,” said Weston. “He was a father, a grandfather and a dog lover. Another was a mother of two that owned and ran her own business. And another was a father of two who loved reading and cooking. These were sons and daughters, brothers and sisters, mothers and fathers. They had friends, they had families, they had lives.”

Mike Lappen, administrator for Milwaukee County Behavioral Health Services, explained how stigma often hampers progress. Lappen pointed to work by the City-County Opioid, Heroin, and Cocaine Task Force to establish sober-living Oxford Houses, operated by Oxford International. People who live in the houses agree to be sober, contribute to the house, and can stay there as long as they want. “I believe that we’re up to 12 Oxford Houses,” Lappen told Wisconsin Examiner. “Each one has been a challenge in that we try to put them in every neighborhood in the community, we try to put them as close to sort of normalized neighborhoods as possible, and there’s often the famous NIMBY (Not In My Back Yard) response.” Lappen has also seen “substantial pushback” against treatment facilities emerge during zoning hearings, complicating the process.

In 2021, there were 644 overdose deaths across Milwaukee County. Final analysis and counts for last year are still underway by the medical examiner. “I’m not sure what the term ‘junkie’ means,” said Weston. “I don’t know what it describes, but these were people. They’re people like you, people like me, people that each of us knows in our own life. People that each of us have in our families, and in our community, and among our friends.”

This story was written by Isiah Holmes, a contributor to the Wisconsin Examiner, where this story first appeared.

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