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It started with heroin: first in the expected places, like the more populated urban centers and cities; but then it began to seep into the smaller towns and rural areas of Wisconsin. Even while it was a reality happening on the streets, many thought, “not here in my town, not in Wisconsin.” From heroin it evolved to opioids, and Wisconsin became yet another state caught up in this recent, destructive scourge plaguing the U.S..
An Alarming Drug Trend
While the numbers in Wisconsin are typically lower than in other states, they are still alarming. According to the Wisconsin Department of Health Services, an estimated .3 percent of adults used heroin in 2018 compared to the U.S. average of .4 percent And an estimated 3.3 percent of Wisconsinites abused opioids, compared to 4.4. percent of Americans overall.
As reported by the Wisconsin Badger Herald, statistics show the upward trend of abuse. In 2008 laboratories saw 270 heroin cases, but in 2014 Wisconsin State Crime Laboratories had examined 1,130 heroin cases, quadruple the 2008 number. In 2014, there were 632 opiod related deaths, while in 2018 there were 839. Counties that ranked highest for opioid-related deaths in 2018 were Milwaukee County with 289 deaths per 100,000, Dane County with 85 and Waukesha County with 56.
Waging The Drug War On Multiple Fronts
To handle escalating drug abuse and deaths, Wisconsin’s health care providers, law enforcement agencies and community organizations are fighting back on multiple fronts:
- Prevention
- Public health approaches over criminalization
- Treatment
- Lawsuits against drug manufacturers and pharmaceutical companies
Prevention
One prevention tactic is a new Wisconsin “PDMP,” or prescription drug monitoring program. This is a program designed to restrict prescription drug abuse from the start, by limiting a patient’s ability to “doctor shop,” getting prescriptions from multiple doctors. Monitoring also helps to reduce the misuse, abuse and diversion of prescription drugs and improves decision making.
Public Health Resolution vs Criminalization
The American Public Health Association (APHA) policy 9123, Social Practice of Mass Imprisonment, notes that “APHA has long-defined drug abuse as a public health problem rather than a criminal justice problem and called for drug treatment to be available for all who request it.” Public health approaches over criminalization, according to the APHA, include expanding access to harm reduction interventions. These interventions include access to sterile syringes (helping stave off diseases that are transmitted via shared needles) and supervised injection facilities. Injection facilities are a safer place for users to inject drugs. They typically also offer access to counseling, health care, social services and even drug treatment.
Wisconsin’s HOPE Legislation
In Wisconsin some of these solutions have been addressed with the passing of the HOPE (Heroin, Opioid Prevention Education) legislation, which has a bill mandating the state’s aforementioned Prescription Drug Monitoring Program. The bill was driven by Senator Nygren, whose own daughter struggled with heroin.
Treatment
The treatment aspect of the multi-faceted plan is addressed in multiple ways:
- Via the HOPE legislation’s Assembly Bill 701, “treatment programs assess individuals to determine treatment needs, provide counseling, and medical or abstinence-based treatment. After individuals successfully complete the program, they are transitioned into post-treatment care.”
- Access to Narcan (the brand name for the nasal spray version of naloxone), used for the emergency treatment of overdose.
- Treatment on college campuses via Adapt Pharma’s Narcan Nasal Spray for Schools program, available at schools such as the twelve University of Wisconsin campuses.
- Access to Adapt Pharma’s Narcan Direct program. As of 2019, twelve organizations across the state are participating in this program (different from the school program).
- In April 2019 a 24/7 opioid treatment program was opened in West Allis, operated by Community Medical Services.
Litigation
Another interesting solution includes cutting out the root of the issue, suing the drug manufacturers and the pharmaceutical companies responsible for aggressive advertising and promotion to doctors who then may often over prescribe painkillers and opioids without warning patients of the negative side effects (which often leads to addiction). And addiction to painkillers has been shown to be a gateway to stronger drugs like heroin, because it is cheaper than the prescription medicines.
An investigation and lawsuit has been launched in Wisconsin with other state’s attorney generals to determine the role opioid manufacturers have had in creating this epidemic. Subpoenas have now been issued to manufacturers Allergan, Janssen, Endo, and Teva/Cephalon. According to Attorney General Brad Shimel in the Lacrosse Tribune, “we have demanded documents and information from these companies and their related entities to determine if they engaged in unlawful practices in marketing and selling opioids.”
In addition to suing the manufacturers, there are 28 Wisconsin counties in the northeast of the state, including Oconto and Sheboygan, that have joined in a lawsuit against pharmaceutical companies. Reported by Wisconsin’s Action News 2, the counties are preparing to battle these big companies who they say “brought highly-addictive opioids to their communities with a high cost.”
Understanding the role manufacturers have had in the epidemic, and suing the pharmaceutical companies that have profited from the demise of many, are two approaches in the overall Wisconsin drug strategy that may have successful results in quelling the ever-increasing epidemic.
