Wisconsin Panel Offers Blueprint to Fight Drug Overdose, Addiction

Aug. 21--A 20-year-old woman stopped breathing and turned blue this week in the Town of Raymond, the victim of a heroin overdose.

Her family dialed 911 just after 4 p.m. Tuesday and dispatchers instructed them in CPR.

Racine County sheriff's deputies arrived, reached for their emergency kits and pulled out nasal naloxone, better known by its brand name Narcan. They sprayed it up the woman's nose. In a few minutes, the woman regained consciousness and was talking with first responders before she was taken to a hospital.

It was the second time in a month that Racine County deputies used the medication, which effectively blocks the central nervous system from the effects of heroin and other opiates and reverses an overdose. The deputies and jail staff were equipped with nasal naloxone in April after Gov. Scott Walker signed off on allowing first responders to administer naloxone as part of a package of bills called Heroin Opiate Prevention and Education, or HOPE.

"It is a lifesaving tool," Sheriff Christopher Schmaling said Thursday. "We would be foolish not to have it."

Not only should law enforcement officers and first responders carry the medication, family members and caregivers of opiate users also should have access and training on it, according to a recently released report from the Wisconsin State Council on Alcohol and Other Drug Abuse.

The report, researched over six months by a special committee for the state council, builds upon the HOPE legislation approved in the spring and outlines 36 recommendations to address heroin abuse throughout the state.

"We don't want this to be just another report that just sits on a shelf," said Danielle Luther, one of the committee's four co-chairs and manager of substance abuse prevention at the Marshfield Clinic Center for Community Outreach.

"We want communities to use it as a starting point," she said.

The committee divided its recommendations into five pillars: prevention, harm reduction, law enforcement, treatment and the workplace.

Although harm reduction stands as a separate pillar, the theory is woven throughout the report.

The goal of harm reduction is to "meet people where they're at" to keep them alive and healthy so they don't face barriers if they seek treatment, committee co-chair Scott Stokes said.

Widely known harm reduction strategies are needle exchanges, which provide free, clean needles to prevent the spread of HIV and hepatitis C, and free distribution of naloxone and training on how to use it. The AIDS Resource Center of Wisconsin, where Stokes serves as director of prevention services, provides both.

"Kids are dying, and now I think the train of thought is, 'Let's keep them alive first and then deal with the issues,'" Stokes said. "Many communities where they are doing these heroin summits, harm reduction is not at the table. They don't want to talk about this."

The number of heroin overdose deaths statewide doubled between 2008 and 2011 with at least 134 deaths in 2011, according to the state council report, while Gannett Wisconsin Media reported 227 fatalities related to heroin statewide in 2013.

The state report was written as a blueprint for community-based heroin task forces and local and state lawmakers, committee co-chair Dorothy Chaney said.

"On the local level, it gives communities a call to action, and it's almost like there are five task forces that can happen," said Chaney, who also is president of the Wisconsin Community Health Alliance.

"If a community's not ready to tackle harm reduction, maybe they do the other four."

The report contains dozens of recommendations, such as:

--Increasing awareness of the 2013 Wisconsin 911 good Samaritan legislation, which gives people immunity from criminal prosecution for drug possession if they bring a fellow drug user to an emergency room or call 911 because they believe the person is suffering from an overdose. It does not provide immunity for drug dealing or other serious crimes.

--Adding state funding to support local heroin coalitions and their activities.

--Providing or expanding drug treatment within the jail and prison system, including the use of Vivitrol when offenders are released. Vivitrol is a prescription drug that blocks the effects of opioids, such as heroin, but does not stop cravings.

--Developing a system to allow the surrender of heroin and drug paraphernalia to law enforcement without legal ramifications.

--Expanding adolescent treatment options in Wisconsin. Only private-pay treatment centers are now available.

--Including families in treatment and creating safety plans for family members, including training them in how to administer naloxone.

The fifth pillar of the report focusing on employers is "the first time where businesses understand they can have a huge impact addressing this," committee co-chair Annie Short said.

"Parents don't have time to go to the meetings at night, and we can reach the parents at workplaces," said Short, who also works in Milwaukee County's Behavioral Health Division.

Businesses can offer programming to teach parents how to look for signs of addiction, to assist parents of children with addiction and to help employees who might be struggling with their own addiction.

More than 73% of illegal drug users are employed, according to the U.S. Department of Labor. In Wisconsin, 4.3% of adults -- or 163,300 people -- reported using heroin or another opiate for nonmedical purposes in the past year during the National Household Survey on Drug Use and Health.

Those who created the state report say it offers possible solutions to an entrenched problem in Wisconsin.

"This is a marathon, not a sprint," Chaney said. "We're going to be in this heroin epidemic for years to come."

Twitter: twitter.com/aluthern

Copyright 2014 - Milwaukee Journal Sentinel