After Madison saw a 10% decrease in opioid overdoses in 2019 from the previous year, city officials and University of Wisconsin researchers are surging forward to increase access to treatment options.
Madison saw a 55% increase in opioid overdoses in 2017, according to the Madison Addiction Recovery Initiative. In late January, Madison Police Department Chief Victor Wahl reported in a blog that Madison saw a 10% decrease in 2019 overdoses.
Wahl wrote there were 275 overdoses in 2018 that the Madison Police Department responded to. In 2019, there were only 246 reported instances. Wahl wrote 42 fatal cases in 2018 decreased to 29 fatal cases in 2019. Sarah Johnson, Health Education Specialist at Madison and Dane County Public Health, said in an email the city’s newest steps to combat opioid abuse developed as the crisis worsened in the community.
“The action you have seen over the past few years to address the opioid epidemic is a direct result of multiple agencies seeing an increase in overdoses, both fatal and nonfatal, as well as the large number of people in our community struggling with a substance use disorder,” Johnson said in an email to The Badger Herald.
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According to Wahl’s blog, the department took several steps following the increase in overdoses in 2017. Wahl wrote every officer carries Naloxone, a drug capable of saving a victim of overdose. Additionally, MPD works closely with the Madison Addiction Recovery Initiative to allow low crime offenders with opioid addictions to complete treatment rather than face prosecution.
Among MPD’s efforts with MARI and other funding opportunities, citywide operatives were instrumental in the decrease in overdose deaths, Johnson said in an email. The epidemic forced agencies to work together, resulting in a change in how people viewed the stigmatized issue of opioid addiction, Johnson said.
“As a community, we are talking about addiction in new ways which are starting to change the stigma and shame that typically surround people and their families and prevent them from reaching out to get help,” Johnson said in an email.
Johnson said in an email the County Human Services is in the process of offering more treatments, such as evidence-based medication-assisted treatment. Johnson also said the Wisconsin Department of Health’s Narcan Direct Program will provide the Public Health Madison & Dane County with nasal Narcan to distribute in the Madison area.
According to Johnson, nasal Narcan is a great intervention option and the increase in accessibility to Narcan contributed to the overdose decrease. Johnson said Dane County Human Services has funds to provide recovery coaching for victims in emergency room units, as well as to users seeking help from a treatment center.
“Certified Peer Specialists and recovery coaches help improve engagement with behavioral health services,” Johnson wrote. “They have a unique ability to offer empathy, mutuality and hope, and serve as a connection for people while they are on waiting lists for treatment services.”
Assistant Professor in UW’s Department of Family Medicine and Community Health Andrew Quanbeck said many scientists at UW are conducting research addressing the epidemic as a local and societal issue. Quanbeck is currently conducting research on the implementation of evidence-based practices and technologies for the prevention and treatment of substance use disorders in primary care settings.
Quanbeck’s two main areas of focus are reworking the guidelines that constitute opioid prescription and how mobile apps can be used to help patients with a substance disorder abstain from relapse or overdose. Quanbeck said there are many existing measures to help with the problem, but Quanbeck is hoping the research on healthcare apps can be adapted to help with opioid abuse.
“We have effective treatments for opioid use disorders, but patients often have trouble accessing these treatments,” Quanbeck said in an email.
One result of Quanbeck and other UW professors’ work is a system consultation project. The project is working with 44 UW health clinics, including 17 clinics in the Madison area, to change primary care physicians’ opioid prescribing practices. The project launched this month and will last about two years, according to Quanbeck.
To get at the true root of the problem and prevent addiction, Quanbeck said it is necessary to put less opioids out into the community, reducing the risk of those who may get addicted to higher dosages.
“Part of what has led to the problem that we have is that there were pretty unrestrictive policies about prescribing opioids for chronic pain. A lot of opioids got into the community, and a lot of patients got high doses,” Quanbeck said.
Another project Quanbeck conducted centered on how support systems and treatment apps could intervene with substance abuse. In the app trial done with 100 patients, Quanbeck said 32 struggled with opioid abuse. Quanbeck said the results showed improvements to patients’ drug abstinence. Another trial of an app dedicated to opioid abusers is currently underway in Massachusetts.
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More research at UW is occurring with medicine-assisted treatment, according to Quanbeck. UW researchers are developing the equivalent of a nicotine patch for opioid users with Naloxone.
Quanbeck said many of the main challenges with this direct opioid treatment and medication are systemic barriers, many of which still exist in Madison. Quanbeck said promoting access to these drugs is key in fighting the opioid epidemic at the local and national level.
“Researchers on campus are trying to find ways to reduce barriers to use that medication,” Quanbeck said. “Patients … who have a hard time accessing it can work with physicians from UW who can facilitate access to these drugs … to help them get off of opioids.”
