You In western Wisconsin, a spike in drug overdoses led the city of La Crosse to issue a safety alert in recent days. What's going on when overdoses were trending down? We asked Dr. Chris Aberlein, emergency medicine physician at Gunderson Health System and Dr. thanks for being here. Yeah, you're welcome. Thanks for having me. So what are the overdose numbers that led to this safety alert? So it's more of a trend. So we've been watching overdose numbers really closely ever since probably early pandemic time. But only in the last several years that we really coordinated with EMS, both first responders, including fire transport agencies, some other members of the county, some others who respond to overdoses and starting to pool data and sharing what we're seeing in the community. So we had noticed and thankfully so last year we had great numbers. You know, we're still way too high, but it was like a 60% improvement year over year and overdose deaths and responses. So really a great trend and we were seeing that at the beginning of this year as well. And we would still go on about one to two overdose calls a week is what kind of the trend was throughout most of the year. We get small spikes and we meet once a week and we discuss the data and we're just watching it. We had a few that were like three or four in a week, but didn't really meet our threshold to make any sort of announcement or change our response. And then over this course of the last couple weeks in late July, we were getting over over 10 responses in a week. And so, you know, you're talking that's a fivefold increase from what we were used to. And so that really made us take pause and then it happened again in the next week as well. So this is why we figured we better get somewhere out, figure out what we could do as a community, see if there's anything we're missing and hopefully prevent some people from having a bad outcome. Because you said that you get concerned when overdose cases begin to increase in quick succession like that. Yes. And that's just a marker for something going on. Yeah, and usually it is a change in supply, change in use pattern. And so we're really looking at trying to figure out what that is. We did figure out what this one was and it was actually a change in the supply of not opiates actually. What we were seeing is that fentanyl was intermixed with other stimulants, primarily cocaine and methamphetamine. So these users had no idea that they were at risk of an opiate overdose. So do these synthetic opioids combined with other drugs, like those of which you speak, render Narcan less effective? They would not. Narcan would still be very effective for these. And still a critical component in our response. And so is it known where these drugs are coming from or is this just kind of the beginning of an investigation to understand the scope of this? Yeah, and unfortunately we usually at our level don't figure, don't ever get that information of where these are coming from. You know, that's more of a law enforcement historically. Being in La Crosse, we're between two major metropolitan areas as far as Chicago and Minneapolis. And so they come from one of those two areas usually. At least that's what I've been told by law enforcement. So what is your message to people, drug users, who might be using these substances and then suddenly there's fentanyl mixed in? What is your message? There's a few things to be aware of. One, any illegal drug could have fentanyl in it. You know, it's something that is relatively cheap to reduce, gets here in large quantities, easily mixed with other drugs. So I would assume that any drug that you use could have fentanyl in it. Use fentanyl test strips to test for fentanyl in the drugs. Those are legal and widely available. And then never use alone. Always have someone there that could call 911 and preferably give Narcan as well as call 911. But you have to have Narcan available, will test your drugs and have a sober by standard nearby that could enact help if you need it. How hard is it for you to see this spike and treat people experiencing it or to lose someone to it? It's always difficult. This is something we've been dealing with for years now. The country's lost hundreds of thousands of people to the opiate epidemic. I think it's touched just about every family at some point over these last 15 years or so since it started. No community has gone without impact. And so when you see the spikes like this, you really want to try and get, because sometimes I feel that we can get a little bit complacent, especially when things are going well. And that was one of my concerns with this, you know, the overdoses have gone down. I just want to make sure as our whole team wanted to make sure that everyone was aware that it is still dangerous. And ideally, you know, we could get them to stop and get help, but this is the first step you have to be alive to be able to do that. And this is the step to do so. Well, Dr. Chris Eberlein, thanks very much. Very welcome. For more on this and other issues facing Wisconsin, visit our website at pbswisconsin.org and then click on the news tab. That's our program for tonight. I'm Frederica Freiberg. Have a good weekend. Thank you. This is how it's been.