In health news, good news.
The Centers for Disease Control and Prevention reports a more than 10% decline in drug deaths
this year for the first time after decades of steep increases.
Wisconsin mirrors the downward trend.
There certainly has been an all-out push to save lives from law enforcement and addiction
efforts to harm reduction efforts like Narcan.
On the ground locally, the Medical College of Wisconsin also helps communities conduct
overdose fatality reviews to look holistically at the victims to help others stay alive
until they can get treatment.
La Crosse County has been conducting such reviews since 2018.
Paula Sillof is from the County Health Department.
She joins us now and Paula, thanks a lot for being here.
Thank you so much.
It's an honor to have this discussion.
So, has La Crosse County also seen a reduction in overdose deaths as has been the case nationally
and statewide?
Well, our rate in 2023 was the highest that it's ever been, so that was end of 2023.
When we're looking at 2024, we're behind the numbers that we saw last year at this time,
so we're hopeful that the total numbers will be less than 2023, but we don't know that
yet.
We've still got a few months of 24 to get through.
When you're conducting an overdose fatality review, what are you looking at in that person's
life?
I think we're looking at early substance use.
We're also looking at trauma that they may have experienced.
Were they a party to a home where other substance use was going on?
Did they have particularly difficult schooling?
Did they move a lot?
Were they a part of a broken family?
People may have heard of the term ACEs, which is adverse childhood experiences, and
we know that there's like 10 different experiences.
We know those experiences make children's lives that much more difficult, so we look
for that.
We aren't following them ACEs, but we look at the growing up history of the person.
If we have access to that, we also look at how much they moved.
There might have been medical problems that people have had.
We've had several people who have had head injuries, and we know that that's our concussion.
We know that that also impacts thinking and coping abilities that young people have.
We look at involvement with treatment, law enforcement, if they've been incarcerated
at all.
We're looking at all of those kinds of things to look at opportunities where prevention
couldn't be implemented to save someone from walking down that same path in the future.
How helpful have you found those reviews to stemming overdose fatalities?
When we're finding themes, I would say, when you do the first one or two, you're looking
at opportunities, and we keep a list of opportunities that we review.
Our overdose fatality review team has established recommendations, a work group that looks at
they meet two or three times a year, and they look at opportunities for change or implementation
of strategies that could help to catch someone early or catch someone, bring them into treatment
or prevent them from furthering their substance use and being at risk for an overdose.
We're finding it very helpful.
Give us a sense of who makes up the team.
The team is a combination of, well, there's probably 12 to 15 professionals and community
members that are a part of the group.
We have a law enforcement.
We have someone from the judicial system.
We have some treatment, people who are involved in treatment.
When we have people from a school setting, whether it's K-12 or post-secondary education,
we have someone from that educational setting as well.
We have pharmacists who we can consult with whenever we need to, our medical examiner,
and then fire department staff who are often the first responders or respond when an overdose
9-1-1 call is called in within a city of La Crosse.
So you spoke to some kinds of changes that have been affected coming out of these reviews.
What's an example of one of those tangible changes?
One of the changes is a jail release kit that's provided to all people who have been
discharged from the county jail.
We were noticing and conducting reviews that within the first couple of months after getting
out of jail, if the individual returned to their former lifestyle, they were at a great
risk of overdose.
So a jail release kit was something that was put together by some of the groups or agencies
that are represented on the team.
And so it includes Narcan, it includes a couple of coffee tokens, it includes sunscreen, includes
a hat, it includes a rescue mask for providing rescue breathing, and it also includes signs
of an overdose because some people might think that person's sleeping really hard and they
aren't able to wake them up when in fact it might be an overdose.
And so that was something that was instituted and is provided to everyone who is discharged
from the county jail and La Crosse.
That's one example.
Another example is the informal system that has been put together where our fire department
staff connect with law enforcement, connect with other EMS providers and are looking
at what are they seeing, what kinds of overdoses have they been responding to in our community.
And if there have been a lot of a certain type acknowledging that we might have a particularly
contaminated supply of drugs in our community because the thought now is that there's no
pure substance that someone can buy that is an illicit drug, it's not just heroin, it's
probably laced with something else.
And substances like meth are often laced with fentanyl or xylazine in the community.
So your most recent report describes reducing the stigma of drug addiction as an important
problem.
Why?
I think it's important to talk about it in the community and not have people look down
on folks who are using substances and in order to do that we need to talk about it openly
in the community.
People sometimes have bad feelings about harm reduction, well why would you prevent
people from overdosing because it's about saving their lives until they're ready to take that
next step towards treatment.
Harm reduction, examples that we use every day, every time you put on your seatbelt,
that's a harm reduction strategy.
If you wear a bike helmet when you're biking, that's a harm reduction strategy.
If you're wearing a motorcycle helmet or a helmet when you're on your scooter or e-bike
or your motorcycle, those are harm reduction strategies as well and so I think we need
to recognize that there is harm reduction strategies that can save lives in substance
use as well.
I also think that we need to acknowledge that many people, not at all, but many people who
are attracted to substance use are attracted because they're struggling with some other
condition.
Something else that has a lot of stigma in our community and probably state and nationwide
is mental health.
Is it okay to talk about having depression?
Is it okay to talk about having anxiety?
In some situations it might be.
In other situations people don't want to acknowledge that and so then they self-medicate to help
themselves feel better and so we need to talk about those compounding health conditions
that people have and the things that they can do to recover or to seek help.
I also think that we need to talk about people who overdose in our community aren't just
unsheltered people.
They're people who have jobs, who have homes, might have college educations.
They just are caught in that cycle, that addictive cycle of substance use and that drive, that
addiction is really, really strong and so they might want to quit but it's one more
experience with a substance and that might be the experience that has the fentanyl in
it that then leads to them not intending to overdose but having an unintentional overdose.
Paula, we leave it there.
Thanks very much.
Thanks for your work.
Yeah, thank you.
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That's our program for tonight, I'm Frederica Fryberg.
Have a good weekend.
Thank you.