A report published today by the Wisconsin Department of Health Services (DHS) shows the state’s opioid epidemic worsened during the COVID-19 pandemic. In response, DHS is unveiling new strategies to prevent and reduce further harm. These strategies are funded by Wisconsin’s share of a recent multistate settlement with McKinsey & Company, a global consulting firm that for years fueled the opioid epidemic nationwide through its work with the manufacturers of opioid drugs. DHS is receiving nearly $10.4 million over five years for work to save lives.

The report, Opioid Overdose Incidents and the COVID-19 Pandemic in Wisconsin, shows opioid overdose incidents in Wisconsin from January 2019 through March 2021 based on ambulance runs and emergency department visits. These data paint a near real-time picture of opioid overdoses during key stretches of the ongoing COVID-19 pandemic, including the start of the statewide pandemic response in March 2020, the surge in cases in the fall of 2020, and the decline in the number of cases with the availability of the vaccine in late 2020 through March 2021.

“Opioid overdoses are caused by complex societal issues with many factors behind them. Some of the reasons for the increases during the COVID-19 pandemic may include anxiety and stress due to social isolation, economic instability, social unrest, drastic changes in people’s daily lives, and the production of stronger, more lethal drugs laced with fentanyl and other synthetic opioids, as well as systemic barriers such as decreased access to naloxone, treatment services, and recovery supports,” said DHS Director of Opioid Initiatives Paul Krupski. “The information in the report clearly shows that we have to be vigilant in our efforts to support people and connect them with help. The initiatives to be funded through the McKinsey & Company settlement will be instrumental in our continued fight against the opioid epidemic.”

Key findings from the opioid overdose report

• Overall, Wisconsin saw an increase in suspected opioid overdose incidents in ambulance run and emergency department visit data since the pandemic began.
• At the start of the pandemic, and for the first two months of the outbreak, there was a decrease in overall ambulance runs and overall emergency department visits, possibly due to people avoiding medical services during the pandemic; less travel or different behavior while staying at home to avoid the virus; or changes in medical practices, such as telehealth.
• Ambulance data showed a greater than expected number of suspected opioid overdose incidents during March 2020 through August 2020 before decreasing to below the expected number of incidents. Emergency department visits also appeared to surge above expected levels, but for a shorter duration (April 2020 through June 2020) and then decreased below the forecasted expected levels, where it has stayed.
• There does not appear to be a connection with the number of COVID-19 cases in a county and the number of opioid overdose incidents, suggesting that the incidents were not connected to having or being exposed to the virus, but are based on a number of other factors.

DHS plan for McKinsey & Company settlement funds

Over the next five years, DHS will use this funding to save lives through:

• Prevention programs for Black and Native American communities, which have been disproportionately impacted by the opioid epidemic. This project will address the root causes of harmful opioid use, including stress which can be caused by systemic marginalization, oppression, exclusion, and trauma, through partnerships with community organizations that understand the needs and work directly with communities that are most affected by the opioid epidemic.
• Mobile harm reduction teams to reduce the negative consequences of harmful opioid use. This project will create teams of public health and social services staff that could be sent to areas of the state experiencing a spike in opioid overdoses. These harm reduction teams will focus on strategies to reduce deaths from opioid misuse. They will also work to reduce the spread and the harm caused by diseases like Hepatitis C and HIV.
• Coverage of room and board costs for residential treatment settings. Wisconsin Medicaid now covers residential treatment for substance use disorders. However, federal law prohibits Medicaid from reimbursing for room and board expenses. This project will allow counties to apply for funding to cover these costs, ensuring all Medicaid members have access to this benefit. Governor Tony Evers proposed funding for this important benefit in the 2021-2023 biennial budget, but the funding was cut by the legislature.
• Short-term and long-term housing for people in recovery. Safe and stable housing is fundamental for recovery. This project will add an option for people in substance use disorder recovery to use the existing housing voucher program managed by the Wisconsin Department of Administration in partnership with continuum of care agencies across the state to better support people’s access to affordable, stable, and safe housing. It will also create a housing option that offers additional services such as classes to help people with the activities of daily living, employment education, and support from people who have been successful in sustaining recovery.

Wisconsin’s response to the opioid epidemic

This work is in addition to ongoing work supported by state funding and federal grants, including:

• Public awareness campaigns on the dangers of opioids and strategies to cope with stress and trauma.
• Support for drug take-back initiatives that help to decrease access to drugs.
• The Wisconsin Addiction Recovery Helpline, which connects people to help in their community.
• A statewide standing order for naloxone that allows people to purchase the opioid overdose reversal drug at participating pharmacies without a prescription.
• The NARCAN® Direct Program, which offers the nasal spray version of naloxone free of charge to people who complete a training on how to use it to reverse an opioid overdose.
• Overdose fatality review teams to look into deaths and identify initiatives that may save lives.
• Connecting people struggling with opioid use disorder with others who are managing their opioid use disorder, as a support system and mentor as they work towards recovery.
• An expansion of treatment options statewide, giving people access to care close to home.
• Trainings for health care professionals on best practices regarding the prescribing of opioids and the treatment of opioid use disorder.

Following a steady increase, opioid overdose deaths in Wisconsin dropped by 10% in 2018 to 839. That number increased to 916 in 2019 and is expected to be over 1,200 when the 2020 death data is finalized later this year. More data on Wisconsin’s opioid epidemic is available on the Opioids: Data, Reports, Studies page on the DHS website.

The most commonly used opioids are prescription pain relievers, such as OxyContin and Vicodin; as well as fentanyl; and heroin.

For information on treatment services for opioid use in your community, call 211 for the Wisconsin Addiction Recovery Helpline or go to addictionhelpwi.org.