Despite campaigns from health officials, outreach workers and law enforcement, the number of heroin-related deaths in Dane County rose by more than 30 percent last year, continuing a stubborn trend officials say mirrors state and national trends.
And as legislators consider a package of bills aimed at reducing the number of deadly overdoses, other indicators of Wisconsin’s heroin problem — including drug-related visits to local hospitals and non-fatal overdoses — are moving in the wrong direction.
In Dane County, heroin contributed to the deaths of 32 people through roughly the first 10 months of 2013, according to Barry Irmen, director of operations for the county Medical Examiner's Office.
That’s up 33 percent over all of the year before, and a more than 350 percent increase from four years ago, Irmen said.
Tests are still pending for deaths in the last two-plus months of the year, he said, and drugs are suspected in some of those deaths as well.
“There are many, many people and groups … that are all trying to figure out how to reduce the heroin epidemic,” Irmen said. “Unfortunately, we’re not seeing a change in the death toll.”
The growing number of fatal overdoses is frustrating, if not surprising, for health officials.
Cheryl Wittke, executive director of the health advocacy group Safe Communities of Madison-Dane County, said she believes Wisconsin has made progress in how it’s sought to deal with the problem, even if results are slow to materialize.
“There’s concern from the highest levels, and action that’s occurring at all levels,” Wittke said. “That makes me very hopeful.”
Safe Communities has sought to address the supply and demand problems that contribute to prescription drug abuse, which often leads to heroin addiction, Wittke said.
On the supply side, that means working with doctors and clinicians to reduce the number of excessive prescriptions for potentially habit-forming drugs such as oxycodone and providing more drop-off boxes for unwanted medications, she said.
Tackling demand involves finding treatment for more users and pushing for alternative drug courts, which focus on providing help for addicts who commit crimes rather than sending them through the regular criminal justice system.
Amid those efforts, however, the number of Dane County hospital visits related to opiates — the drug category that includes heroin, oxycodone and others — rose for the sixth straight year in 2012, the most recent year for which statistics are available.
According to Public Health Madison and Dane County, 292 people went to county hospitals in 2012 because of opiates, up from 271 in 2011 and 114 in 2006.
Not every aspect of the problem has gotten worse: Police believe they are seeing fewer problems with people driving under the influence of heroin in 2013, though statistics were not available.
But given the challenging nature of addiction, and delays in gathering statistics, Wittke said, “It’s going to take a while to see these efforts pay off.”
Lawmakers looking for solutions
Seeking to stem the tide of fatal overdoses, state legislators are considering three bills advocates say would save lives and keep some people from becoming addicts in the first place.
The bills, introduced by Rep. John Nygren, R-Marinette, would allow more first responders to carry the anti-overdose drug naloxone, grant immunity from drug possession charges to users who call 911 to report an overdose and expand efforts to collect unwanted prescription drugs.
Naloxone, also known by the brand name Narcan, counteracts the effects of heroin and other opiates and can reverse an overdose in minutes. Health officials credit it with saving thousands of lives.
The problem, according to officials and advocates, is that too few people have access to Narcan.
Although the drug can cost as little as 50 cents per dose, emergency medical personnel are sometimes limited by law and liability concerns from using naloxone, and it’s only available with a prescription. Under Nygren’s bill, firefighters, police officers and EMTs with training would be allowed to use the drug on patients who overdose.
The Assembly’s criminal justice committee heard emotional testimony from parents of addicts and overdose victims at a lengthy hearing on the trio of bills Thursday.
Alex Hoffmann, a Menominee Falls man whose 22-year-old son died from a heroin overdose last year, implored legislators to take action to curb the problem.
“Doing nothing is unacceptable,” Hoffmann told the committee. “More children will die.”
The committee approved Nygren’s bills, sending them to the Assembly floor for a vote on Tuesday.
Scott Stokes, director of prevention services for the AIDS Resource Center of Wisconsin and coordinator of a statewide needle exchange program, said the bills are a good start.
Stokes’ organization gives free doses of naloxone to opiate users who watch a short training video on how to use the drug and asks them to report back any time they use it.
Like other measures, the number of “peer saves” reported to the center has grown. In 2013, users reported administering Narcan more than 1,000 times, up from 519 in 2011.
Stokes and others said they would like to see naloxone become an over-the-counter medication and want to get it “in the hands of as many people who can be potential first responders as possible,” including the parents and spouses of users.
Health officials told the Assembly committee Narcan has few consequences — it’s not addictive and won’t harm someone who isn’t having an overdose.
“People don’t die from Narcan,” Dr. Mike Miller said Thursday. “They die from not getting Narcan.”
The rates of heroin abuse’s most serious consequence — a fatal overdose — could be the first to show results if the state takes the right steps, Wittke said.
She points to the example of North Carolina, which expanded access to naloxone and quickly saw a drop in the number of fatal overdoses. Do the same in Wisconsin, Wittke said, and the deadly overdoses could start falling fast.
Still, reversing the broader impacts of heroin abuse in Wisconsin will be a lengthy process, Wittke said.
“That’s going to take some time,” she said.
[Editor's note: This article has been updated to correct Barry Irmen's title. He is the director of operations for the Dane County Medical Examiner's Office.]