Synthetic opioids like fentanyl, mixing drugs driving increase in Dane Co. overdose deaths

MADISON, Wis. — The latest data from local public health officials shows drug overdoses are still increasing in Dane County, although the reasons behind the overdoses are changing.

Public Health Madison and Dane County’s latest Overdose Fatality Review released Thursday includes data through 2020. The updated numbers show the age-adjusted drug overdose death rate in the county rose 11 percent between 2019 and 2020, to 25.2 overdose-related deaths per 100,000 people. That rate is 4.2 times the rate of motor vehicle deaths and 3.4 times the rate of firearm-related deaths in the county, officials said.

“(This is) the highest loss of life due to overdoses we’ve ever seen in Dane County and all indications are that we have surpassed this number in 2021,” Julia Olsen of PHMDC said during a briefing Thursday.

“The overdose epidemic in this country is more than just a law enforcement, a treatment, or a health care issue to fix,” Olsen added. “To stop deaths in our community, we need multiple agencies and multiple partners to collaborate and cooperate to make change across all systems for people who use drugs and all the systems they interact with.”

The report finds that opioids continue to be a significant problem when it comes to overdose deaths in Dane County, but the types of opioids being blamed has changed over time. The number of prescription opioid-related overdoses has actually leveled off recently, which health officials attribute to a number of factors, including new state drug monitoring programs, local drug takeback events, drug dropboxes at local police stations and pharmacies, and community education efforts.

The number of heroin deaths in Dane County also appears to be dropping, although officials say more data is needed to confirm the trend.

The problem, PHMDC’s report finds, is that the rate of overdoses from synthetic opioids — like fentanyl — is rising, and more people are dying after mixing multiple drugs. The number of people who died of an overdose from synthetic opioids was 5 times higher from 2018 to 2020 than it was from 2014 to 2016, and a total of 44 percent of Dane County’s drug overdose deaths from 2018 to 2020 were people who had multiple drugs in their system.

Among those who died of a multiple drug — or “polydrug” — overdose, the most common combinations of drugs in their toxicology reports were fentanyl-other opioid-stimulant and benzodiazepine-fentanyl-stimulant.

A total of 365 people lost their lives due to an overdose from 2018 to 2020 in Dane County. In terms of demographics, the research found 78 percent of the people who overdosed were white, and nearly 2 in 3 were male. More than half of the people who overdosed were between the ages of 25 and 44.

While white people made up the vast majority of overdose deaths, local health officials say the county’s Black population is seeing a higher rate of deaths. When the higher proportion is considered, the study found Black people in Dane County were 3 times more likely to die of an overdose compared to white people. Health officials say there is an “urgent need” to understand why the Black population is affected more by drug overdose deaths.

Report recommendations

The team in charge of the Dane County Overdose Fatality Review took a closer look at information related to 20 people who died of an overdose in 2020, and combined it with what they gathered from case reviews, interviews of 25 loved ones, and other data to pinpoint common themes and recommendations going forward.

“Our team interviewed their families affected by drug overdose to help gain insight that we know we never could get from medical records or criminal reports. Their voices are heard throughout our report, sharing their memories, their frustrations, and their hopes for the future,” Olsen said during a briefing Thursday.

The recommendations focus on a number of conclusions as to why overdose deaths continue to increase, including the idea that addiction is criminalized (those who survive an overdose are often arrested on drug charges and then taken to jail), the stigma and bias of addiction (facing discrimination when getting health care or other services), adverse childhood experiences and substance abuse as a youth, traumatic loss and grief, barriers to accessing care or treatment for addiction, and the effects of the start of the COVID-19 pandemic (including social isolation, lost jobs, care facilities shutting down).

The recommendations, which come from the report’s review team and not from PHMDC itself, include:

  • Adjusting the state’s Good Samaritan Law to provide limited immunity from probation and parole violations for people who call emergency personnel when someone is having an overdose, and for the person experiencing the overdose
  • Continue to explore alternative responses to overdoses that do not involve the police
  • A closer examination of the social, cultural, and illicit drug market factors that are driving the rapid increase of drug overdoses in the Black community
  • Expand culturally-appropriate treatment and harm reduction services for those struggling with substance abuse in the Black community
  • Additional funding to support programs focused on adverse childhood experiences, which are a significant contributing factor to future substance abuse
  • Increase support for families, including overdose education and Narcan distribution efforts that focus on those living with people struggling with addiction
  • Comprehensive training for human service and healthcare providers on navigating grief support
  • Provide more recovery resources to people surviving a suspected overdose, like what FitchRona EMS began in 2021
  • Put Narcan in all first aid kits, AED boxes, etc. for public overdose situations
  • Screen all patients at emergency rooms for substance misuse

You can read more about all of the recommendations and the other data in the report here and embedded below.