Dane County works to reduce drug harm

Faced with a growing drug crisis, Dane County Public Health leaders are taking steps to ensure the safety of the community in respect to drug usage.

“We are in the midst of a drug overdose crisis,” Public Health Madison and Dane County, the local health department, said. “Since 2000, Dane County has seen a 139% increase in the number of people who died of a drug overdose.”

In Dane County, 365 people died because of drug overdoses from 2018 to 2020 — the largest cause of deaths being fentanyl. The substance was detected in 75% of deaths from drug overdoses in a report from the Dane County Medical Examiner. 

There continues to be an increase year by year of overdose deaths in Dane County — 4.2 times the rate of motor vehicle deaths. According to the report, opioids are the main cause of this continuous increase, and synthetic opioids like fentanyl are mostly at fault. 

Amid this crisis, Public Health Dane County and Madison began the Dane County Overdose Fatality Review. The review, among other steps, seeks to address the drug epidemic through increased access and education to naloxone (a lifesaving anti-opioid overdose medication) and supplies like fentanyl test strips, overdose spike alerts and the support of mental health and substance abuse rehabilitation.

“[Public Health Madison works] to reduce harms to people who use drugs and aims to treat them with dignity and respect,” said Julia Olsen, Public Health Supervisor for Madison and Dane County. “[The program offers] a non-judgmental space to access safer use supplies and have conversations about their needs.” 

Olsen also explained how the criminal justice system has historically had a “war on drugs” approach, where the emphasis has been on arresting drug users rather than rehabilitation. 

“Speaking on a general level, drug policy in the United States treats the chronic disease of addiction by criminalization,” said Olsen. “There is more work we can do to help law enforcement and other systems adopt harm reduction approaches.”

Wisconsin’s Good Samaritan Statute does not provide any protection to individuals after an overdose and very limited protection for those who call for help, per the Madison and Dane County Drug Overdose Annual Report. 

“People surviving an overdose are often arrested on a drug charge and taken directly to jail from the hospital,” the report said. “Making people criminals because they suffer from addiction is expensive, ruins lives, and can make access to treatment and recovery more difficult.”

Olsen emphasized how the overdose fatality review aims to achieve this anti-criminalization — through exclusive programs with law enforcement.

“[The program] collaborates with law enforcement on ways to keep our community safe,” Olsen explained. “Some examples include the Madison Area Recovery Initiative (MARI) and the Pathways to Recovery program. These programs help divert people from the criminal justice systems to treatment, recovery, and peer [support].” 

Faced with long standing systemic bias, communities of color have experienced issues with unequal access to resources to fight drug usage.

“From 2018-2020, the drug overdose death rate among Black people was more than 3 times the rate among white people,” Public Health Madison and Dane County said in the report. 

As shown in the Dane County Overdose Fatality Review, Black people have experienced steep increases in drug overdose rates in the past decade — the overdose rate for the Black population in Dane County from 2018 to 2020 was 71.2 per 100,000 people as compared to 21.7 per 100,000 over the same period for white people and 10.4 for the Hispanic/Latino population. 

“[Dane County Public Health recommends examining] quantitative and qualitative data beyond deaths to better characterize the experience of Black people with substance use disorder in Dane County, including the social, cultural, and illicit drug market factors that are driving the rapid increase in drug overdose death in this population,” the report stated.

The review is working to eliminate racial disparities in overdose deaths with the African American Opioid Coalition, along with efforts to promote health equity in overdose prevention and response.

“It is our responsibility as Public Health to call attention to these inequities, advocate for, and help implement change to reduce inequities,” Olsen said about the initiative. “Part of our job is also to help systems understand alternative evidence-based harm reduction practices exist and help implement them locally.” 

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