The number of Wisconsin deaths caused by drug overdoses is expected to be well into the hundreds again this year, after totaling more than 900 last year. Health officials say most of those deaths were due to opioid abuse. Some businesses and medical experts say they have innovative ideas for reducing the opioid crisis.
More than 40 percent of the people who die of opioid-related deaths in Wisconsin are from Milwaukee County. The Medical Examiner estimates the number of local deaths will be down this year, but only about 5 percent from 2017.
For every person who dies from an addiction of legal painkillers, heroin or illegally-made fentanyl, many more survive and face perhaps a lifetime in recovery. Milwaukeean Adam Lovejoy became addicted to pain pills and later heroin, after being shot in the right leg during a robbery 13 years ago. He says he eventually abused opioids to deal with different kinds of stress.
"Once you have been using it for a couple years, you use it as your crutch for coping with anything. When life shows up, you use it to cope. Whereas normal people have other methods for coping with stress, any kind of stress, any kind of bad feelings, any kind of grief, heartache, depression, anxiety," Lovejoy says.
He says halting his use of opioids was difficult, and he had to relearn a full range of emotions. He's now back in college and is taking his recovery message public.
Lovejoy spoke during a public comment session Nov. 30 at Milwaukee City Hall, endorsing the final recommendations of a city-county opioid task force. He emphasized a greater need for transitional housing after recovering addicts leave a residential treatment center.
"I know a lot of individuals who didn't make it, because they didn't have that transitional housing. They didn't have that bridge into some housing. Not forever, just a few months. Let us get back on our feet," Lovejoy told the panel.
Better access to housing is one of the more traditional ways of attacking the multi-pronged opioid problem. There are also some non-traditional ideas.
A recent forum in Madison discussed how technology is trying to curb the opioid crisis. Katie Keating of IBM told the Wisconsin Technology Council gathering that another state paid her firm to analyze the data of what she calls "super-utilizers" of the health care system.
Keating says one addict had 87 opioid prescriptions and two dozen ER visits, and had gone to thirteen different pharmacies — all because of fear to have surgery for a gallbladder problem.
"They were able to go and have a person-based intervention to understand what the initial problem had been, and how they could help, and they were able to get them surgery. They were able to get them treatment for the opioid issue," Keating told the audience.
The Madison-based start-up firm Kiio says it has another way to reduce the opioid problem. The company uses a mix of screening, software and online coaching known as digital therapeutics, to treat people with lower back pain. Many physicians have prescribed painkillers for that ailment. But Kiio president and CEO Dave Grandin says not everyone needs medication.
“The patient can stay in the home. It really is about delivering appropriate care to the appropriate patient at the appropriate time. And that's a big part of why digital therapeutics are important, because there's the immediacy factor. If you need help, you can get it immediately. There's no waiting. There's no co-payment," Grandin says.
Grandin acknowledges that not all opioid addicts have computers or smart phones or may not be able to follow long-distance instructions.
Some health insurance companies say they're also trying new ways to fight opioid abuse. Dr. Tim Bartholow is chief medical officer of WEA Trust. He says his company now tries to limit painkiller prescriptions to seven days' worth.
"And if you need more, and you haven't had it before, we'll give you another week. Then, if you need more, we want to have a conversation with you. Not necessarily 'no,' but we want to have a conversation with you, because it's dangerous," Bartholow told the audience.
A UW-Madison assistant professor of Family Medicine and Community Health says innovation in attacking the opioid crises can be a good idea. But Dr. Aleksandra Zgierska says there should be caution, too.
"What I see is the pendulum is swinging from this opio-philia in the past, where everybody could get opioids for 30 days, to now opioid-phobia, where even those who need opioids, and there is a subset of patients that is doing well on opioids. There is not really a reason to discontinue opioids, just because that's the current climate," Zgierska told the forum.
Zgierska wants to see more people who can legally prescribe opioids to complete training in addiction treatment.
With the number of Wisconsinites dying each year of opioid overdoses still well in the hundreds, and hundreds more surviving overdoses thanks to emergency treatment with the nasal spray Narcan, it appears both innovation and caution will be tried for some time to come.
Support is provided by Dr. Lawrence and Mrs. Hannah Goodman for Innovation reporting.
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