Milwaukee, suburbs fight to contain wave of opioid overdoses

First responders, addiction counselors warn the still-expanding crisis of overdose deaths fueled by drugs tainted with fentanyl and xylazine requires testing kits and Narcan to encourage safer use.

By Zac Schultz | Here & Now

May 4, 2023 • Southeast Region

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Fire Station 31 on the south side of Milwaukee isn’t used to respond to fire calls anymore, but the firefighters inside are still dealing with emergencies.

Captain Dave Polachowski opened a cabinet where they store the “HOPE Kits” they distribute to opioid users.

“We have a few things inside here,” said Polachowski about the kits. “Most importantly for harm reduction we have Narcan inside of here.”

Polachowski runs the MORI program — the Milwaukee Overdose Reduction Initiative. They follow up every drug overdose call and attempt to provide help. But lately, many overdoses have been fatal.

On April 4, the Milwaukee Fire Department called a press conference to announce there had been 17 fatal ODs in just three days — but that was just the beginning.

“That was a rough couple of days — a lot of fatal overdoses. Like we said — the 17 — which I think, the oldest one being, like, 83 years old, which is really unheard of,” Polachowski said. “Right after that, I think I believe we had another 17 within, I think, four to five days after that. So you had over 30 in about a week period, which is just a horrific number for a city our size.”

Polachowski said Milwaukee saw more than 640 fatal overdoses in 2022 — and the number would have been higher if it weren’t for the harm reduction measures like free Narcan and fentanyl testing strips.

“Otherwise, I’m sure we would be well over 1,000 here in the county,” he said. “But that was a kick in the stomach. With all that we’re doing, when you see something like that happen in such a short time, it’s like, what are we doing here?”

What should be done differently then, given that there’s an increase in the amount of assistance that’s out there? There’s the testing strips, there’s the Narcan and there are programs like Milwaukee’s. Yet the community is still seeing this dramatic increase.

“Yeah, I don’t know if I have an answer to that, to be honest,” Polachowski said.

“It’s shocking, right?’ asks Ryan Gorman, an addiction counselor for Community Medical Services.

He said people in the drug-using community don’t need a press conference to understand what’s happening.

“They’re aware of it, I think, in a much more real sense than the rest of us are experiencing it,” Gorman said.

He explained how drugs are being cut with other substances to increase their narcotic effect.

“The supply is tainted and it’s not getting better,” said Gorman. “The prevalence of actual heroin is almost nonexistent from what we see in urinalysis and just word on the street. It just doesn’t exist anymore. The presence of fentanyl and the fentanyl finally being adulterated with even more complicating substances being added to that — I think that’s what’s responsible for the sharp increase in overdoses.”

The latest ingredient being added to drugs is xylazine, most commonly used as an animal tranquilizer. But since xylazine is not an opioid, Narcan won’t reverse its effects.

“I think it’s very serious, and the part that’s really scary about it is the fact that Narcan doesn’t work on it,” said Polachowski

But Gorman doesn’t want people to lose focus about what’s causing the fatalities.

“I really want to be explicit about [xylazine]. It doesn’t present the same degree of danger as fentanyl. Fentanyl is still the thing that’s killing people en masse. It is a very, very dangerous drug,” he said.

As the opioid epidemic grows, the way the impact is handled has to change as well. For Polachowski, that means going to the user and offering them ways to be safer.

“People call it enabling. We don’t look at it like that. We say it’s enabling you to stay alive until you are willing to get treatment,” he said. “So while some people look at having Narcan out in the community is, ‘you’re just allowing people to use more drugs,’ well, if the Narcan isn’t there, they’re going to potentially die and never get the help that they need.”

For Gorman, that issue means opening up a new medication assisted treatment center in Pewaukee — where the waiting room contains a table for kids who are there with a parent.

“The vast majority of our patients are gainfully employed — family, lots of homeowners, renters. Yeah, they’re not the person that most people picture,” he said.

How much of the social view of drug use and how to do harm reduction has changed as drug use has moved out of certain populations that are already stigmatized, and become more known in suburbs, in wealthier areas, among people that have more privilege?

“Yes,” said Polachowski.

“Well, you know what? It’s funny,” Polachowski added. “I mentioned that before. I’ve been everywhere in the county, in some areas where you just say, ahh, you know what, it doesn’t happen over [there] — absolutely happens there.”

“I think people attribute the rise in overdoses in the suburbs to there suddenly being opioids here, and that’s not my experience,” Gorman said. “I grew up in the suburbs and they’ve always been there. They’re just more dangerous. People are aware that people are using because people are dying. So it becomes more necessary to treat them.”

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