Here & Now

Wisconsin Calls Health Advisory On Opioid Use

THE STATE OF WISCONSIN THIS WEEK ISSUED A PUBLIC HEALTH ADVISORY ON THE OPIOID CRISIS. CITING THE FACT THAT OPIOID-RELATED DEATHS EXCEEDED 600 IN 2015. A HUGE ESCALATION SINCE 2003 WHEN THEY NUMBERED FEWER THAN 200. JOINING US TONIGHT WITH DETAILS ON THE PUBLIC HEALTH ADVISORY STATE HEALTH OFFICER KAREN MCKEOWN. THANK YOU FOR BEING HERE.

KAREN MCKEOWN:

THANK YOU FOR HAVING US AND FOR SHINING A LIGHT ON THIS CRISIS.

FREDERICA FREYBERG:

HOW UNUSUAL IS IT TO ISSUE A PUBLIC HEALTH ADVISORY?

KAREN MCKEOWN:

VERY UNUSUAL. I’VE BEEN HERE FOR FOUR AND A HALF YEARS AND THIS IS THE FIRST TIME WE’VE ISSUED A PUBLIC HEALTH ADVISORY.

FREDERICA FREYBERG:

IT WENT OUT TO LOCAL HEALTH DEPARTMENTS ACROSS THE STATE TO WHAT AFFECT? WHAT ARE THEY SUPPOSED TO DO WITH THIS ADVISORY?

KAREN MCKEOWN:

THIS IS TO RAISE AWARENESS AND IT’S A CALL TO ACTION. WE AND MANY OF OUR PARTNERS HAVE BEEN MONITORING THIS PROBLEM AND WORKING TOWARD IT AROUND THE STATE BUT THIS IS A SORT OF A CALL TO REDOUBLED ACTION AND TO COORDINATED EFFORTS TO MAKE SURE THERE IS REALLY A SPOTLIGHT SHINED ON THIS CRISIS.

FREDERICA FREYBERG:

DESCRIBE FOR US THE OPIOID CRISIS IN WISCONSIN AND HOW IT HAS GROWN?

KAREN MCKEOWN:

IF I COULD BE SHOWING YOU A GRAPH RIGHT NOW, WHAT YOU WOULD SEE IS THE ARROW JUST GOING UP, UP, UP. AS YOU SAID, IN 2003 FEWER THAN 200 PEOPLE DIED FROM OPIOID OVERDOSES. AND IN THE LAST TWO YEARS, THAT’S BEEN MORE THAN 600. AND THE GRAPH JUST KEEPS GOING UP. SO WE KNOW THAT IF WE DON’T TAKE ACTION NEXT YEAR IT WILL BE WORSE AND THE YEAR AFTER IT WILL BE STILL WORSE.

FREDERICA FREYBERG:

WHAT HAVE YOU DISCOVERED ABOUT WHY THIS HAS ESCALATED TO THIS EXTENT?

KAREN MCKEOWN:

IT’S A PROBLEM NATIONWIDE AND IT’S MULTI-FACTORIAL. THERE’S CERTAINLY A LOT OF OPIOIDS AVAILABLE TO PEOPLE. SO PEOPLE MAY BE PRESCRIBED OPIODS FOR THEMSELVES OR THEY MAY HAVE BEEN PRESCRIBED SOME AND LEFT THEM IN THE MEDICINE CABINET AND THEN KIDS IN THEIR FAMILY MAY BE ACCESSING THEM THAT WAY. THOSE ARE A COUPLE OF THE WAYS THAT PEOPLE ARE GETTING ACCESS TO OPIOIDS.

FREDERICA FREYBERG:

HAVEN’T WE BEEN TALKING ABOUT THAT FOR MANY YEARS, THOUGH?

KAREN MCKEOWN:

WE HAVE BEEN. SO THAT’S WHY WE’RE SEEING THIS PROBLEM ESCALATING AND IT IS TIME TO MOVE PAST TALKING ABOUT IT AND TAKE ACTION.

FREDERICA FREYBERG:

WHY DON’T YOU THINK WE’VE BEEN ABLE TO STEM ITS GROWTH?

KAREN MCKEOWN:

IT TAKES SOME SYSTEMIC CHANGES AND WE’RE REALLY WORKING WITH PARTNERS AT THIS POINT TO MAKE THOSE SYSTEMIC CHANGES. SO FOR EXAMPLE, WORKING WITH PROVIDERS TO MAKE SURE THAT THEY ARE PRESCRIBING APPROPRIATELY. AND THE MEDICAL COMMUNITY HAS DEVELOPED GUIDELINES FOR PROVIDERS. WORKING WITH THE PUBLIC SO THAT YOU DON’T LEAVE THOSE MEDICINES IN YOUR CABINET AFTERWARDS. AND A LOT OF PARTNERS ARE NOW MAKING IT EASIER TO TURN THOSE MEDICINES IN WHEN YOU’RE FINISHED WITH THEM. WORKING WITH THE PRESCRIPTION DRUG MONITORING PROGRAM SO THAT WHEN A PROVIDER GETS READY TO PRESCRIBE THEY CAN SEE WHAT OTHER MEDICINE SOMEBODY MAY BE TAKING. AND MAKE SURE THEY’RE NOT ADDING ANY DANGER TO THAT PERSON.

FREDERICA FREYBERG:

IT DOES SEEM AS THOUGH EVEN FOR KIND OF OUT PATIENT PROCEDURES, PEOPLE GET PRESCRIBED THESE MEDICATIONS. PRESCRIPTION PAINKILLERS. ARE THEY THE FIRST LINE OF PAIN MANAGEMENT?

KAREN MCKEOWN:

IT’S A VERY — PAIN MANAGEMENT IS VERY COMPLEX. AND WE’RE TRYING TO WALK A GOOD BALANCE HERE TO MAKE SURE WE DO STILL TREAT PAIN APPROPRIATELY AND DON’T CREATE ADDICTION. AND SO FOR SOME PROCEDURES AND FOR SOME CONDITIONS, OPIOIDS ARE EXCELLENT TREATMENT. AND WE WANT TO MAKE SURE THAT THEY CONTINUE TO REMAIN AVAILABLE IN THOSE SITUATIONS. BUT THEY’RE NOT THE FIRST LINE FOR EVERY TYPE OF PAIN OR FOR EVERY TYPE OF PROCEDURE.

FREDERICA FREYBERG:

ARE THEY ALWAYS ADDICTIVE?

KAREN MCKEOWN:

OPIOIDS ARE FREQUENTLY ADDICTIVE. THERE ARE PEOPLE ARE ABLE TO TAKE OPIOIDS FOR THE PERIOD OF TIME THAT THEY NEED TO AND STOP. BUT THERE ARE ALSO PEOPLE WHO ARE PRESCRIBED THEM FOR SOME SIMPLE PROCEDURE AND HAVE A HARD TIME STOPPING AT THE END. AND IT’S DIFFICULT TO PREDICT EXACTLY WHO IS GOING TO HAVE THAT TROUBLE. SO WE WANT TO REALLY BE CAUTIOUS IN ALL SITUATIONS.

FREDERICA FREYBERG:

BECAUSE IT’S THE STEP FROM THE PRESCRIPTION PAINKILLERS TO THEN HEROIN.

KAREN MCKEOWN:

MANY PEOPLE DO MOVE FROM PRESCRIPTION PAINKILLERS TO HEROIN. ESPECIALLY IF THEY HAVE TROUBLE ACCESSING THE PRESCRIPTION PAIN MEDICINE. THEN HEROIN MAY BE AN EASIER, CHEAPER ALTERNATIVE.

FREDERICA FREYBERG:

AND WHAT ABOUT ACCESSING HEROIN? I MEAN IS THAT JUST UBIQUITOUS?

KAREN MCKEOWN:

HEROIN IS PRETTY EASY TO ACCESS THESE DAYS. AND SO LAW ENFORCEMENT IS ANOTHER CRITICAL PARTNER TO TRY TO MAKE SURE THAT WE REDUCE ACCESS. AND THEN ALSO MAKING SURE ANOTHER PIECE OF THIS IS WORKING WITH PEOPLE WHO ARE ADDICTED TO SUCCESSFULLY ENTER RECOVERY FROM THAT ADDICTION.

FREDERICA FREYBERG:

AND WHAT IS THE MOST SUCCESSFUL METHOD OF GETTING AT THE ADDICTION?

KAREN MCKEOWN:

THERE ARE SEVERAL METHODS. BUT ONE IS CERTAINLY MEDICATION-ASSISTED THERAPY WHERE YOU’RE ABLE TO MOVE THEM INTO MEDICINES THAT ARE NOT AS ADDICTIVE AS THESE OPIOIDS.

FREDERICA FREYBERG:

IS THERE A PARTICULAR DEMOGRAPHIC THAT IS HIT MOST WITH THIS CRISIS?

KAREN MCKEOWN:

SO MALES MORE THAN FEMALES. AND INTERESTINGLY THE RATE IS HIGHER AMONG WORKING AGE ADULTS. SO AGE 25 TO 64 IS WHERE WE SEE THE HIGHEST RATES OF OPIOID ADDICTION AND OPIOID ABUSE. BUT CERTAINLY ALL AGE GROUPS AND ALL DEMOGRAPHICS ARE AFFECTED.

FREDERICA FREYBERG:

ALL RIGHT. KAREN MCKEOWN, STATE HEALTH OFFICER, THANKS VERY MUCH.

KAREN MCKEOWN:

THANK YOU.