From 2019 to 2021, Waukesha County witnessed a concerning surge in opioid-related deaths, particularly among residents aged 18-44, aligning with a distressing national trend. This demographic faces heightened vulnerability, primarily attributed to the dramatic rise in fentanyl usage.

The escalating death toll underscores the critical importance of various factors, including treatment accessibility, family support, harm reduction strategies, trauma-informed care, effective communication, system navigation, and community literacy on harm reduction. Conversely, challenges such as insufficient treatment access, lack of family and community support, family history, the politicization of the topic, and societal stigma contribute to the worsening situation.

Addressing the root cause requires a collective commitment to education on substance use disorders, combatting bias, and dispelling stigma. Unfortunately, the issue currently lacks the necessary prioritization by policymakers, resulting in inadequate funding and pervasive public misconceptions.

Contributing Factors:

• Enhanced treatment accessibility
• Robust family support
• Targeted interventions
• Harm reduction strategies (Narcan, needle exchange)
• Improved access
• Support groups
• Trauma-informed care
• Effective communication networks
• Efficient navigation systems
• Comprehensive community education on stigma

Restricting Factors:

• Lack of treatment access
• Lack of family support
• Family history
• Politicized subject
• Stigma

Root Cause: Lack of education about substance use disorders, harm reduction, and stigma.

When considering partnerships, the action team kept things as broad as possible. Not all potential partners end up being a vetted resource and partner for the CHIP process, but it was still worthwhile to consider a wide-range of options. Below is a list of potential partners that may have a link to substance use, opioid related deaths, or access to life-saving interventions.

Potential Partners List:

1. 16th Street Community Health Centers
2. Addiction Resource Council
3. Aging and Disabilities Resource Center
4. Alano Club
5. Al-Anon
6. AA
7. American Lung Assocation
8. Ascension
9. Aspen Center
10. Aurora Health Care
11. Bethany Christian Services
12. Bethesda Park
13. Bridges Library System
14. Carroll University
15. Case workers
16. CDC
17. Community Care
18. Community Medical Services
19. Crosswalk Church
20. Denoon Recovery
21. Elevate
22. Elmbrook Church library
23. Emergency services
24. Evangelical & Reformed United Church of Christ
25. Family Promise of Western Waukesha County
26. First Baptist Church
27. First Congregational Church
28. First United Methodist Church
29. Friendships Unlimited
30. Froedert Community Memorial Hospital
31. Grace Evangelical Lutheran Church
32. Hebron Housing Services
33. Hope Center
34. Impact 2-1-1
35. Interagency Programs for the Intoxicated Driver Committee
36. James Place
37. Justice system
38. Lake Area Alano Club
39. Law enforcement
40. Lutheran Social Services/ Aspen Center
41. Medical Examiner's Office
42. Mental Health America
43. Mental Health America of WI NAMI
44. Meta House
45. Minooka Park
46. Moorewood Park
47. NAMI SE WI
48. NA
49. Oconomowoc Memorial Hospital
50. Phopenix Recovery
51. ProHealth Care Behavioral Health
52. ProHealth Care Rehabilitation Center
53. Public Health
54. Representative Adam Neylon
55. Representative Scott Allen
56. Rogers Memorial Hospital
57. Salvation Army
58. School Districts
59. Senator Chris Kapenga
60. SMART Recovery
61. Silver Haze Smoke Shop
62. Spring City Corner Clubhouse
63. St. Joseph's Catholic Church
64. St. Luke's Lutheran Church
65. St. Mark's Evangelical Lutheran Church
66. St. Matthias Episcopal Church
67. Statewide Poison Center
68. Substance Use Advisory Committee
69. The Women's Center
70. Todd Wehr Memorial Library
71. Trinity Lutheran Church
72. Trinity Presbyterian Church
73. VA Medical Center
74. Vivent Health
75. Voices for Recovery
76. Waukesha Church of Christ
77. Waukesha City Church
78. Waukesha Comprehensive Treatment Center
79. Waukesha County Health & Human Services
80. Waukesha Memorial Hospital
81. Waukesha Public Library
82. Waukesha Springs Park
83. WC Public Health Center
84. WCTC Library
85. WHARP
86. WI DHS
87. Wisconsin Department of Community Corrections
88. Wisconsin Family Ties
89. Wisconsin Peer Support Certification
90. Wisconsin Society of Addiction Medicine
91. Wisconsin Community Services
92. WisHope Recovery

What Works is a brainstorming process where the action team identifies strategies to address opioid-related deaths, focusing on the root cause— a lack of education about substance use disorders, harm reduction, and stigma. Additionally, the importance of including someone with lived experience, facilitating warm hand-offs among providers, and establishing a fluid step-down/up process tailored to each individual's needs. 

While the action team cannot undertake every identified strategy, community partners may find this list helpful as a collaborative resource to address mental health for adolescents in Waukesha County.

Evidence-Based Strategies:

• Stigma Reduction Marketing Campaign: Launch a marketing campaign focused on reducing stigma around substance use disorders, leveraging evidence-based approaches for maximum impact.
• Harm Reduction Education and Trainings: Conduct education programs and training sessions on harm reduction, including safe injection sites, with a focus on utilizing phone/text services for supervised use.
• Holistic Care Including Family Members: Provide holistic care that actively involves family members, recognizing the crucial role they play in supporting individuals with substance use disorders.

Innovative and Creative Strategies:

• Summit for Stigma Reduction and Harm Reduction Techniques: Host a summit dedicated to reducing stigma and exploring innovative harm reduction techniques to address the opioid crisis effectively.
• Community for Family Members: Create a supportive community for family members of individuals with substance use disorders, fostering understanding and sharing resources.
• Advocacy for Harm Reduction Policy Change: Utilize available funding to lobby for political changes that support harm reduction methods, challenging existing categorizations as "paraphernalia."
• OAK Boxes in Public Spaces: Introduce OAK boxes in bars/taverns and other public spaces, providing easily accessible resources, such as hotlines, text lines, and information on available peer support.

Low-Cost/No-Cost Strategies:

• Social Media Awareness and Education: Leverage social media platforms for cost-effective awareness campaigns and educational initiatives to reach a broader audience.
• Education and Engagement with Policy Makers: Engage in cost-effective education and discussions with policy makers to address the root causes of opioid-related deaths.

Data Development & Research Agenda:

• Community Engagement for Disparity Analysis: Reach out to communities of color to understand and address disparities in treatment access, education, and resource availability related to substance use disorders.
• Promotion and Research on Substance Use Disorders: Advocate for the promotion of effective strategies and conduct additional research to assess their efficacy in addressing substance use disorders and promoting harm reduction.

Substance Use End Result 1: People who use or are in recovery for opioid use in Waukesha County have access to life-saving interventions.

Selecting an effective strategy involves a meticulous evaluation based on four key criteria:

• Leverage, which assesses the potential impact on progress
• Feasibility, ensuring practicality and achievability
• Specificity, detailing budget and timeline considerations
• Values, ensuring alignment with the values of both the community and the organization

This comprehensive approach ensures that the chosen strategies have a meaningful impact, are feasible to implement, align with established values, and are supported by a clear budget and timeline.

Substance Use Team Selected Strategies:

Data Source: Dose of reality: Opioid deaths by county dashboard. Wisconsin Department of Health Services. (2024, February 20). https://www.dhs.wisconsin.gov/opioids/deaths-county.htm