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Wisconsin battling opioids on multiple fronts

Patty Schachtner suspects she saw a new level of desperation in 2017.

The St. Croix County medical examiner this year determined a person died from consuming horse wormer medication. Schachtner said the suicide was the first of its kind the Wisconsin State Crime Laboratory has reviewed.

"I think it's a sign of deeper desperation," she said, adding that the deceased obtained the drug through the Dark Web.

Schachtner fears addicts are moving beyond — or augmenting — opioid abuse by tapping into different substances that aren't meant for human consumption.

"This is far bigger than people think," she said.

Schachtner exists within a framework of health professionals, law enforcement members and lawmakers struggling to make headway against opioid addiction in Wisconsin, where greater access to a critical antidote, a class-action lawsuit and new laws are among the emerging answers to the evolving problem.

Two people — Attorney General Brad Schimel and Rep. John Nygren, R-Marinette — have figured prominently as leaders in Wisconsin's battle against opioid abuse.

Nygren, a Marinette Republican whose family has been deeply affected by addiction, has put drug abuse in his crosshairs and has seen nearly 30 bills signed into law since 2013. Nygren's daughter has struggled for years with heroin addiction, including a 2017 homicide charge stemming from a Wisconsin man's fatal overdose.

Spurred by his daughter's struggles, Nygren has been the driving force behind Wisconsin's HOPE (Heroin, Opioid Prevention Education) legislation, which includes a bill mandating the state's Prescription Drug Monitoring Program.

The program includes a provision that took effect in April, which requires medical professionals to check with the Prescription Drug Monitoring Program before approving opioids for a patient. The PDMP includes information provided by law enforcement, public health, pharmacies and health care professionals.

The effort is aimed at curbing so-called "doctor shopping," where addicts bounce from one office to the next in hopes of getting a prescription filled.

St. Croix County Sheriff Scott Knudson said laws like that are proving to be successful "so a person isn't pharmacy shopping." Still, law enforcement efforts to spread awareness about the problem — as St. Croix County has addressed through a task force — remain necessary, he said.

"We continue to hope for way to work more cooperatively with the pharmaceutical industry in the area," Knudson said.

The sheriff said western Wisconsin hasn't dealt with the volume of opioid-related overdoses that his counterparts have in the state's eastern region. According to county records, 2015 and 2016 each saw four accidental opioid overdoses.

"We continue to increase, and my concern is that what they're experiencing across the state, that we're going to start seeing that," Knudson said. "The problem really is: One overdose is too many overdoses."

On Dec. 15, Schimel, the state's attorney general, outlined a three-pronged effort he's touting in response to an epidemic that killed 827 people last year in Wisconsin.

"We cannot arrest our way out of the opioid epidemic," he said.

Schimel said the state is attacking opioid abuse through prevention, treatment and enforcement.

Among those efforts is an investigation launched in concert with other attorneys general to determine the role of opioid manufacturers in creating and prolonging the epidemic. That effort has included investigative subpoenas issued for manufacturers Endo, Janssen, Teva/Cephalon and Allergan.

Meanwhile, 28 Wisconsin counties, including Douglas County, have joined in a lawsuit against pharmaceutical companies, alleging "aggressive and fraudulent marketing of prescription opioid painkillers that has led to a drug epidemic in the state" and beyond, according to a news release.

The state's justice department on Dec. 13 announced a program providing expanded access and affordability on University of Wisconsin-System campuses for Narcan, the antidote used in overdoses.

The program, forged in partnership with the drug's manufacturer, Adapt Pharma, will provide law enforcement and campus security with Narcan at no cost. Nine campuses, including Superior, are among those receiving the antidote.

More people are being saved by the drug Narcan than ever before, Schachtner said.

"What Narcan's supposed to do is working," she said.

But, she explained, addicts are also aware of that.

The emerging problem, Schachtner said, is that some users have their own access to the drug and have it administered to them after overdosing. That makes her wonder what happens when people are receiving the antidote weekly or monthly.

"What are the long-term effects of that," Schachtner said.

She noted the rise of ultra-potent drugs like fentanyl and carfentanil, which create immediate exposure risks. Schachtner and law enforcement investigators have been given Narcan doses to administer to officers who overdose on those drugs simply by responding to a crime scene.

"That's how potent this stuff is," she said. "It is now a workplace hazard for frontline workers."