New report offers deep dive into fentanyl overdose trends

A new report by Forward Analytics, a research division of the Wisconsin Counties Association, is taking a deeper look at the fentanyl-fueled overdose crisis. Deaths linked to synthetic opioids, namely fentanyl, rose by over 1,000% from 2015 through 2021. The surge claimed the lives of over 4,300 people across the Badger State.

Fentanyl was originally developed in 1959, and was used as an anesthetic. Doctors over the decades began prescribing it for severe pain, especially after surgery or to address pain from terminal diseases like advanced cancer. Fentanyl is about 50 times more potent than heroin, over 100 times stronger than morphine, and is undetectable by smell or taste.

While fentanyl has ushered in the latest era of drug-related deaths, it’s hardly the first drug to do so. An era of heroin usage coincided with the Vietnam War, and preceded crack cocaine in the 1980s. The Forward Analytics report highlights the creation of OxyContin in 1995, which seeded the opioid crisis of the 2000s. In Wisconsin, overdose deaths have climbed sharply over the last 22 years. From 1999 to 2021, the report found, drug overdose deaths increased by more than 700%. The same period of time saw deaths involving opioids increase by over 1,800%. The first phase from 1999 to 2007 was fueled by prescription opioids. Between 2007 and  2015, heroin use drove the crisis. Ever larger waves of fentanyl-related deaths have followed.

The Forward Analytics report took a closer look at who is hit hardest by the deaths. It found that the mortality rate for men is 2.6 times greater than women, and nearly three times greater for Black and Native American residents than for white residents. Wisconsin’s Black population, the report highlighted, saw its mortality rate related to drug overdose deaths triple from 2019 to 2021. In 2020, fentanyl deaths were 2.6 times greater than the second leading cause of death, motor vehicle accidents, for people 25 to 34 years old. From 2015 to 2021, the report found, fentanyl was linked to over 4,300 deaths in Wisconsin, resulting in 155,000 years of potential life lost.

While the Center for Disease Control and Prevention (CDC) reports that  fentanyl deaths are plateauing in Wisconsin, the numbers are still overwhelming. Roughly 1,300 people died in 2022 across the state, the report noted. Meanwhile, local municipalities are struggling to keep up with the tide of fatal and non-fatal overdoses. Treatment specialists believe that an estimated 20,000 people are using opioids in Milwaukee County. A new medication-assisted treatment center is planned to open on Milwaukee’s northwest side after a five-year battle. All the while, drug trends continue to shift and change throughout the state. Recent months have seen the tranquilizer xylazine, at times also mixed with fentanyl, cause deaths.

The Forward Analytics Report found that mortality rates were particularly high in southeastern Wisconsin, at 31.6 per 100,000 residents from 2020 to 2021. Combining fentanyl-related deaths for 2020 and 2021, Forward Analytics found that the average urban mortality rate was more than double the average for rural communities at 23.1 vs. 11.4. The organization highlighted that this rate is much higher than the national average. Rural communities in the southern portion of the state had higher rates than those in the north. Rural southwest Wisconsin had the lowest average of 5.4. By comparison central, west central, and northern Wisconsin had rates averaging between 8.4 and 11.2 per 100,000 residents.

There is a lot of variation even within regions,  however. Sawyer County, in the northwest of the state, had a fentanyl mortality rate of 35.9 per 100,000 people, according to the Forward Analytics report. This was the second highest rate, right behind Milwaukee County. “Sawyer’s rate was significantly above the average rural rate and the average rate for its region,” the report states. Other examples included Adams and Juneau counties, which had rates of 25.1 and 22.3 respectively. “These rates were more than double the regional rate and about three times the rural rate,” the report noted.

Dale Knapp, director for Forward Analytics, warns that communities shouldn’t let their guard down when death rates plateau. “While promising, this fight is far from over,” said Knapp in a statement. Knapp points to the Drug Enforcement Administration (DEA) as an example. The agency seized more than 50.6 million fentanyl laced pills nationwide last year, with 60% testing positive for lethal doses of fentanyl. This was more than double the number from 2021, the report noted. DEA agents also seized 10,000 pounds of fentanyl powder. Those captures represented more than 379 million potentially lethal doses of fentanyl, which is a larger number than the population of the United States.

The report recommends more education on the street names of fentanyl and increasing access to testing strips and Narcan, which is used to reverse an overdose. “Illicit fentanyl has been a scourge of the nation and Wisconsin since 2015,” the report concludes. “Through last year, this drug has been associated with more than 5,600 deaths and an estimated 200,000 potential years of life lost in the state.”