This brief published by the Bureau of Justice Assistance (BJA) Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) describes the efforts of the overdose fatality review (OFR) team in Winnebago County, Wisconsin, and the reforms resulting from their work.
This publication by the Bureau of Justice Assistance (BJA) Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) describes the work of the overdose fatality review (OFR) team in Winnebago County, Wisconsin. Based on the OFR team’s recommendations, reforms were enacted that reflect the correlation between addiction and related mental health and childhood trauma challenges and leverage networks of providers to identify and treat problems proactively. OFRs, confidential death reviews conducted by multidisciplinary teams to identify system gaps and improve overdose prevention and intervention strategies, stand as perhaps the best vehicle available to make community responses to substance use a holistic effort that is alert to service gaps and equipped with real-time tools to overcome them. The OFR team began the review with a clear-eyed acknowledgement that Winnebago County continues to struggle with overdoses. The county recorded 37 overdoses resulting in unintentional deaths in 2020—its highest total ever—and has already witnessed 28 with nine more pending or probable in 2021 (through November 29). In 2020, it recorded a 250 percent increase in overdose deaths among women, as well as a rise in overdoses among individuals aged 25–34. Concurrent with the rise has been an increase in suicide attempts in the county. The negative trends have been attributed in part to the emergence of fentanyl in Winnebago County’s drug market. However, it was clear that COVID-19 had most impacted overdoses in the county—and the work of the OFR team. While the team continued to meet monthly, it switched to a virtual format, which mirrored gaps in county services caused by COVID-19’s impacts—among them housing and residential treatment—which in turn had negative effects on individuals struggling with substance use. Rising unemployment rates and evictions and diminishing access to child care for many parents added new stressors to many households—serving as another driver of addiction.