“911, what is your emergency?”

The caller was frantic, breathless as they fumbled with their phone. They pleaded for help because they found their father/mother/son/daughter/ brother/sister/neighbor on the floor unresponsive. The caller breathed heavy and tried to get their loved one to wake up. Nothing worked.

They had to start CPR. They needed an ambulance. They tried to remember their address for the dispatch. They tried to stay calm as they cycled through compressions. They tried to remember “Staying Alive” to follow a beat— anything to keep their head on straight while another person’s life was on their fingertips then slipped quietly away.

That scene has played out thousands of times across the United States. Sometimes the victims make it and sometimes they don’t. Each year, 100,000 people die from overdose, according to the US Department of Health and Human Services (HHS).

Wisconsin, like most states, has struggled with opiate-related overdoses and fatalities, and, with the advent of Fentanyl, the problem has exacerbated. Gundersen Health Systems, citing an article from Forward Analytics, reported Fentanyl had become the number one killer of people age 25-54 in Wisconsin. In 2020, Fentanyl related fatalities would have accounted for two and half times more deaths than car accidents in that age group if Fentanyl was recorded as a cause of death at the time.

“We have not seen the end of this epidemic,” Chris Eberlein, MD, Gundersen Health System Emergency Medicine Physician, said. “It continues to stress our healthcare systems, our providers and the community at large.”

To combat the swelling numbers, the Health Resources and Services Administration (HRSA) announced $1,089,231 in awards to rural Wisconsin communities. The funds seek to improve services for small, less densely populated areas that suffer from “geographic isolation” and transportation barriers. People in those areas were deemed to have difficulties to find and access substance abuse and mental health treatment.

The HRSA money, claimed to be part of President Biden’s Unity Agenda, ear-marked $300,000 for immediate needs, including the supply of opiate overdose reversal medications and an additional $789,231 for communities to develop interventions for the treatment and care of opioid exposed infants.

“Far too many rural families have faced the devastation of overdose, and these deaths are felt deeply across rural communities—where often everyone knows someone lost too soon,” Carole Johnson, HRSA Administrator, said.

The government’s move to assist less populated areas of Wisconsin may not be directly felt in Crawford County, but Fentanyl has left its mark. From January to July 2023, Crawford County has recorded five opioid-related overdoses in individuals 11 years or older. And while five is a small fraction of Wisconsin’s 5,264 total incidents, that’s still five more than zero. Crawford County has recorded as many as five overdoses in one month (Oct. 2021) against a population under 17,000 people.

For Ryan Fradette, Lieutenant Detective for the Crawford County Sheriff’s Department, Fentanyl posed a risk to the community because it’s ubiquitous and transmitted easily.

“It’s like meth; it’s easy to get your hands on,” Fradette said. “It’s such a fine, powdery substance that it’s airborne very easily. And once you breathe it in, it affects your respiratory system.”

“We’re finding Fentanyl in every drug right now,” Casey Cox, Investigating Lieutenant for the Prairie du Chien Police Department, said. “We’re even finding it in Marijuana. It’s affecting us. We’ve had some overdoses with heroine and Fentanyl.” Cox noted that many people are misinformed about Fentanyl, including the misconception that its primary form of transmission is through the skin rather than the respiratory system. Cox said the drug’s transmission effect through the skin can be “sped up” through the use of topical alcohol products, like hand sanitizer.

“Everyone’s concerned if you touch it you’ll overdose, and that’s just not the case,” Cox said.

While Fentanyl has seeped into the nooks and crannies of Wisconsin, law enforcement and government officials have developed strategies to mitigate its influence. Emergency responders’ first tool is Narcan/Naloxone, a drug that can be introduced through the nose with an applicator to negate the effects of opioid overdoses. Both Fradette and Cox stated the Sheriff’s Department and Prairie du Chien Police Department are equipped with Narcan to respond to overdoses. Cox also said Gundersen ambulance has a supply as well.

“These [numbers] would look drastically different if we didn’t have Narcan available,” Dr. Eberlein said. Eberlein estimated Fentanyl most often has caused overdoses in people in their forties, but that age curve would shift “probably 15 years” without Narcan’s wide availability.

Fradette stated Crawford County has received grants from the Department of Justice to combat the presence of methamphetamine. The Sheriff’s Department has implemented new procedures to ensure the safety of their officers.

“We’ve had to change our process with that,” Fradette said. “Now it takes two people to field test.” Fradette noted an investigator has to use an evidence hood for Fentanyl testing and both officers must use proper personal protective equipment (PPE). Equipment includes masks, gloves, and face-shields to prevent exposure.

The Sheriff’s Department has communicated and shared information with the Richland, Iowa and Grant County Task Force (RIG) and credits the K9 units as “a game-changer.” Moreover, Fradette credited the County agencies’proactive law enforcement strategies. “Because of that, I think we’ve kept our numbers down.”

Cox described proactive strategies as traffic stops, the addition of K9 units, extended hours for officers, and patrolling in the community. More than that, Cox pointed to the educational presentations law enforcement officials conduct “all the way from grade schools to the PDC correctional institute.”

InNovember,theDepartment of Emergency Management, part of Crawford County’s Sheriff’s Office, received 2,304 doses of Narcan from the Wisconsin Public Health’s Narcan Direct Program. The Department of Emergency Management distributed doses to emergency management teams, Sheriff’s offices, police departments and other first responder services throughout Crawford and Grant counties. The grant saved local budgets approximately $52,000.

How to Recognize an Overdose: -skin is blue (lips, fingertips first) -body is limp -face is pale -cold, clammy skin -person is conscious but unable to respond -choking, gurgling sounds -breathing slow, irregular, or stopped -pulse slow, erratic or not there -emesis -lack of consciousness How to Respond to an Overdose: -Try to wake them up -give Narcan/naloxone -start CPR -put them in recovery position On Dec. 6, 2023, Crawford County’s Department of Emergency Management issued a notice that the county had obtained a grant for 6,000 Fentanyl test strips, valued at $4,500. The test strips were made available at all of Crawford County’s first responder agencies, including previous Narcan partners.

Crawford County’s Narcan partners include: Mar-Mac Police Department ·Richland County Sheriff’s Office ·Vernon County Sheriff’s Office ·Viola Police Department ·Richland Center Police Department ·Grant County Emergency Management ·Grant County Sheriff’s Office ·Bridgeport Fire and First Responders ·North Crawford Rescue ·Ocooch Mountain Rescue ·Ferryville Fire and First Responder ·City of Prairie du Chien Police Department