The state of Wisconsin has been working for several years to address its opioid crisis, and in 2018 saw a 10 percent decline in deaths and 20 percent decline in hospitalizations related to the drug. Still, policymakers have sought to further lower overdose tolls, most recently with three bills that were signed into law on March 3, 2020.
These new measures will boost treatment and prevention efforts across the state. They seek to:
The most effective treatment for opioid use disorder (OUD) is FDA-approved medication, including buprenorphine, methadone, or naltrexone, ideally supplemented by behavioral therapy. Recovery housing, an intervention that provides recovery and peer supports, is specifically designed to offer a safe and healthy living environment for a person in recovery. Such residences have been shown to help reduce substance use, lessen the risk of relapse, lower incarceration rates, and increase employment. Until now, many recovery houses in Wisconsin prohibited or discouraged use of OUD medications, keeping people in treatment from accessing a critical resource.
Assembly Bill 646/Senate Bill 591 changed that by requiring that the state Department of Health Services (DHS) establish and maintain a registry of approved recovery residences that will not exclude people based solely on their use of OUD medicine. That change is important, in part because federal and state funds can go only to those recovery residences included on the registry, creating a strong incentive to serve people still in treatment with these medications.
State statistics show that 69 percent of people who are incarcerated in Wisconsin have a substance use disorder. Naltrexone has been made available to a limited number of jails through state grants, and to a portion of the state prison system. None of these facilities currently offer either buprenorphine or methadone, both which have been proved effective. People entering jail or prison who are receiving either of those medications are weaned off in favor of drug-free treatment that is common in these settings—despite a lack of evidence that it works.
This has missed an important opportunity to connect some of the most vulnerable people with OUD to effective treatment, which has been linked to reduced recidivism and fewer overdose deaths. Assembly Bill 645/Senate Bill 594 requires DHS, in consultation with the Department of Corrections, to study the availability of OUD medication across Wisconsin prisons and jails, and then use the results to propose a pilot project to make all three drugs available for initiation of treatment and maintenance for individuals with an OUD in at least one of the state facilities.
Prescription drug monitoring programs (PDMPs) are electronic databases that track controlled substance prescriptions. They have been meaningful tools in helping to identify and prevent dangerous prescribing practices during the opioid crisis. Some states, including Wisconsin, require physicians and other prescribers to consult the PDMP when planning treatment options to view a patient’s prescription history and to help them determine whether to recommend an opioid or other drug.
Assembly Bill 647/Senate Bill 581 extends this requirement for another five years in Wisconsin and requires a quarterly review by the state’s Controlled Substances Board to evaluate how the PDMP is working. In doing so, the state can encourage health care providers to do their part to help prevent opioid misuse in the first place.
With the signing of these three bills, Wisconsin has taken additional steps toward curbing its opioid crisis and serving state residents in need.
Beth Connolly is the project director and Andrew Whitacre is an associate manager with The Pew Charitable Trusts’ substance use prevention and treatment initiative.