May 20, 2023
Clinicians learn tools to treat substance use disorders
On May 20th, clinicians from around the Fox Valley and surrounding areas gathered at Fox Valley Technical College to learn how to combat the opioid overdose epidemic. The event, Stemming the Tide of the Overdose Epidemic, was attended by over 70 physicians, nurse practioners and physician assistants. Clinicians came from as far away as Sturgeon Bay, Wautoma and Shawano to learn how to diagnose and treat opioid use disorder.
Attendees learned how to prescribe the life-saving medication buprenorphine, better known by its brand name Suboxone. Opioid overdose is now the leading cause of death in younger adults in Wisconsin and across the county. Treatment with buprenorphine reduces the risk of premature death by over 50% in people suffering from an opioid use problem. Many people struggle to access these medications and most PCPs do not treat addictions.
The event featured a panel of family physicians who are successfully treating opioid use in their busy primary care clinics. The panelists included Dr. Gretchen Wagner at Ascension in Greenville, Dr. Eric Smiltneek at Aurora in Oshkosh, Dr. Robert Sedlacek at ThedaCare in Waupaca and Dr. Karen Hulbert at ThedaCare in Princeton and Markesan.
The event closed with a panel discussion on stigma reduction in the treatment of people suffering from use disorders. Panelists shared how stigma keeps people from accessing life-saving treatment. The panel discussion was led by Joe Galey from Safe Communities of Madison and included Stephanie Good, a substance abuse counselor at Apricity/Mooring House in Neenah, Caitlin Reider, a substance abuse counselor at ThedaCare Behavioral Health and Jami Carlovsky, a collaborative care nurse manager at ThedaCare in Waupaca.
The event was led by Dr. Ritu Bhatnagar, an addiction psychiatrist at UW-Madison and the current president of the Wisconsin Society of Addiction Medicine (WISAM), and by Dr. Ezra Lyon, a family physician at ThedaCare in Waupaca and ThedaCare’s Associate Medical Director for Integrative Addiction Treatment. The event was free to participants due to generous grant support from the ThedaCare Family of Foundations and from WISAM through federal and state grants. Fox Valley Technical College provided generous in-kind support for the event. Another training is planned for fall of 2023.
Panel discussion on stigma reduction featuring (from left) Jami Carlovsky, Caitlin Reider, Stephanie Good and Joe Galey.
The Drug Enforcement Administration received a record 38,000 comments on its proposed telemedicine rules. We take those comments seriously and are considering them carefully. We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards.
For this reason, last week, DEA, in concert with the Department of Health and Human Services, submitted a draft Temporary Rule to the Office of Management and Budget entitled “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications.” Further details about the rule will become public after its full publication in the Federal Register.
For additional context, please click here.
The Drug Enforcement Administration (DEA) announced changes in rules regulating prescribing of buprenorphine for opioid use disorder (OUD).
Section 1262 of the Consolidated Appropriations Act, 2023, removes the federal requirement for practitioners to have a DATA-Waiver to prescribe buprenorphine for treatment of OUD.
Effective June 21, 2023:
Beginning June 27, 2023, all DEA-registered practitioners will be required to check a box on their online DEA registration form affirming they have completed a one-time eight-hour training on treatment and management of patients with opioid or other substance use disorders.
These changes could improve access to medical treatment for OUD for pregnant persons in Wisconsin.
For more information on the 8-hour training requirement, click here.
For more information, visit the Substance Abuse and Mental Health Administration’s FAQ.
The Wisconsin Department of Health Services (DHS) has awarded $10 million to three organizations for the construction of spaces designed to provide treatment and recovery support services for women.
“Women with opioid use disorder have unique care needs and require a broad range of services to meet these needs,” said DHS Secretary-designee Kirsten Johnson. “The facilities built through this grant program will remove barriers to long-term recovery by providing space to supports women with opioid use disorder to succeed in their journey to wellness.”
The funded projects include:
This project will establish the first residential treatment facility in western Wisconsin open to supporting pregnant women and mothers. It serve up to 20 women at one time once construction of a new building in Menomonie is completed in 2025.
This project will add space to an existing residential treatment program in southeastern Wisconsin open to all women that currently has a wait list for admission. The expanded program will be able to serve 60 more women when construction is completed in Glendale in 2024.
This project will create the first space in northeast Wisconsin focused on supporting pregnant women and mothers in need of safe and stable housing for their families while they participate in outpatient treatment. It will be able to house up to seven women at one time when renovations are completed on an existing building in Manitowoc in 2024.
These spaces will serve all state residents who qualify for the services to be provided.
These one-time grants are for construction costs only. They are funded from Wisconsin’s share of National Prescription Opiate Litigation settlement funds managed by DHS that were received last year. The funded organizations are responsible for costs related to staffing, program supplies, and materials for the delivery of services.
The National Prescription Opiate Litigation settlement funds were awarded in 2022 as part of agreements the Wisconsin Department of Justice entered into with pharmaceutical companies and distributors, settling the state’s legal claims that their actions fueled an epidemic of opioid use disorder, overdoses, and deaths. DHS is expected to receive $130 million over 18 years.
The first payments from the settlement funds were received in the last five months of 2022, totaling nearly $31 million. Based on feedback received through virtual listening sessions and a survey open to all state residents and service providers, and with approval of the legislature’s Joint Committee on Finance, the 2022 funds have been allocated to projects to prevent opioid use, reduce opioid overdoses and other harms from opioid use, expand access to treatment and recovery supports, and enhance data collection efforts to support decisions on the allocation of resources. Tribal nations and law enforcement agencies are receiving a portion of the 2022 funds to support projects unique to their communities and work.
All providers currently offering prevention, harm reduction, treatment, and recovery services for people with an opioid use disorder were invited to apply for a share of the $10 million in funding awarded today. The proposals submitted by the grantees most closely aligned with the approved goals of this grant program, which included the readiness of the agency to begin construction on the project and a focus on serving a population or region in need of services. Part of the funding was required to be allocated to projects that support the expansion of bed capacity for the treatment of pregnant women and mothers in a family-centered environment. At least $3 million was required to be allocated to projects in counties with fewer than 500,000 residents.
In partnership with tribal nations, other state agencies, county and municipal agencies, and community organizations, the DHS response to the impacts of opioids use has evolved as the impacts have become greater. The Dose of Reality public awareness campaign was revised last year in collaboration with the Wisconsin Department of Justice to provide information on how to build supportive communities where prevention works, treatment is effective, and recovery is possible. Naloxone and fentanyl test strips are more widely available to prevent overdoses and deaths. Treatment programs have been expanded and enhanced to focus on the most helpful approaches for care. Recovery supports delivered by people who have experienced the impacts of opioid use have become more accessible, with the peer-to-peer connection shown to be effective in promoting long-term health and wellness.
Learn about services and supports available for opioid use disorder by visiting the Wisconsin Addiction Recovery Helpline website or call 211. More information about Wisconsin’s response to the opioid epidemic can be found on the Dose of Reality webpages.
Join UW PROTEA & FAMMED for a Substance Use Disorders Management Boot Camp conference this spring, May 4-5, 2023! This training aims to enhance confidence and competencies related to the management of substance use disorders in general medical settings. Through case-based and interactive didactic content, the workshop will explore issues related to assessment, monitoring, prevention, and management in the setting of unhealthy substance use.
For more information, please visit https://www.fammed.wisc.edu/protea/
Or contact Kathleen Maher, Outreach Specialist, at Kathleen.Maher@fammed.wisc.edu
On behalf of Jamie Kuhn, Wisconsin Medicaid Director, you are invited to attend a briefing on upcoming changes to BadgerCare Plus and other Wisconsin Medicaid programs that may affect one in four Wisconsinites. Staff from the Wisconsin Department of Health Services will provide updates on program eligibility, operational changes, agency readiness, partner outreach, and engagement opportunities. The agenda is attached. Mark your calendar and plan to attend.
When: Wednesday, April 12, 2023, at 1 p.m.
Where: Zoom meeting
One tap mobile: +16468287666,,1607480003# US (New York)
Meeting URL: https://dhswi.zoomgov.com/j/1607480003
Call In: (669) 254-5252 or (646) 828-7666
Meeting ID: 160 748 0003
During the COVID-19 emergency, the federal government allowed states to implement temporary changes in their Medicaid programs to protect member health and safety. The federal government has now given us a timeline to end those changes. “Unwinding” is the term they have coined to describe the period it will take for states to reinstate routine operations.
The biggest change will be that all of our members who have had continuous health care coverage since March 2020 will need to complete a renewal due in a month assigned to them between June 2023 and May 2024. This topic and more will be discussed during the briefing.
The target audience for this message is broad and includes health care associations, managed care organizations, providers, advocates, and partners. If you have questions or would like more information, email DHSForwardHealthPartners@dhs.wisconsin.gov.
The 2023 Opioids, Stimulants, and Trauma Summit agenda is available now. It is loaded with exciting content and lots of speakers to present the most up-to-date information from some of the smartest people working in substance use and trauma prevention, harm reduction, treatment, and recovery services.
You are invited to join us May 16-18, 2023, in person (Wisconsin Dells) or virtually for five keynote presentations and more than 20 workshops. There is a pre-conference activity May 15.
See more information about this event and information on how to register to attend.
This event is designed to give you the facts and skills that will make a difference for you, your work, and your community in a positive and forward-thinking environment.
Continuing education credits are available for people who attend the live event either in person or virtually.
The registration deadline is 5 p.m. May 11, 2023. Register early. Registration fees increase April 16, 2023.
Today, the Wisconsin Department of Health Services (DHS) submitted its plan to use nearly $8 million in opioid settlement funds to the Legislature’s Joint Committee on Finance (JFC) to support prevention, harm reduction, and capital projects to address the state’s opioid crisis. The money is part of the $400 million the state receives in annual installments through an agreement with major pharmaceutical firms. $130 million of the total amount goes to the state, while the remainder is provided to counties and municipalities.
2021 Wis. Act 57 requires DHS to submit a plan for the anticipated settlement funds to the JFC every year. While the plan submitted in 2022 was created through information gathered at listening sessions across the state, this year DHS conducted a survey to gauge priorities for this plan and over 4,100 people responded.
“As with last year’s proposal, this plan prioritizes what people with lived experiences, their families and friends, and our partners told us is needed to address the state’s opioid crisis,” said Paul Krupski, DHS director of opioid initiatives. “People who responded to our survey ranked the programs and services they see as priorities, and we’re eager to have the committee’s approval of them.”
In 2022, the Wisconsin Department of Justice (DOJ) announced final approval of an agreement with the nation’s three major pharmaceutical distributors (Cardinal, McKesson, and AmerisourceBergen) and Johnson & Johnson. Payments from the distributors will continue for 18 years. Payments from Johnson & Johnson will continue for nine years.
This year, Wisconsin will receive two payments from these settlements. The first payment of $617,290 from Johnson and Johnson is expected to arrive in mid-June. The second payment of $7,371,693 from the distributors is expected on July 30.
In fiscal year 2023, DHS received three settlement payments totaling just over $30 million, and under the plan approved by JFC in 2022, nearly $13 million has gone toward expanding the Narcan® Direct Program; capital projects to expand prevention, harm reduction, treatment, and recovery services; and room and board costs for residential treatment for Medicaid members. The remaining funds will go to programs and projects awaiting approval of applications, including funds to tribal nations, medication assisted treatment, and for after-school programming. Details about these projects will be released soon.
The opioid settlement funds supplement the ongoing efforts by the state to address the opioid epidemic in Wisconsin. Through the Dose of Reality campaign, a joint effort of DHS and DOJ, Wisconsinites can find resources for themselves and loved ones about preventing harm using overdose reversal medications, like Narcan® and fentanyl test strips, treatment and recovery options, and information about talking to family and friends about opioid use. Resources for health care providers is also available.
While data for 2022 has yet to be finalized, 2021 data show there were 1,427 opioid overdose deaths in Wisconsin, and 3,133 emergency room visits, as a result of opioid use. An increase in overdose deaths can be traced in large part to the addition of fentanyl, a powerful, synthetic drug, in substances like opioids.
DHS Issues Public Health Advisory to Warn of the Risks of Death from Drugs Laced with Fentanyl Numbers show an increase in overdose deaths in Wisconsin are linked to the addition of synthetic substances and a mixture of drugs used
Fentanyl is up to 50 times stronger than heroin and up to 100 times stronger than morphine. Because it is so strong and cheap to produce, people who manufacture illegal drugs use fentanyl to make other drugs more powerful and less expensive to make. Fentanyl can be added to pills, heroin, cocaine, methamphetamines, and other drugs.“As we continue our work to promote mental health, reduce harm, and increase support for those struggling with substance use disorders, we can't ignore the greater risks people face by not knowing what is included in the drugs they are taking,” said DHS Secretary-designee Karen Timberlake. "This is a public health crisis, and it's necessary to sound the alarm to prevent unnecessary deaths."
The Wisconsin Department of Health Services (DHS) has issued a public health advisory to inform Wisconsinites about the increased number of deaths caused by drugs laced with synthetic substances, especially fentanyl
DHS data shows that just last year, synthetic opioids, primarily fentanyl, were identified in 91 percent of opioid overdose deaths in Wisconsin, and in 73 percent of all overdose deaths. From 2019 to 2021, the number of fentanyl overdose deaths in the state grew by 97 percent.
Wisconsin Health News
The Wisconsin Department of Justice has reached an agreement in principle on the financial terms of a settlement with opioid-maker Teva that would provide up to $4.3 billion to participating state and local governments over 13 years.
Wisconsin is one of a dozen states leading negotiations with the Israel-based drugmaker over its alleged role in the opioid epidemic.
“Our efforts to pursue accountability from companies whose unlawful conduct contributed to the opioid crisis continue,” Attorney General Josh Kaul said in a statement. “This agreement, if finalized, will mark another significant step forward in bringing resources to Wisconsin for fighting this epidemic.”
The settlement is subject to ongoing negotiations. Details like the amount that will head to the state are still being worked out, per a Department of Justice spokeswoman.
Teva makes fentanyl products for cancer pain and generic opioids, including oxycodone.
The states alleged the company promoted fentanyl products for use by non-cancer patients, deceptively marketed opioids and failed to comply with suspicious order monitoring requirements.
As part of the agreement, Teva would provide up to $1.2 billion in generic naloxone over a 10-year period or $240 million in cash. The final settlement depends on complying with critical business practice changes and transparency requirements, according to the department’s statement.
The agreement would also provide $100 million for Native American tribes over 13 years, according to a Teva statement on its second quarter financial results.
The company expects the agreement to be finalized in the coming weeks, with a nationwide settlement sign-on process to follow.
“While the agreement will include no admission of wrongdoing, it remains in our best interest to put these cases behind us and continue to focus on the patients we serve every day,” the company said.
Wisconsin Society of Addiction Medicine563 Carter Court, Suite B,Kimberly, WI 54136