Synthetic opioids like fentanyl are increasing nonfatal and fatal drug overdoses nationwide. In 2022, Wyoming reported that 93 people died from a drug overdose. Fourty-eight of those involved fentanyl.
After months of investigations, requesting data, and coming up dry, WyoFile reporter Madelyn Beck has come out with a four part series on what data the state collects and how that data is lacking. Wyoming Public Radio’s Kamila Kudelska asked what was the question that started it all.
Editor’s note: This interview has been lightly edited for brevity and clarity.
Madelyn Beck: The main question that I wanted to know was, ‘What do the local areas in Wyoming look like when it comes to overdose trends?’ I wanted to find out which counties are seeing an increase, which aren't, and what's happening at local levels. Unfortunately, that is something that I can't quite answer yet. We can see some trends with the data that I was able to get. But ultimately, the answer to my question was, we don't know and can't know, unless more information was provided in a different way.
Kamila Kudelska: That leads you to take this deep dive into the drug overdose data that the state does have? And can you kind of explain what type of data the state collects on overdose?
MB: EMS tend to collect information on the codes as far as what they suspect is going on with someone. And then you have coroners reporting deaths in the form of death certificates from local areas. And you have different officials from sheriffs to coroners reporting to a larger system, this mapping application called ODMAP. So all of those are forms of data that we know are collected and reported and aggregated at the state level.
KK: What does that data show?
MB: So, obviously, they don't want to provide all of the data to me and to anyone because they have privacy concerns. And those are valid concerns. Wyoming is a rural state, you don't want to say, ‘Well, one person died of a drug overdose this week.’ And everybody knows that one person died in this county this week. That's problematic. So they've suppressed a lot of data. They've also provided some of this EMS data to me. That data has shown an increase in several counties of these EMS suspected overdoses over the last few years and decidedly a spike in January. The Office of EMS wants to keep an eye and see if that spike has continued to say whether there was a real trend, or talk to people. But from my analysis, it was a clear and defined trend of the highest numbers that we've seen from the data collected.
The county level overdose death data and things like that was much harder to get. They tend to use five year averages, which can be problematic when looking at something that's changing as quickly as the overdose crisis. Because about five years ago, we had a dip in overdoses. And then now we have an increase. And so if you use a five year average across that, you don't really see much of a change. So we are able to get some more annual data from the CDC for some counties. But a lot of that is harder to see. But what we have found is there are certain counties that are seeing more overdoses than others. But that's pretty much all we can say right now.
KK: And I think a thread throughout the four piece investigation is just Wyoming is unique in the sense. Like you said, it's rural, but it's also a very small population. So how can we analyze this data?
MB: I think when you ask, ‘How can we analyze it?’ we can also turn to what other states are doing. So the Wyoming Department of Health has said, ‘We are giving you all the data we can. We follow HIPAA.’ But at the same time, you look at Alaska. And Alaska gives you annual data by Health District. It gives you raw numbers, it gives you rates of overdose deaths and overdoses per health district. And I contacted their health district, and they said they haven't heard any concerns about privacy from what they've been able to provide.
Similarly, I looked at Missouri's opioid dashboard that shows a lot of their statistics. And their Health Department also said they haven't heard any privacy concerns. And they provide data by county by year. So those are other models that are out there from states that said they haven't heard any privacy concerns. So there potentially are other models that Wyoming could follow.
KK: What's the significance of the fact that that data is so limited to the question that you were initially asking?
MB: I mean having that limited data just kind of hamstrings your ability to watch things change over time. And that's problematic for local areas because right now, we have opioid settlement funds to the tune of millions of dollars. We're expecting more than $9 million from the settlements already reached, and there's more settlements to come. So we're expecting more settlements to come from groups like Purdue Pharma. Wyoming struck a deal. They agreed 65 percent of those opioid settlement funds are going to counties and towns around Wyoming.
So you have this batch of money coming in, and you're a county commissioner, but you don't actually know what things look like in your county. How is that going to affect how you spend that money? Are you going to use it more on prevention? If you know that there is an increasing number of overdose deaths in your area, does it mean you spend more on Narcan, or on fentanyl test strips or other kinds of tools? It really depends. So I think that's why we felt it was so important to hammer home the point that local data matters.
Then you have nonprofit groups and groups that could use some local data to get grants to bring more money into the state of Wyoming to provide more resources to people on the ground. Because these opioid settlements, as great as they are, they're going to be coming over the next several years. But they're finite. They're not going to be a yearly thing; they're going to end at some point. So having ways to bring other sources of funding will be important if this crisis continues and continues to get worse.
KK: You spoke to a lot of people on the ground, a lot of Wyomingites who are dealing with this. What was the feeling that you got from them about this problem and how there could potentially be or if there are any solutions?
MB: Generally talking with folks on the ground about the dangers of fentanyl, what I've been hearing and seeing is one, fentanyl is incredibly hard to get off of. For some people anecdotally, it's harder to get off of than meth or heroin, which is a huge problem. Because those are already so incredibly hard to recover from. And with that, they're asking for more mental health resources, especially for people, like, talking with those at the homeless shelter in Cheyenne. They want access to more resources to help them recover. Things like medically assisted detox. That's something that they feel could be really helpful because detox itself can be so torturous and dangerous and quite deadly. So you need help a lot of the time to get through that process.
And then folks like Levi Wardell, who had a history, but now works at a funeral home in Cheyenne. He is hoping for more access to information, like we saw with COVID-19, because he has kids. For him, just looking forward, he'd want to know what the trends are, what things are looking like in his area, so he can talk to his kids about it. So he was frustrated that we've had overdoses for a lot longer than COVID-19. And we've had more local data for COVID-19 and a much shorter timeframe. Why can't we do that for overdoses, too?
There's a lot of different requests here. And a lot of these things do take money and time. But right now, Wyoming is seeing that influx in resources. Hearing from people like Levi, like vulnerable adults, in situations like at shelters, those with mental health conditions, that might help allocate funds in a way that might have more lasting results,
KK: That anecdotal voice might help with the lack of data to put the money in the right place.
MB: It can help. But also, that anecdotal voice also wants access to that data. So we want more data. But we also need to pair that data with expertise, with people who are experts in the mental health field, people who've lived through this, so those are both things. So the data alone will often not be enough. But data paired with these experiences of the people around Wyoming [who] are seeing firsthand on the ground. I think that could be really helpful to local leaders who are trying to figure out what is the best way.
Even without data, county commissioners and cities are working together. They are holding hearings and meetings and reaching out to groups to try to figure out what to do because a lot of them are not experts in opioid overdoses with the opioid crisis.
