888* Bodies and Counting *  overdoses  through  12-­‐29-­‐15           O F F I C E   O F     C O M M O N   C O U N C I L   P R E S I D E N T   M I C H A E L   J.   M U R P H Y     200  East  Wells  Street   Milwaukee,  WI  53202   414.286.2074   mmurph@milwaukee.gov             Drug  Overdoses  in  Milwaukee   Like   much   of   the   nation,   Wisconsin   continues   to   battle   a   heroin   and   opiate   epidemic   that   is   placing   an   increased   burden   on   communities   to   better   understand   the   local   challenges   associated   with   addition   and   its   public   health   implications.   Milwaukee   County   alone   has   seen   a   495%  increase  in  heroin  related  deaths  between  2005-­‐20141.  These  deaths,  together  with  other   opiate-­‐related  overdoses,  have  exceeded  injury  related  deaths  such  as  motor  vehicle  fatalities   and   homicides.   Yet   while   our   community   faces   a   major   outbreak   in   the   use   and   abuse   of   opioids,  policymakers  have  much  to  learn  and  about  the  complexities  of  the  problem  in  order   to   introduce   a   targeted   public   health   prevention   model   that   is   dynamic,   multipronged,   multilayered  and  integrated  across  different  governmental  jurisdictions.   Targeted  Policy  Initiatives   To   move   Milwaukee   County   away   from   an   opiate   and   heroin   abuse  outbreak  to  a  county  of  superior  public  health,  we  must   narrowly   define   the   problem,   identify   who   is   most   at   risk   and   deploy   a   targeted   communication   strategy.   Defining   the   problem   requires   the   implementation   of   an   effective   data   strategy.  To  optimize  the  use  of  data,  we  must  not  only  ensure   a  consistent  approach  to  data  collection  and  management,  but   also   that   the   data   collected   is   easily   accessible   by   the   general   public.   With   quality   data   in   place   and   key   experts   across   different   sectors   engaged   in   the   analysis   process,   Milwaukee   County   will   be   a   leader   in   drug   overdose   prevention   strategies   through  its  use  of  data  as  a  strategic  asset.       photo  credit:  WI  DOJ                                                                                                                             1  http://www.jsonline.com/news/health/heroin-­‐deaths-­‐in-­‐milwaukee-­‐county-­‐jump-­‐by-­‐72-­‐b99447450z1-­‐292396321.html   Page  2           Understanding  the  Numbers     DistribuKon  of  Age  Ranges  for     Overdose  Deaths  by  Race/Ethnicity  2012-­‐2015         40%   35%   30%   25%   20%   15%   10%   5%   0%     38%   22%   26%   1%   0%   under  9   6%   1%   10-­‐19   20-­‐29     8%   14%   9%   30-­‐39     27%  20%   22%   0%     1%   40-­‐49   50-­‐59   60-­‐69     3%   70-­‐79   0%   0%     80-­‐89   Axis  Title     All  Overdoses   White   Black     Contrary   to   popular   discourse   that   young   people   are   primarily   overdosing,   nearly   50%   of   overdoses  in  Milwaukee  County  are  occurring  between  the  ages  of  30-­‐59.     While   white   overdose   victims   nearly   match   the   distribution   of   all   overdoses,   black   overdose   victims  skew  older,  with  38%  of  overdoses  occurring  between  the  ages  of  50-­‐59.  The  majority  of   white  overdoses  (26%)  occur  between  the  ages  30-­‐39.   The  average  age  of  an  overdose  victim  in  Milwaukee  County  is  43.       Page  3           Understanding  the  Numbers:  Geographic  Location   N 60TH ST W DEAN RD W BRADLEY N RD BA GR W BRADLEY RD N LAKE DR Bayside N RANGE LINE RD River Hills N REGENT RD W BROWN DEER RD W BROWN DEER RD Fox Point N 51ST BL N SANTA MONICA BLVD Y EE RD N N 107TH ST MILWAUKEE COUNTY Heroin / Opioid Death Density 2012-2015 W FAIRY CHASM RD Brown Deer RT N PO RD INGTON WASH N SWAN RD   9 W GREEN TREE RD DU AP STR IAL E RD PL VE YA BA N 91ST ST EN RE N IN NG N 43RD ST W GOOD HOPE RD W TO N W N MILWA U R IVER KE E PK AP N 32ND ST CAMERON AV W ST NIA UTO N TE T AV ELL FA RW N L IA MO R ME CO LN IN NL S W HIT L S CLEMENT AV DR Saint Francis NA LL AV SW HIT E LAYTON AV W EDGERTON AV W EDGERTON AVE Y E 13 Greendale W GRANGE AV S % Æ W GRANGE AVE NALL AV E S PENNSYLVANIA AVE S NIC H AV O L SO N E P KW AK S PACKARD AVE S 60TH ST S ER High ST S PINE AV S 20TH ST 43 " $ ! # W LAYTON AV W LAYTON AVE RIO R E BOLIVAR AV W BOLIVAR AV " $ ! # S 94 " $ ! # S HOWELL AV S 84TH ST OLT AV W H RD 894 IV BOR D R ER ST S 2ND ST WA T S 6TH ST S 5TH ST S 16TH ST IS M S 13TH ST O AV LO E W M S 27TH ST HO S 6TH ST S 43RD ST S 68TH ST S 76TH ST T LAKE MICHIGAN AV KE GO SM US S LAYTON BL S 35TH ST S 92ND ST S RE PE L FO W MORGAN AV E HOLT AV E MORGAN AV S W SU E OKLAHOMA AV EL DR W HOWARD AV Low S FI 14 E AV KE L SE US AV ER KIN NIC KIN NIC AV 43 " $ ! # W CLEVELAND AV ER PK LA Freeway Heroin / Opioid Death Density E BAY ST E LINCOLN AV D 11 W HOWARD AVE W Waterway N HA R N 17TH ST S 27TH ST 4TH ST S S 59TH ST S 1ST ST N 39TH ST N HAWLEY R D N 68TH ST S 70TH ST S HA RD WL E Y N 92ND ST N MAYFAIR RD N 76TH ST S 76TH ST 4 W BECHER ST T Milwaukee County Municipality DR 41 £ ¤ AS R IV RO OT R ER IE ST S CH S 108TH ST AV 12 NI C LO W PA BS AV County Parcels S WK N ICKI N BE AL W NATION W LINCOLN AV IN W E W LINCOLN AVE Greenfield RD " $ ! # W CANAL ST W GREENFIELD AV 8 West Milwaukee E JUNEAU AV 794 W BRUCE ST W PIERCE ST W OKLAHOMA AV IT 94 " $ ! 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# O TA L DR R ID AVE W FOREST RD HOME CRY E COLLEGE AVE E COLLEGE AV W COLLEGE AV W COLLEGE AVE Y R VERS LANE RD S LO NORT H CA PE W PK AGO AVE RD ODS R N CHIC W WO W SPEEDWA Y DR VE RI S RD E RYAN RD STH 100 W OAKWOOD RD S PENNSYLVANIA AVE IN S HOWELL AVE RT MA S 5TH AVE ST W RYAN RD W RYAN RD Oak Creek 0 0.5 1 2 Miles Source: Milwaukee County Medical Examiner's Office, City of Milwaukee - ITMD Prepared By: Milwaukee ITMD/GIS-jga, 3/2/2016 E OAKWOOD RD Franklin     Page  4             Understanding  the  Numbers:  Demographics     Of  the  888  overdoses,  598  (67%)  were  white  individuals,  far  outpacing  all  other  categories.   Drug  Deaths  by  Race/Ethnicity       6%       3%   White   24%   Black   67%     Hispanic   Other           544  (61%)  were  male  and  344  (39%)  were  female.       DistribuKon  of  All  Overdoses  by  Sex               Male   39%   Female   61%         Page  5           All Overdoses 2012-2015 Sex % of All Deaths Freq. White 2012-2015 Black 2012-2015 % of White Deaths Freq. % of Black Deaths Freq. Male 544 61% 376 63% 116 54% Female 344 39% 222 37% 97 46% 3 0% 1 0% 1 0% 10-19 14 2% 7 1% 3 1% 20-29 158 18% 129 22% 12 6% 30-39 194 22% 153 26% 20 9% 40-49 210 24% 133 22% 57 27% 50-59 214 24% 121 20% 82 38% 60-69 79 9% 46 8% 30 14% 70-79 15 2% 8 1% 7 3% 80-89 1 0% 0 0% 1 0% White 598 67% - - - - Black 213 24% - - - - Hispanic 55 6% - - - - Other 22 2% - - - - Age Range under 9 Race/ Ethnicity Most Prevalent Drugs All Deaths % of All Deaths Freq. White Black % of White Deaths Freq. % of Black Deaths Freq. Heroin 346 39% 252 42% 64 30% Oxycodone 264 30% 164 27% 71 33% Cocaine 200 23% 91 15% 97 46% Alprazolam 174 20% 126 21% 30 14% Diazepam 148 17% 107 18% 34 16% Methadone 114 13% 81 14% 22 10% Morphine 138 16% 91 15% 29 14% 59 7% 44 7% 13 6% Other Opioids & Benzos of Importance Fentanyl     Page  6             Drug  Frequency  for     Most  Commonly  Occuring  Drugs  in  Toxicology  Report   2012-­‐2015       116   108   120   70   69   53     58  61   49   47   46  49  48   37   36   34   31   26   46   39   37  31   27   26  26  23   24   16   5   11   20   heroin   -­‐30   cocaine   alprazolam   diazepam   2012   2013   82   60  64   58   fentanyl   methadone   morphine   oxycodone   2014     2015     Heroin   was   the   most   commonly   occurring   drug   found   in   toxicology   reports,   appearing   in   39%   of   toxicology   reports   between   2012-­‐2015.   Oxycodone   and   cocaine   follow.   However,   while   heroin   was   the   most   commonly   occurring   drug   found   in   white   toxicology   reports   (42%),  cocaine  had  the  highest  frequency  for  black  toxicology  reports,  appearing  in  46%  of   reports.  Also  of  importance  is  the  continued  increase  of  fentanyl  occurrences.               HEROIN   COCAINE   ALPRAZOLAM   DIAZEPAM   FENTANYL   METHADONE   MORPHINE   OXYCODONE   %  change     2012-­‐2015   +104% +79% +55% -28% +440% +50% +92% -3% %  change    2014-­‐2015   -­‐7%   +5%   -­‐2%   -­‐47%   +69%   +70%   +48%   -­‐29%   %  of  2015   overdoses   43%   24%   19%   10%   11%   16%   18%   23%   %  of  2015  overdoses  equates  to  the  percent  of  toxicology  reports  where  the  specific  drug   appears.       Page  7           Drug  Profiles:    Heroin     Total  White  Heroin-­‐Related  Death   Frequencies  by  Age  Range  2012-­‐2015   94   69   44   26   14   5   10-­‐19   20-­‐29   30-­‐39   40-­‐49   50-­‐59   60-­‐69   The  majority  of  white  heroin-­‐related  deaths  occur  between  20-­‐39  years  of  age.         White  Heroin-­‐Related  Deaths  by   Gender  2012-­‐2015       30%     Male   Female       70%           Page  8               Total  Black  Heroin-­‐Related  Death     Frequencies  by  Age  Range  2012-­‐2015   18   20   10   8   5   1   10-­‐19   20-­‐29   30-­‐39   40-­‐49   50-­‐59   60-­‐69   1   1   70-­‐79   80-­‐89     The  majority  of  black  heroin-­‐related  deaths  occur  between  40-­‐59  years  of  age.         Black  Heroin-­‐Related  Overdose  Deaths   by  Gender  2012-­‐2015           30%   Male   Female   70%   Page  9               Heroin  Related  Overdoses  2012-­‐2015   53   2012   116   108   2014   2015   69   2013   Page  10           Drug  Profiles:    Fentanyl     Age  Ranges  for  White   Fentanyl-­‐Related  Overdoses  2012-­‐2015     15   11   8   4   2   1   60-­‐69   70-­‐79   0   10-­‐19   20-­‐29   30-­‐39   40-­‐49   50-­‐59             White  Fentanyl-­‐Related  Deaths    by   Gender  2012-­‐2015       25%   Male   Female   75%   Page  11             Age  Ranges  for  Black   Fentanyl-­‐Related  Overdoses  2012-­‐2015   6   3   2   0   0   10-­‐19   20-­‐29   2   0   30-­‐39   40-­‐49   50-­‐59   60-­‐69   70-­‐79       Black  Fentanyl-­‐Related  Deaths  by   Gender  2012-­‐2015           31%     Male   Female       69%             Page  12             Fentanyl  Related  Overdoses  2012-­‐2015   5   2012   11   2013   27   16   2014   2015                                 The  data  analyzed  in  this  report  was  provided  by  the  Milwaukee  County  Medical  Examiner’s   Office  and  includes  confirmed  overdose  deaths  in  Milwaukee  County  from  January  2012   through  December  29,  2015.     Page  13