Bad batches, overdose clusters: new DHS system gives real-time data to health agencies

Every 16 hours, someone in Milwaukee County dies from a drug overdose.

"When you look at those folks who are dying from overdose, it's not a single demographic. It's not young, it's not old, it's not Black, white or Hispanic, male or female," said Ben Weston, chief health policy adviser for Milwaukee County. "It's folks who have college degrees, it's people who are business owners, it's people who have kids, it's people who are grandparents. It's across the spectrum."

Although Wisconsin saw a provisional 9.6% decline in drug overdose deaths this year , a downward trend that parallels with the national count , it remains the case that thousands of lives are lost every year.

Understanding when and where these deaths occur, said Weston, would have "a lot of benefits," namely saving lives. That's been part of the thinking behind developing a new system from the state Department of Health Services called Wisconsin Suspected Overdose Alerts for Rapid Response, or WiSOARR.

WiSOARR went live Thursday, with the goal of providing public health partners near real-time data on where and when suspected overdoses are happening.

The system will automatically alert authorized users of where and when suspected overdoses occur, should the number exceed a threshold based on geographical information, said Michelle Haese, DHS director of substance use initiatives.

"It gives our substance use partners a faster and clearer understanding of when and where suspected overdoses are occurring in the communities, really helping to push steps forward in our ongoing work to better understand and respond to the drug overdose epidemic in Wisconsin," Haese said.

How does WiSOARR work? Data on suspected overdoses are gathered two ways: through the state's ambulance run systems and emergency room department visits, Haese said.

The data enable authorized users ― local and tribal health departments, as well as overdose prevention partners ― to monitor local trends, set and receive alerts around suspected overdose cluster sites, and connect communities to specific spike response resources, Haese said.

"Instead of a larger scale, one-size-fits-all statewide response to what is happening locally, this really homes in on the needs of each individual geographic community across the state of Wisconsin," Haese said. "We know data informs action, and that's foundational to public health."

What are the benefits of WiSOARR? Milwaukee's public health and emergency service officials lunged into action in April 2023 when 17 people died from overdoses over the course of 72 hours, translating into a death every four hours. Fentanyl played a lethal role.

Weston believes that if the county had access to WiSOARR, lives could have been saved in that deadly wave.

"When there's a cluster of overdoses, often there's a reason why," Weston said. "Getting the information even two hours later oftentimes is too late to really have an impact on the community."

WiSOARR could potentially help rapid response teams locate bad batches, a big culprit in overdose spikes. A batch might have a higher concentration of fentanyl or xylazine , a potent animal tranquilizer that made its way into the illicit drug scene in 2020.

Having the ability to distribute fentanyl and xylazine test strips ― one of the hallmarks of harm reduction ― can also lead to changes in behavior, Weston said. When people are given access to fentanyl test strips, studies demonstrate that four out of five people with an opioid use disorder administer them ahead of drug use.

Fentanyl is found in 93% of overdoses, so being able to test drugs ahead of use, Weston said, encourages people to take smaller doses, take the drugs with someone else present and have the opioid-reversing drug Naloxone nearby while they're using.

When will this system go into effect? Different counties and entities, such as Milwaukee County, have already been participating in pilot versions of the program, Haese and Weston both said.

It launched statewide Nov. 14.

Why is WiSOARR monitoring 'suspected' overdoses? It can take weeks for toxicology reports to confirm whether somebody died of a drug overdose, Weston said.

WiSOARR relies on emergency medical service experiences. If EMS feels the need to administer Naloxone to someone, often due to some telltale signs such as pinpoint pupils and decreased respiration levels, they'll report that as a suspected overdose, Weston said.

Those suspected overdose numbers feed into county data, enabling agencies to compare what they're seeing to statewide numbers and other counties across the state, Haese said.

The aim of the system is to help agencies locate, more generally, where spikes happen. It doesn't individually target anyone, Haese emphasize.

"That's important, because we want to make sure that the response is the focus, not the identity of who may be experiencing the suspected overdose," Haese said. "We want to make sure the awareness is on spikes, in order to save lives."

Natalie Eilbert covers mental health issues for the Milwaukee Journal Sentinel. She welcomes story tips and feedback. You can reach her at or view her X (Twitter) profile at .