Project Description Narrative:
This project aims to tackle the intensifying drug overdose crisis in and around Milwaukee. In 2022, there were 5,585 recorded nonfatal drug overdoses in Milwaukee County and 655 fatal overdose deaths. The crisis of overdose deaths has intensified annually, almost doubling from 2018. In the last five years, 2,583 people died from drug overdose in Milwaukee. Despite the worsening public health crisis, there is still a significant shortage of primary care or addiction medicine clinicians that are regularly prescribing highly effective medications for opioid use disorder treatment (MOUD). Only 18% of patients with opioid use disorder are receiving first-line, evidence-based lifesaving treatment with medications, a proportion that has remained unchanged for the past decade. There is a pressing need to address the drug overdose crisis through workforce development.
The opioid crisis not only jeopardizes individual well-being, but also places a substantial burden on the healthcare system, emergency services, and the criminal justice system. The safety net is full of holes for people who use drugs (PWUD). The available resources for support are not well-suited to provide what is needed. Unsurprisingly, repeated utilization of emergency medical care services, housing and other social services, and disproportionate levels of incarceration and community supervision result. This crisis disproportionately affects communities suffering from significant socioeconomic challenges and causes these challenges for PWUD. These challenges make recovery incredibly difficult. Addressing substance use disorders in this context is crucial not only for individual health but also to reduce health disparities and enhance health equity. The proposed project encompasses a holistic approach to support PWUD.
This project’s primary focus is to establish an academic addiction medicine fellowship, based at the Forest Home Health Center, which will strengthen existing efforts to provide low-threshold care for PWUD, including MOUD. The Forest Home Health Center is located in the 53204 ZIP code, the Milwaukee community most heavily affected by the overdose crisis and one of the most disadvantaged communities in Milwaukee. Fellows will also provide inpatient clinical care for PWUD at Froedtert Hospital and the VA, helping relieve some of the strain on overburdened psychiatry and medicine services. This fellowship will play a pivotal role in delivering direct patient care to PWUD, integrating specific training in behavioral health interventions, and collaborating with community partners already serving this population. Fellows will provide education and support to resident physicians, thereby improving resident skill and attitude towards treating PWUD. Fellows will graduate with the tools to teach in or initiate fellowship training programs of their own.