According to The Substance Abuse and Mental Health Services Administration (SAMHSA), Recovery Month is “a national observance held every September to promote and support new evidence-based treatment and recovery practices, the emergence of a strong and proud recovery community, and the dedication of service providers and community members across the nation who make recovery in all its forms possible.”

In 2020, SAMHSA enlisted community members to manage the Recovery Month observance and identified Faces & Voices of Recovery to lead the charge. The organization’s mission is, “Changing the way addiction and recovery are understood and embraced through advocacy, education and leadership.”

Trends in Overdose Deaths

Locally, in Madison and Dane County, we’ve experienced increases in drug overdoses, substance and alcohol use, mental health crisis, and suicides. Public Health Madison & Dane County from their Drug Overdose Deaths Dane County Annual Report 2022 (Note: Data updated through 2020) highlight the following key takeaways:

• The number of people who died of a drug overdose death from 2018 to 2020 was 43% higher than from 2014 to 2016 (254–365).
• 86% of all drug overdose deaths involved an opioid from 2018 to 2020.
• We often talk about opioid deaths in waves. The first wave, which started in the 1990s, was driven by prescription opioids, the second wave, which started in 2010, was driven by heroin. The third wave in 2013, was driven by synthetic opioids (illicit fentanyl, specifically). We are now in a fourth wave, characterized by polydrug—or multiple drug—overdose deaths.
• More than half of all people who died of an overdose death from 2018 to 2020 were between the ages of 25 and 44 years old.
• 78% of all people who died from a drug overdose in Dane County from 2018 to 2020 were white. However, Black people in Dane County experienced a disproportionate rate of overdoses in 2018 to 2020 and were three times as likely to die of an overdose than white people.

Impact on Our LGBTQ+ Community Members

Unfortunately, Public Health Madison & Dane County does not collect data from our LGBTQ+ community. Substance use disorder and mental illness among LGBTQ+ adults, from the most recent nationwide information from SAMHSA from 2019, reports:

• 18.3% (2.6 million) people 18 year or older had a substance use disorder (SUD)
• 12.9% (1.9 million) people 18 year or older had BOTH a SUD and a mental illness
• 47.4% (6.8 million) people aged 18 or older had a mental illness

Anecdotally, recovery treatment, mental health, and healthcare providers report that since the pandemic began in 2020 SUD, alcohol, drug overdoses, mental health crisis, and suicides have increased in disproportionately affected communities, including LGBTQ+.

Harm Reduction Strategies

Since we are in the midst of a drug overdose, SUD, and mental health crisis, it’s important to remember that harm reduction saves lives. Harm reduction includes promoting the concept of “never use alone,” encouraging the use of fentanyl test strips, and warning users not to mix drugs. Fentanyl is present in illicit drugs other than just heroin and opioids, so harm reduction practices need to be applied when using meth, marijuana, etc. In the past, 12-Step programs like Alcoholics Anonymous and Narcotics Anonymous required complete abstinence as a measure of recovery success. Now, harm reduction recognizes that any reduction in use and the addition of safe practices and peer support are a first step to recovery. 

Following are harm reduction strategies:

Address Stigma and Bias

• Expand culturally appropriate services
• Trauma-informed judicial practices

Good Samaritan Laws

• Alternative responses

Substance Use Prevention

• Address ACE’s (Adverse Childhood Experiences)
& youth substance use

Support for Families

• Increase overdose education &
Narcan distribution training
• Support services for family members

Traumatic Loss

• Grief support training for providers
• Process traumatic loss in treatment center

Harm Reduction Saves Lives

• Promote “never use alone”

Risk Mitigation

• EMS leaves behind a program
• Emergency Department take-home programs
• Naloxzone boxes

Access to Care

• Expand outside of traditional hours
• Integrate primary care and behavioral health services

Ending Deaths from Despair Task Force

As a member of Dane County’s Ending Deaths from Despair Task Force, representing OutReach and our LGBTQ+ community, I meet monthly with a coalition of 26 people, including mental health providers, first responders, and court and community advocates. We focus on ways to prevent death by suicide, alcoholism, and drug overdoses.

“In spite of our strong local economy, active social networks and excellent health care, Dane County has not been spared losses caused by the opioid overdose epidemic and suicide,” said County Executive Joe Parisi. “We continue to see unnecessary loss of life and harm to families and can’t stand by and watch this trend continue. The task force is intensifying our efforts to end preventable deaths by expanding county created initiatives and implementing new strategies to save lives.”

The coalition’s initiatives include monthly recorded webinars which began in May and will continue into 2023, available on YouTube (safercommunity.net website). Following is the coalition’s 2022–23 strategy at a glance:

• Reduce drug harm
• Use data to prevent alcohol/drug harm
• Reduce access to lethal means
• Promote health care best practice to prevent suicide
• Prevention awareness and skill building
• Improve treatment access
• Reduce access to drugs
• Tipping the Pain Scale  

As part of September Recovery Month, a special screening of Tipping the Pain Scale is scheduled for Wednesday, September 28 at 7:30 p.m. at Marcus Theaters Ultra Point Cinemas at 7825 Big Sky Drive in Madison. Tickets are $12 and can be reserved in advance on the Gathr Films website.

The screening will be introduced by members of the Madison recovery community, Charlie Daniel, Founder of the African American Opioid Coalition; Tom Farley of Rosecrance Addiction Treatment Center; and Linda Lenzke, OutReach LGBTQ+ Community Center, LGBTQ+ AODA Advocate.

From the Gathr Films event website “Tipping the Pain Scale is a feature documentary film following individuals grappling with the current systematic failures of how we have dealt with addiction in communities and their journey to develop new, innovative, and often controversial solutions to the problem. It is a quasi-anthology, weaving characters through their own stories as they connect to the issues plaguing all communities and the country in an urgent fight to save lives.”

As the film says, “Addiction isn’t a choice. Compassion is.” 

 Harm Reduction Resources & References

• OutReach LGBTQ+ Community Center
• Faces & Voices of Recovery (Recovery Month)
• Public Health Madison & Dane County
• Safe Communities
• Dane County Ending Deaths from Despair Task Force
• Behavioral Health Resource Center Dane County
• 988 Crisis & Suicide Lifeline (Wisconsin)
• Tipping the Pain Scale (National Recovery Month,
Madison Screening) gathr.us/screening/32081.

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Linda Lenzke (she/her) is the LGBTQ+ AODA (Alcohol & Other Drug Abuse) Advocate for the OutReach LGBTQ+ Community Center. Linda recently completed Wisconsin Certified Peer-Specialist Training.