Overdose deaths involving opioids in La Crosse County, which had ballooned to 19 in 2016 and fell to eight in 2017, continued the downward trend last year, when two fatalities were recorded.
“We saw a reduction last year, but we didn’t know if it was just a blip,” said Dr. Chris Eberlein, an ER doctor at Gundersen Health System and longtime battler against illegal drug use.
Although lamenting the loss of even two lives to prescription opioid use, Eberlein expressed optimism that several initiatives appear to be taking root.
“The decline started when we pushed education on proper prescriptions,” said Eberlein, co-chair of the La Crosse County Heroin and Other Illicit Drug Task Force, which reconfigured itself in September to become the Alliance to HEAL (Halting the Effects of Addiction Locally).
The education introduced prescribers to more alternatives to opioids, which has produced tangible results, he said, adding that quashing the opioid abuse epidemic will help combat other forms of illegal drug abuse, such as heroin.
“We’ve found that IV drug users started with opioids,” and thwarting that abuse is expected to filter down to other abuses in the next few years, he said.
Eberlein also cited the effectiveness of Wisconsin’s Prescription Drug Monitoring Program. Begun in 2014, PDMP gives drug prescribers and dispensers access to a database system that monitors patients’ controlled drug prescriptions to prevent overprescribing — either accidentally or illegally because of patient deception.
Without such programs, addicted patients freely resorted to tactics such as doctor-shopping, obtaining prescriptions from several doctors, unbeknownst to each other.
Despite PDMP restrictions, some people still manage to obtain and sell opioids, Eberlein said.
“Diversion is a big problem, and we need to make sure those who need medication get it, and those who need it don’t become abusers. It’s an ongoing struggle, but being down to two deaths indicate fewer are entering addiction,” Eberlein said.
The availability of Narcan, a life-saving drug that counteracts the effects of overdoses, has played a role since the task force began promoting it in 2014 and ’15, Eberlein said.
“Narcan’s role is more in IV drug use rather than prescription drugs,” he said. “Only now have we begun co-prescribing Narcan with opioids,” partly because patients hesitate to request it.
The decline in the number of deaths the past two years “is much more with prescriptions and mobilizing PDMP,” he said.
Eberlein also cited the importance of HEAL, “morphing from the original task force for this to take hold.”
HEAL is perusing all local programs that address addiction, often in divergent ways. It aims to identify service gaps and fashion a joint approach to create a continuum of care in a quest to eliminate addiction.
Guiding HEAL is the Institute for Healthcare Improvement, a Boston-based organization that using the county as a project to create a national model. The La Crosse Community Foundation provided a grant to provide $75,000 a year to the three-year, $400,000 project.
Also contributing to the project are Gundersen, Mayo Clinic Health System-Franciscan Healthcare and the La Crosse County Health Department.
New surge pricing for Uber has come to La Crosse, according to a companywide email Uber sent its drivers this week.
Passengers will now pay a flat fee instead of a percentage-based surcharge on the base fare during peak demand periods known as surges.
The new pricing system would benefit drivers by giving them longer, more reliable surges that take the guesswork out of pricing, Uber said in the email.
Uber began rolling out its new surge system in larger cities last year. Lyft has introduced similar changes to its peak demand pricing system, known as Prime Time, though not yet in La Crosse.
Uber driver Lance Schmeckpeper of Shelby said he was initially skeptical of the new system because it cuts into what drivers make on long rides.
Uber’s surge system works by incentivizing drivers to pick up passengers from areas where there are more passengers than drivers, such as in the city center after concerts or sports games. In La Crosse, high surge events include New Year’s Eve and Oktoberfest, when fares can reach as high as 5.5 times the going rate.
Under the old surge system, drivers made the most money when they accepted passengers who needed long rides during high surge windows.
Long surge rides are so rare they’re known as “unicorns” in the industry because drivers aren’t told where they’re taking their passengers until after they’ve agreed to the drive. Drivers also keep a larger portion of the fare on longer drives, about 70 percent, as opposed to shorter rides where the company takes about half, Schmeckpeper said.
After thinking it over, however, Schmeckpeper said flat surges could help drivers in a small to medium market like La Crosse, where about 90 percent of his trips are short.
Schmeckpeper considers anything within two miles a short ride, including trips between downtown La Crosse and the university campuses.
On Thursday nights and weekends, Schmeckpeper said he can expect a multiplier of 1.5 to 2 times the surge on a ride that normally costs passengers $6.80.
If the flat surge exceeds $3.40 to $6.80, passengers would pay more for that ride than they would under the old pricing system — which would in theory increase how much Schmeckpeper earns from the ride.
“That adds up if you have a lot of short runs with Thursday nights, weekends,” Schmeckpeper said. He noted that Friday night surges aren’t guaranteed because the bar scene tends to be quieter on Friday evenings.
Ryan Cornett, of La Crosse, who’s been driving Uber full time for about four months, said he prefers the old system because it’s more straightforward. “When I see a 2x surge, I know I’m getting double the rate.”
However, despite seeing online Reddit conversations where drivers didn’t seem too happy with the changes, Cornett said the changes could be good for local drivers and passengers.
Uber’s promise of more reliable surges, which would make the surge window up to three times longer, could incentivize drivers to drive more during bad weather, Cornett said.
The recent cold snap has kept him busy picking up passengers, including people using Uber for the first time because their cars broke down, Cornett said. “People need rides out there.”
MADISON — Gov. Tony Evers was set to warn against “playing politics” with his first state budget being released to a skeptical Republican Legislature on Thursday evening, a spending plan full of proposals that are likely dead on arrival or unlikely to pass without significant changes.
In an excerpt of the speech provided ahead of delivery, Evers called for allowing people in the state illegally to receive driver’s licenses and state ID cards. He planned to introduce someone who came to a budget listening session to talk about the need for driver’s licenses for immigrants and those here illegally, especially in communities where there’s limited access to public transportation.
“I shared that tonight so that everybody understands what’s at stake in choosing to play politics with this budget,” Evers said in the excerpt.
The budget’s unveiling during a joint meeting of the Legislature on Thursday night will kick off the monthslong process of lobbying, cajoling, bartering and begging to — hopefully — reach a deal that Evers and Republicans both agree to this summer.
Evers, a Democrat, has previewed much of what will be in his budget but hasn’t given details on how he will pay for all the ideas, which include a $1.4 billion boost in K-12 education funding, a 10 percent income tax cut and a $150 million boost for the University of Wisconsin.
The roughly $76 billion two-year spending plan affects nearly every person in Wisconsin. It will determine how much money goes to schools and prisons, the University of Wisconsin System and technical colleges, public assistance programs and corporate tax breaks.
The budget will also determine whether it will cost more to fill up at the gas station, go hunting or pitch a tent at a state park. And if Evers gets his way, the budget will make Medicaid available to 76,000 more people, legalize medical marijuana and establish a new process for drawing political boundaries free from partisan gerrymandering.
While Evers and Republicans who will vote on his plan have said they’re open to compromise, they’ve shown little willingness to work together so far. Evers has already vetoed a middle-class income tax cut Republicans passed, and now he plans to introduce his own version in the budget.
Republican leaders have warned Evers not to include “poison pills,” meaning proposals the GOP are sure to reject. That includes expanding Medicaid , as Evers has promised he will, decriminalizing marijuana and freezing enrollment in taxpayer-funded private voucher schools.
One of the biggest unknowns is what Evers’ transportation plan will be. He’s suggested that a gas tax increase, along with other possible fee hikes, is likely. Republicans have been divided on the best way to pay for roads in the past, and leaders this year have indicated that they favor looking at toll roads as a possibility.
Evers insists his budget reflects the will of the people, as expressed through his victory over Republican Scott Walker. But he needs to convince Republicans to go along, or much of what he wants will never be enacted.
The new budget year starts on July 1. If the Legislature has not passed a budget Evers can sign by then, the old one remains in effect.
In 2017, when Walker was governor and Republicans controlled the Legislature, disagreement over transportation funding delayed passage until September. In 2007, the last time there was divided government, the budget was not signed until October.