On The Front Lines of Overdose Crisis

Amy Molinski, a peer support specialist with Community Medical Services, and Milwaukee firefighter Lieutenant Robert Rehberger meet a lot of people on what may be the worst  — or ultimately the best — day of their life.

Their job is to make contact with people who have recently overdosed and try to give them help.

Molinski and Rehberger serve on the city’s Milwaukee Overdose Response Initiative (MORI). Created in 2029, in response to the overdose crisis in the county, it is a partnership of the Milwaukee Fire Department, Milwaukee Health Department and community organizations to provide those who have overdosed with help navigating the drug treatment options available to them, or at the very least, giving them harm reduction kits that include opioid-reversing drugs like Narcan and fentanyl testing strips.

The opioid epidemic has been raging for more than a decade, but in recent years the number of overdose deaths has continued to worsen largely due to the increasing prevalence of dangerous synthetic opioids like fentanyl. In 2015, Fentanyl accounted for only 8% of all overdose deaths in the City of Milwaukee. Five years later, it would be found in approximately 73% of overdose deaths in the city. At the same time, the number of overdose deaths in Milwaukee County increased 60%.

The MORI program is composed of two teams, each with two firefighters and one peer specialist, like Molinski. Each day begins roughly the same way. First, the program supervisors, which includes Lieutenant Rehberger, look at fire department data on overdose calls from the previous day. Then the teams get in their cars and start driving the city, knocking on doors and working their way through the list.

Not every knock leads to treatment. Sometimes all they can do is try to talk to the person about their options and build trust. “We kind of meet them where they’re at,” Rehberger said, “whether that’s getting Narcan in their home or giving us giving them a business card… And a year later, they give us a call and we’re there.”

Molinski, who is in recovery herself, explained that the MORI teams are often overcoming deep-seated distrust. “I really was led to believe all those years using and even for a long time in early recovery, that other people didn’t care about people like me, especially professional people,” she said.

Sometimes the first visit leads to treatment. But even then, navigating the system is another hurdle to clear, even for professionals like Molinski and Rehberger.

The same day they spoke with Urban Milwaukee, they had been struggling to make a placement at a treatment center.

“We’ve been working with this guy for a year,” Molinski said. “We’ve taken him to detox several times per his request.”

For the first time, he had spent more than 24 hours in detox and he wanted treatment, she said. They spent hours trying to find him a bed, asking the hospital to extend his stay until they could place him somewhere. They made 17 different calls trying to get him into treatment.

“Most people that are struggling won’t make that many phone calls,” Molinski said. “They feel defeated after the first couple of no’s. And it’s not because they’re quitters. It’s just because they feel ashamed and embarrassed, and to continue to be told no, it’s sometimes more than that they can handle in that moment.”

The system has programs that work, like MORI, and residential treatment centers, and medication-assisted treatment. What it doesn’t have is enough of them.

“We need more medication-assisted treatment facilities scattered throughout the city,” Molinski said. “We need more beds available for residential, and we need a process that is actually conducive to people getting well, and it’s just not there.”

The job isn’t easy. But they both said it’s worth it, especially when they follow up with people they’ve helped and witness the progress they’ve made in their life. But with nearly 700 overdose deaths in Milwaukee County last year, not every story has a happy ending.

Though Molinski and Rehberger did get a small win that day they made 17 calls. “We did seem to have a plan for our guy,” Rehberger said. “Yeah, we got him a bed,” Molinski added.