1. Wyoming Land Area: 97,093.14 square miles
Population: 584,153 people
Land Area: 97, square miles
Population Density: 5.8 people per square mile
Introduce self
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First, let’s get to know Wyoming.
As the least populated state in the nation, Wyoming contains 584,153 people in its 97,093 square miles.
The two most populous towns are Cheyenne and Casper, which collectively account for about one-fifth of the state’s population. The remaining residents live in small towns, rural communities and frontier settings scattered throughout the state.
Wyoming is classified as a frontier state as it has less than 6.0 persons per square mile, as compared with an average of 90.3 persons per square mile in the United States.
The frontier nature of the state has engendered a culture and character conducive to substance abuse.
U.S. Census Bureau: State and County QuickFacts (2015)

2. Most people in Wyoming have seen this infographic that the media has utilized countless times or at least heard about the data. This places Wyoming as the second most deadly state for drug-related overdose deaths. The problem with this, is they lumped everything under one heading. The reality is…
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3. Wyoming’s here and is colored blue (point to it) which means the most abused substance causing death and drug of choice is alcohol. This does not mean that we have been immune to the opioid issues, but contrary to many reporters, Wyoming’s main public health concerns continue to be alcohol and suicide. ( data)
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4. Receiving Treatment: 3.4%
Opioid Deaths: 16.4 per 100,000
Estimated Need: 16,000
Receiving Treatment: 3.4%
In 2015, Wyoming’s age adjusted overdose death rate from opioids is 16.4 per 100, This places Wyoming 37th in the nation. (Wyoming Vital Records, 2015)
The most recent Treatment Episode Data Set (TEDS) data indicate that 545 Wyomingites were admitted to treatment with a primary substance of heroin or other opiates in In addition, in 2014 the National Survey of Drug and Health (NSDUH) indicated that approximately 16,000 Wyomingites age 12+ reported non-medical prescription drug use. Based on this information, we estimate that approximately 3.4% of the population who may be in need of treatment are receiving treatment.
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5. Beginnings of Prevention
Through the Partnerships for Success Grant and the Strategic Partnerships for Success Grant – Wyoming began general education and drug disposal practices.
Wyoming purchased drug disposal boxes and incinerators for the majority of law enforcement agencies within the state. In conjunction with this, also promoted the medication donation program.
In partnership with local coalitions and pharmacies, we distributed a number or at home Deterra drug deactivation kits and safe storage means such as locking pill bottles or larger lock boxes.
The Wyoming Rx Abuse Stakeholders (RAS) was formed around 2010 to address general prescription drug abuse issues, including coroner’s death data, policy changes, and overdose. Members of the RAS include the Board of Pharmacy, Board of Medicine, Board of Nursing, Wyoming Medical Society, Division of Criminal Investigations, Wyoming Department of Health, Women’s Civic League, the Governor’s Office, and more. In collaboration with the WDH, the RAS works to disseminate information as well as serve as a data collection location.
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6. Legislation Standing Orders Training Policies Reporting
The 2017 legislative session created the Emergency Administration of Opiate Antagonist Act that was effective on this past July 1. This statute provides legal, civil, and professional protections to those who administer naloxone. The statute does not include protections to those who report a potential opioid overdoes in the event that they are in possession of illegal substances. Such a bill, which offered immunity for overdose reporting, was introduced but failed to pass.
With this statute, changes that will take effect in Wyoming soon include –
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Standing orders – currently only one county out of 23 has created a county-wide standing order.
Training – mass training and education of the general population and first responders will begin soon. Wyoming is working with the online training module through getnaloxonenow.org to push out training as quickly as possible.
Policies – Entities utilizing naloxone must create and follow internal policies and practices that adhere to best practices, and
Reporting – Creation of mechanisms for reporting any time naloxone is administered. We are working with the application OpiRescue to provide an easy means of reporting through either a smart phone, tablet, or online website.
Also, Wyoming received 2 grants the STR and the PDO

7. Wyoming State Targeted Response to the Opioid Crisis – STR Grant
Increase treatment access
Reduce unmet treatment need
Reduce opioid overdose deaths
Wyoming received State Targeted Response to the Opioid Crisis (STR) grant funding in May The purpose of this project is to address the opioid crisis by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through the prevention, treatment, and recovery activities for opioid use disorder (OUD).
STR grant targets OUD treatment and recovery
Year 1 grant awards totaled $2 million dollars with another $2 million planned for in Year 2 of the grant cycle
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8. Needs Assessment Identified Counties Selected for Treatment Grant Awards
Schedule II Prescriptions
Prescribing Rates
Opioid Overdose Deaths
ER discharges
Inpatient Discharges
A science-based needs assessment was conducted to identify and address the opioid disorder crisis in Wyoming. Five indicators were use to determine where opioid misuse and related harms are most prevalent to include:
Wyoming PDMP Schedule II prescription fills
Opioid Prescribing Rates
Opioid Involved Overdose Deaths
Emergency room discharges and
Inpatient hospital discharges related to opioid overdoses
Wyoming’s rural and frontier nature is a risk factor for higher substance abuse rates and creates pockets of limited medical treatment access within certain counties. The whole state represents the population of focus for the STR with $1.8 million in STR grant funds going to 5 treatment agencies selected by region to deliver services statewide. Treatment services under the STR are expected to begin August, 2017.
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9. Building Treatment Capacity
Zero Opioid Treatment Programs
34 Certified Opioid Treatment Providers
Medication Assisted Treatment
Wyoming does not have any Opioid Treatment Programs (OTPs).
There are 34 certified opioid treatment providers with the majority located in Cheyenne and Casper. Wyoming is building OUD treatment capacity within its general treatment system, which delivers general outpatient and residential substance use disorder services throughout all counties in the state.
Two programs are currently providing MAT services through the SAMHSA MAT-PDO grant and five more programs will come online through the STR grant.
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10. STR Strategic Plan Activities
Access to Treatment
Telehealth
ECHO OUD Treatment
Media Campaigns
School and Community Programs
STR grant activities will improve access to treatment by increasing availability of transportation and use of telehealth. One treatment program will expand transportation services throughout five counties for persons who need support in traveling to treatment locations. We are expanding the use of telehealth services and are pursing the access of state purchased licenses of the Zoom platform. Expanding the use of videoconferencing may also support the development of an ECHO learning community on OUD treatment services and recovery support. The ECHO would build treatment provider capacity through trainings and technical assistance.
STR Prevention efforts will focus on providing education and information derived from the Opioid Overdose Prevention Toolkit. Media campaigns will focus on information for prescribers, patients and family members, and building community awareness. School education activities will be conducted at the University of Wyoming and several community colleges.
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11. PDO/Prevention Media and Information Dissemination
Safe Prescribing Practices
Naloxone Distribution
Training
Reporting
Beyond previously mentioned prevention activities that we will continue such as drug disposal and collaboration of stakeholders, through the Prescription Drug Opioid Overdose Grant and other collaborative funding, Wyoming is planning multiple prevention activities such as
Two media campaigns, One focused on drugged driving and another as a call to action to reduce abuse and educate on risk factors.
Utilizing PDMP data, Wyoming is educating prescribers on safer prescribing practices.
Distribution of Narcan Nasal Spray through a contract with Adapt Pharma
Training of general populations utilizing the getnaloxonenow.org training. EMS and Law Enforcement will receive more comprehensive information through in-person trainings.
Partnership with OpiRescue which is an smartphone app or website that allows for naloxone use reporting as well as extensive information on overdose signs/symptoms and how to administer naloxone.
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12. Challenges/Barriers Rural and Frontier Nature
Lack of Treatment Facilities
Lack of Recovery Supports
Sustainability
Legal
The rural/frontier nature of the state of Wyoming creates a number of challenges to addressing opioid abuse. The state’s rurality, already a risk factor for increased substance use in general, creates areas of limited medical and psychological treatment access for some individuals. This is evidenced by the complete absence of SAMHSA certified OTPs in the state and the fact that more than half of Wyoming counties are not served by a certified OBOT. Instead, Wyoming is served by a single RCO.
As such, many residents in the more remote areas of Wyoming are required to travel great distances in order to reach the nearest provider, which can be particularly difficult in the winter months due to inclement weather. Alarmingly, as mentioned prior, it is estimated that only 3.4% of the population who may be in need of treatment are actually receiving it, a rate that may well be due to the stigma associated with seeking substance use treatment in Wyoming, as well as the geographical and financial barriers that many Wyoming residents face.
In addition, there are a lack of recovery support initiatives throughout the state, with established recovery communities present in only two cities, and only 41 peer recovery specialists to serve the entire state.
Other than limited time federal funding, currently, there is no dedicated state funding for MAT or naloxone.
And statutes or other policies currently prevent the use of needle exchanges and reporting immunity.
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13. Opportunities
Despite these limitations, Wyoming’s prevention network extends to all 23 counties and has done substantial work to combat opioid abuse. Specifically, the WDH has worked for years to create a comprehensive and integrated prevention system throughout the entire state capable of changing direction quickly at the community level to address emerging issues.
and Although there is a lack of treatment and recovery facilities, existing facilities are highly dedicated to reducing the negative consequences through educating themselves and community partnerships.
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14. Contact Alexia Harrist MD, PhD State Epidemiologist
Chief, Public Health Sciences Section
Treatment
Marla Smith
STR Project Director
Community Services Unit Manger
Prevention
Erica Mathews
SPF PFS and PDO Project Director
Substance Abuse Prevention Program Manager