Milwaukee County’s overdose deaths fell to a decade low as harm-reduction access expanded citywide

Overdose fatalities drop sharply after record highs

Milwaukee County recorded 440 confirmed overdose deaths in 2024, a marked decline from 668 in 2023 and 674 in 2022, based on Medical Examiner data. The 2024 total is subject to change as toxicology results are finalized; county officials reported 85 cases still pending at the time of the most detailed year-end update, including 25 considered probable overdose deaths. Even if all probable cases are confirmed, the county’s 2024 total would still represent a reduction of more than 30% from the prior year.

The local decline follows a broader national downturn. Federal provisional estimates show U.S. drug overdose deaths fell substantially in 2024 compared with 2023, reaching the lowest annual level since before the COVID-19 pandemic.

What changed locally: faster distribution of life-saving supplies and follow-up outreach

Milwaukee’s recent progress has coincided with a strategy centered on widening access to overdose-reversal medication and drug-checking tools, while improving the speed and precision of data used to deploy resources. In 2023 and 2024, the county expanded a network of harm-reduction vending machines that provide free supplies. By August 2024, Milwaukee County reported 19 machines operating across the county after adding eight units to an earlier set.

The machines have been stocked with nasal naloxone and test strips used to detect substances such as fentanyl and xylazine in drugs. County reporting on the program said the vending machines distributed thousands of units of naloxone and fentanyl test strips over the first year of operation. The county has also used first-responder distribution models, including kits that pair naloxone with test strips, and post-overdose engagement efforts intended to connect people to services after emergency responses.

Data infrastructure becomes a public tool for targeting interventions

In February 2025, Milwaukee County launched an Overdose Dashboard designed to consolidate trends from Medical Examiner fatality records and Emergency Medical Services data. County officials described the dashboard as a planning tool for policymakers, public health agencies, community organizations, and researchers, intended to support more targeted outreach and more timely identification of emerging risks.

The dashboard grew from multi-agency collaboration, including an overdose case-review framework known as OD-PHAST, developed with support from a federal justice grant awarded in 2020. County materials describe OD-PHAST as a multidisciplinary effort to share near real-time information, review fatal overdoses, and translate findings into prevention strategies.

Funding and coordination: opioid settlements and multi-agency partnerships

Milwaukee County has reported recovering more than $100 million through opioid litigation settlements, with funds directed toward a range of overdose-reduction approaches, including distributing harm-reduction supplies, strengthening residential treatment capacity, and expanding data analytics. Separately, county emergency management officials have described work with local fire departments to develop follow-up and referral teams that can engage people after overdoses.

Key numbers at a glance

• Milwaukee County confirmed overdose deaths: 674 (2022), 668 (2023), 440 (2024 confirmed, with additional cases pending toxicology).
• City of Milwaukee fatal overdoses: 369 in 2024, described by city health officials as a 30% decrease compared with peak years from 2021–2023.
• County harm-reduction vending machines: 19 reported operating by August 2024.

Milwaukee’s declining overdose deaths reflect simultaneous changes in access to naloxone and testing supplies, post-overdose engagement, and a shift toward faster, shared data to guide interventions.