PUBLIC HEALTH CRISIS ROUNDUP: SERIOUSLY? A NALOXONE PATCH? OD DEATH DROPS A MYSTERY? YOU’RE CALLING IT “TREATMENT”? SUBSTANCES CONTROL US?
Health and medical news and reports have become ridiculous parody, but humorless, instead lethal
by Clark Miller
Published September 11, 2026
The remarkable news report, appearing in a local affiliate, was carried by a major national news outlet, CNBC, and possibly others. That seems important to remember.
BLACKSBURG, Va. – Researchers at Virginia Tech are testing a small wearable patch that can detect fentanyl in a person’s system and automatically release naloxone — no bystander required.
The device, called the iNal patch, is smaller than a penny. It uses nanoparticles loaded with naloxone and embedded in 121 microneedle tips. When those nanoparticles sense fentanyl, they open and deliver the drug directly through the skin.
“When our nanoparticle detected the fentanyl, it will open the gate and release the naloxone inside,” said Penghui Zhao, a visiting instructor at Virginia Tech’s Academy of Integrated Science who helped develop the technology.
.. Lab and mouse trials have shown promising results, according to the researchers.
What could be more promising and exciting than news of a new potentially game-changing cure for high-risk opioid use, on top of so many game-changer cures to have come along recently?
The patch is “smart”! Just like the top medical and public health researchers and experts we depend on for our safety and well-being.
And! It will work “without anyone present”. High-risk opioid users will be able to feel confident engaging in high-risk use even when they are not in proximity to other users, no longer dependent on that collective practice that evolved over the past decade or so and has saved so many lives.
Game changer.
From the very same Virginia Tech where vaccines are being readied to solve high-risk opioid use.
And with promising outcomes for the smart patch! –
“Lab and mouse trials have shown promising results, according to the researchers“
In a sober synchronicity, this critique of the exciting new opioid death game-changer appeared –
Abstract
Opioid overdose is a leading cause of preventable mortality, particularly in cases where no bystander is present to initiate timely intervention. Closed-loop opioid overdose reversal (CLOOR) systems have been proposed as a solution for solitary overdose events. In this Perspective, we outline the scientific, technological, regulatory and translational challenges unique to these systems. We provide an integrated assessment of CLOOR technologies through a three-component framework: sensing strategies for detecting overdose; feedback-controlled antidote-delivery architectures; and control algorithms for interpreting physiological data. Importantly, we examine key gaps in the translation of CLOOR systems, including the absence of validated biomarkers and limited clinical evidence, and address important translational factors, such as patient acceptability, stigma and the regulatory landscape for autonomous overdose-reversal devices. By synthesizing engineering, clinical, regulatory and public health perspectives, we aim to clarify priority areas for innovation and outline considerations essential for advancing these life-saving systems towards practical implementation.
[emphasis added]
That’s one way to put it, and further explanation and analyses are behind a paywall.
What seems most valuable is for readers to take time to imagine – considering that at present the devices can detect fentanyl in the user, not reliable measures of overdose – what levels of motivation, inhibitions, mistrust, and profound ambivalence a high-risk opioid user might have using something like this.
And, not likely considered behind the nature article paywall, all sarcasm and snark suspended, the gravest threat may likely come if it works.
In the existing, evolved ecologies of high-risk opioid use and natural support (peers, family, others proximate carrying naloxone), the confidence gained by high-risk users in reduced risk of overdose death established by intensive, targeted, community-based naloxone campaigns has fostered a new reality of that use, each repeated reversal associated with biological and neurological changes that further impair judgment, emotional regulation, and capacity to benefit from real (psychotherapy) treatments and protective factors like employment and effective interpersonal functioning.
Naloxone is a dead end. Pun intended.
Let’s move on,
to an American think tank, as we have before, this time The Commonwealth Fund.
Spoiler alert: there is no indication in this report, not even in “HOW WE CONDUCTED THIS STUDY”, that anyone involved read and sought understanding of, let alone critically evaluated, the research and evidence marshaled to support widely published and universally-accepted explanations of natural changes and claims regarding the effectiveness, evidence-based support, and benefit from the variety of “treatments”, public health policies, and other approaches that are assumed in this report to have contributed to reduced drug overdose deaths.
(The report addresses overdose deaths for all drugs, not just opioids, which in the U.S. consistently account for the large majority of OD deaths.)
That approach is congruent with the conclusions and summaries offered.
Conclusion: A combination of policies, changing drug supply, and behavioral changes among people who use drugs may have contributed to reduced overdose deaths. Several U.S. states have offered greater access to naloxone and fentanyl testing strips. Medicaid expansion has also provided coverage and access to medication for opioid use disorder to a wider U.S. population. Several countries have implemented programs designed to reduce drug-related deaths among people recently released from prison who face a dramatically higher risk of overdose. Efforts to improve data collection and coordination, including monitoring the drug supply at the local level, have also helped support overdose-reduction efforts.
To paraphrase:
Well, we certainly found that many different changes and public health approaches likely have been working to reduce drug overdose deaths, and we learned that by reading a lot of reports in which experts explained why those changes and approaches have been reducing deaths.
That’s why we note the importance of continued funding for and implementation of those approaches.
And, as in another recent analysis, we hope that our really cool graphics will mesmerize readers to distract them from the fact that no one involved in this article is remotely capable of forming thoughts about whether the expert claims and explanations for factors contributing to reduced deaths are accurate, or if they are lethal lies.
“fentanyl testing strips”?
No, no evidence that they have prevented deaths.
“changing drug supply“?
No, see links above, and here.
Reduced drug deaths for “people recently released from prison” by provision of the common street currency for fentanyl, aka “buprenorphine?
No, that’s a lie too. The outcomes have been predictable. See also here and here and here.
And?
“Several U.S. states have offered greater access to naloxone”
Seriously? “Several U.S. states”?
Essentially all U.S. states have been engaged in intensive, well-resourced, effective, desperate naloxone campaigns so successful, in fact, that they more than account for all drops in opioid overdose deaths over recent years, leaving no avoided deaths to be accounted for by any other means. That’s established in scores of analyses for many U.S. states, cities, and locales here.
Let’s move on,
to consider research that was undertaken to determine which of American Medicine’s two opioid cure meds most commonly dispensed to diseased brains, – proven, gold standard, “miracle molecule” cures – is actually more miraculous. Research published in America’s top medical journal.
Let’s avoid the absurd pretense of a legitimate research article to get to the salient points, the first from the co-authors of the JAMA study –
“The short treatment durations, high rates of mortality, and repeat opioid overdose among this group of individuals who started recommended treatments for [opioid use disorder] highlight the importance of improving treatment outcomes in this high-risk group,” they concluded.
“highlight the importance of improving treatment outcomes in this high-risk group”
AI is envious of that writing.
Here’s the second point, again from the MEDPAGE TODAY piece, more direct and truthful, from independent reviewers –
“The most noteworthy finding of the study … may not be the potential modest relative differences between medications, but rather the persistently poor outcomes observed among overdose survivors regardless of treatment choice,” Wood and Naji wrote. “Approximately 6% of participants died within 1 year, more than one-quarter experienced another overdose, and nearly 90% discontinued treatment during follow-up.”
That comes a bit closer to an informed, legitimate response to the original research and report.
But, Seriously?
The most salient, valid concern is about the lethal absurdity of using the word “treatment” in the MEDPAGE TODAY piece, in the JAMA article, anywhere and everywhere that “treatment” is used to refer to the medical provision of methadone or buprenorphine to someone experiencing problem, compulsive opioid use (“addiction“).
Yes, I mean that literally, 100 percent.
Neither are supported by evidence as functioning as providing beneficial effects for stopping high-risk or compulsive use of opioids, let alone saving lives, those fictions established as lies in scores of analyses over the past 8 years here at A Critical Discourse.
Just as in the case of the powerful, universal consensus allowing runaway medical misprescribing of opioids that generated the crisis as we know it based on ….nothing … nothing fabricated as if it were scientific evidence, the supporting research has never been there, always having been invalidated by confounding factors and multiple additional errors in research validity and interpretation. And increasingly invalidated by all lines of relevant evidence, as here.
A reasonable way to better understand the deceit of a body of research evidence supporting buprenorphine and methadone as “treatments” for opioid use disorder, read this recent article on why, despite the frenzied excitement and forgone conclusions, the research on benefit from the hallucinogen ibogaine for PTSD symptoms is inconclusive, cannot support benefit until and unless confounding factors – things occurring over the same time period that subjects were possibly benefiting from ibogaine and that reasonably could account for some or all of the reported beneficial effects – are ruled out and/or controlled for in future studies. The piece is well written and in an informal style.
For buprenorphine and methadone, the main confounding factor has always been the real, established life-saving effects of naloxone and its association with engagement in healthcare visits and other environments in which high-risk users, by virtue of receiving those drugs and associated services, would certainly, predictably be more likely to gain potential protective factors related to naloxone provision and use.
They are, in fact, not “treatments”, because there is a lack of research evidence that they have provided benefit and overwhelming evidence that they do not.
Let’s move on,
to obesity, GLP-1 medications, and beyond, to confront the fictions required to escape facing the roots of compulsive substance use and its underlying emotional distress, at any cost.
[from a transcript of the remarks of Laura Schmidt, PhD, of the University of California San Francisco]
Trying to solve the problem by defining obesity as a medical condition that needs treatment with these medications means that we’re taking our eyes off the ball when it comes to really thinking about the food environment as the driver of the problem. …
We know from clinical trials that ultraprocessed foods cause obesity. They make people overeat and they make people eat more calories than an unprocessed diet. So if that’s the driver of the problem, anything we do to medicalize obesity is kind of moving us in the wrong direction. …
We can have GLP-1s for people who already have cardiometabolic disease and they seem very effective. So we can have that for the people who are already suffering and then we can be preventing at the same time the emergence of more obesity, especially in kids through these food environment reforms.
[emphasis added]
It’s hard to not want to fully embrace this researcher’s sentiments when she starts with the obvious, forbidden truth that,
“defining obesity as a medical condition”
is wrong and predicts harm.
But not that hard, when the remainder of her analysis is so far off and just as potentially lethal as medicalization of the entirely non-medical condition as was medicalization of chronic pain.
But, SERIOUSLY?
“We know from clinical trials that ultraprocessed foods cause obesity. They make people overeat and they make people eat more calories than an unprocessed diet.”
We could, very generously, pass that off as intentional hyperbole intended for the effect of powerful emphasis. But it’s not, because the expert clinical and policy recommendations are entirely congruent with those fantastical assertions, to target only the substance abused itself, and its sources, as if, for example, parents are not responsible for the “food environment” in their own homes.
We have seen the same, absurd, nonsensical, escapist consensus elsewhere, in performance of the scapegoating (and here) necessary to flee from accurate understanding of the forces (and here) driving the opioid crisis.
And we must not ignore the fiction and the public health focus generated from it, because taken seriously, that is lethal.
One can easily disabuse oneself of the assertion that mood-altering substances, like food, used compulsively with adverse effects, control us, that we are powerless against them, and that they “make people” overuse them by simply considering the evidence, including the fact that problem, compulsive substance use, “dependence”, (or “addiction”), is established by longstanding epidemiological studies, to end in the large majority of cases when the user chooses to.
If that assertion were true about ultraprocessed foods, then, for example, either all of the children or none of the children growing up in a family, with no other outcomes, or in a foster home with lots of kids, or in a culture, or other shared environment, would end up obese. Because the determining factor is the control of ultraprocessed food.
Etc., etc., etc.
The same rudimentary critical reasoning disputes the absurdity that opioids themselves, or any other substance whose use can lead to dependence, cause individuals to become dependent on them, with development of adverse effects. Of the millions of Americans who were recklessly overprescribed opioids in the run-up to the crisis, a small portion became dependent, not even a majority.
And, most fundamentally, we know why and what forces generated the vulnerability of that small minority resulting in persistent, problem, compulsive use.
Those horrible answers that your culture must flee from are exactly what must be faced in the childhood obesity epidemic.
From a recent post –
Some things are beginning to tie together, and that’s important if we are to begin to face a latent youth health crisis.
Overeating and obesity in youth, with rare exception, are the result of unconscious, compulsive, soothing behaviors providing the very strong reward of distraction from or moderation of the discomfort of inner states like confusion, worry, emotional pain, fear, others … “stress”. That’s explained here (scroll down).
Compulsive food use is no different psychologically, behaviorally, clinically or diagnostically from other mood-altering substances, including the applicability of DSM diagnostic criteria.
The primary difference is that, unlike as with food, with extremely rare exceptions, America’s parents generally do not for other mood-altering substances (e.g, alcohol, THC, opioids) provide children unrestricted access to, model harmful misuse of, and/or encourage use as a way to soothe and distract their children to cope with the parents’ own overwhelming stress. Just with food.
The same – psychological, emotional – forces drive initiation of compulsive nicotine use in youth, contributing to not just risk of prediabtes, but multiple, magnifying stressors and conditions as well including sleep problems and pain perception.
It all ties together and comes in the context of America’s top experts distorting the outcomes and validity of national surveys that are methodologically fatally flawed, disguising or hiding signs of worsening youth substance use epidemics.
The unifying factor is stress: parent stress, child stress, family stress, increasingly worsened by multiple factors over past years including a disruptive pandemic and public health response that left children disoriented, behind, unconnected, without safe refuge, and/or missing from care after school closures; generalized heightened insecurity and role overload for parents and children attempting to cope with financial, material, social, world, and environmental threats and instability; adult substance use epidemics impacting families by deaths and impairments.
Lacking social or family support, functional mental health and public health systems, and humane social safety nets, stress generates attempts to cope by transient soothing relief from compulsive use of substances and behaviors whose costs exacerbate illness and stress.
Back to our current post, and to more medical news that should help us understand the gravity of public health crises facing us. The barriers to change are formidable.
The encouraging news from this report? – the implicit recognition that “emotional eating” is a thing, real and driving juvenile obesity.
The disturbing, harm-predicting disclosures and exposures of medical model conceptualization of the problem? – the rest of it.
In this secondary analysis, patients with an emotional eating phenotype lost more weight when they participated in a lifestyle program that directly addressed the emotional factors driving their eating. These patients also reported less anxiety, fewer emotional eating behaviors, and greater confidence in managing eating during stressful situations. These improvements suggest that emotional eating should not simply be viewed as an obstacle to weight loss. It is something we can identify and treat.
[emphasis added]
Duh.
But,”something we can identify and treat”?
No, because the very nature of compulsive use of food – or any other mood-altering substance – for a gain related to moderation by mental/emotional numbing of inner distress is strictly a psychological and psychosocial phenomenon, the effective therapies behavioral and psychosocial, identifying medical professionals as entirely out of scope of practice and predicting harms of types persistently generated i.e. obesity and substance use epidemics.
The findings also have practical value for clinicians. Most of us do not have access to formal obesity phenotyping in everyday practice, but we can still identify patients whose eating is closely tied to stress, anxiety, or mood through careful history-taking and validated questionnaires. For these patients, adding cognitive behavioral therapy, mindfulness strategies, health coaching, or behavioral health support may improve outcomes beyond standard nutrition and exercise counseling. These approaches can also complement anti-obesity medications rather than replace them. …
That is an important step as obesity medicine continues to move toward more personalized care.
[emphasis added]
No, really … seriously?
Obesity starts in childhood and, almost invariably, is due to ACE inflicted on children by dysfunctional parents. The advice for interventions, above, “For these patients,”, for any child of preadolescent age or younger, is lethally misguided medical misinformation. For those children, the focus of treatment is psychotherapy – with the parents – targeting their pathological parenting toward ending the infliction of stress, and worse, on their children. Is there a pill for that?
Right.
The use of “anti-obesity medications“, reinforcing passivity and external locus of control, robs children and adults of agency, responsibility, and the key, necessary element for gaining management of any compulsive, problem substance use: self-efficacy.
And “obesity medicine” = addiction medicine.
Seriously.
