IN CHICAGO AS ELSEWHERE – SURGING NALOXONE OVERDOSE REVERSALS EXPLAIN DROP IN DEATHS, AFFIRM WORSENING OPIOID CRISIS
In Chicago as consistently elsewhere, data affirm the longstanding obvious meaning of recent drops in opioid overdose deaths and not in nonfatal overdoses – desperate intensive Narcan campaigns to moderate deaths due to continuously mounting high risk use and treatment failure represent a worsening crisis
by Clark Miller
Published February 14 , 2025
The numbers don’t lie, nor do the front line healthcare, community, and support workers who are witnessing first-hand the intensively expanding distribution, training, effective use, and outcomes of campaigns to make the potentially lethal opioid overdose reversal agent naloxone more accessible in communities.
Consider, from the Chicago Tribune news piece –
CHICAGO — Chicago and Cook County are on pace to see a drastic decline in opioid-related fatalities in 2024, keeping with a nationwide downturn in fatal drug overdoses since the peak of the COVID-19 pandemic. . . .
“Whereas we have seen opioid overdoses spike over the summer for the past several years, this year we saw that, other than May when we saw that big spike over the city, we have seen, generally, a tapering of that trend in the summer,” said Dr. Miao Jenny Hua, medical director of behavioral health at the Chicago Department of Public Health. “Essentially, we flattened the curve in the summer months.”
While overdose deaths dropped rapidly, nonfatal overdoses appeared to remain high, per an NBC 5 News report,
The city’s Department of Public Health said that on Saturday alone EMS responded to 50 overdoses. That number almost doubled compared to an average day of 27 last year.
Dr. Hua offered impressions on how the sudden decreases in deaths could be understood.
“Some of our efforts at stemming the root causes of overdoses, at responding to this as a public health crisis, such as getting people into treatment, making sure that there are fewer people actually living with unmanaged substance use disorder, those type of efforts are likely not driving this more recent, precipitous decline . . .
So far, so good, then Dr. Hua adding,
and it’s more supply-chain-related,” Hua said.
OOPS !
She had in mind the reports (same article) that –
NPR reported earlier this week that the supply of fentanyl — an opioid present in the vast majority of fatal overdoses in Cook County — entering the United States was greatly curtailed in recent months, both by efforts to stop it at the border and through government pressure to address the supply of precursor chemicals in other countries.
As far as we know, Dr. Hua did not go on to provide additional explanation along the lines of,
When high-risk users on the street find it harder to get their drug of choice, in this case fentanyl, instead of then switching to any other combination of drugs readily available on the street that may include some combination of other opioids, stimulants, stimulant-opioid combinations, or any combination including the new synthetics or animal tranquilizer drugs available to them, they stop engaging in high-risk drug use and protect themselves against risk of overdose. That’s why we saw the drop. And that’s why law enforcement efforts to stop drugs from being available on the streets is key to ending the crisis.
Dr. Hua did not say that.
As far as we know.
She might as well, though. It would have fit and captured her understanding of the issues.
Another explanation came from an Illinois DEA official.
“Fentanyl remains the deadliest drug threat facing our country, and the DEA remains focused on the mission of saving lives throughout Illinois, Indiana and Wisconsin,” Luis Agostini, a spokesperson for the DEA’s Chicago office, said in a statement. “The recent decrease in opioid-related deaths and fentanyl poisonings is a reflection of the shared commitment between federal, state and local law enforcement in holding fentanyl traffickers accountable, as well as the individuals and organizations working tirelessly in the prevention, education, treatment and recovery spaces.”
As far as we know, Mr. Agostini did not go on to provide additional explanation along the lines of,
The war on drugs has been effective over decades now in preventing and moderating deadly substance use epidemics. That’s why we are committed to doubling down on our interdictions and why we saw the sudden, anomalous drop in overdose deaths over past months. Just as effective over decades have been traditional education, prevention, and addiction treatment.
Mr. Agostini did not say that.
As far as we know.
He might as well, though. It would have fit and captured his understanding of the issues.
Back in the real world of America’s worsening opioid crisis:
Overdose deaths remained high over 2023 for Cook County and Chicago.
Then something happened.
Over the summer, the city bolstered its outreach efforts, going door-to-door in West Side neighborhoods to distribute intranasal Narcan kits — also available at all Chicago Public Library branches — and working with the state to operate a 24/7 opioid crisis hotline. Between mid-May and late August, CDPH handed out more than 1,000 Narcan kits and more than 10,000 fentanyl test strips, according to the department.
That description, it turns out, is a gross underrepresentation of what suddenly became an intensive, highly targeted, successful naloxone (Narcan) campaign in Chicago, beginning early in 2024.
From this NBC 5 News piece dated May 16, 2024 –
Outreach workers set up a table Thursday morning in Chicago’s North Lawndale neighborhood to give away free Narcan and Fentanyl test strips to anyone who needs them.
“I think it’s very important because you’re meeting people firsthand,” said outreach worker Ralph McNabb said. “Not only the ones that are on drugs, but you see the people who are pushing the drugs.”
McNabb is part of the West Side Heroin and Opioid Task Force. He’s been in the community for the past year training people on how to use the nasal spray and test strips. . . .
North Lawndale is one of five neighborhoods in Chicago where health officials said they have seen an increase in opioid overdoses in recent weeks. Thirty-four percent of EMS calls for overdoses last year were in those same five neighborhoods. The list includes West Garfield Park, East Garfield Park, Austin and Humboldt Park. . . .
The city’s Department of Public Health said that on Saturday alone EMS responded to 50 overdoses. That number almost doubled compared to an average day of 27 last year. The health commissioner addressed those concerns at a committee hearing Wednesday. . . .
CDPH is doubling down on its harm reduction strategies. The commissioner said the goal this summer is to flood impacted neighborhoods with more resources, like access to Narcan, harm reduction education and connection to treatment.
“We have the supply. There is no shortage,” said Dr. Ige. “We can get as many as you want, but how do we get it to people that need it? That’s our ask.”
The city said more than 6,000 Narcan doses have been distributed in the past year on the West Side . . .
Additional acute response efforts to get overdose-reversing naloxone where it was needed began around the first of this year.
From a CBS News report in December of 2023 –
Thus, the plan is to get the antidote to places where it is needed most.
“This is what we’re supposed to do. Government is supposed to work together with the community, with the people who we serve, and what we’re doing today makes sense,” said Dr. Jane Gubser, executive director of the Cook County Department of Corrections. . . .
On Tuesday, McFarland, of the Lawndale Christian Legal Center, was back to teach Gonzalez a new life-saving step. He showed Gonzalez how to take off the needle cap, go right into the patient’s thigh, and press the needle for two seconds.
McFarland said he and his group have trained the entire first shift at the gas station.
With help from the Cook County Sheriff’s office, McFarland will get busy training clerks at 15 gas stations. . . .
“It’s really taking the antidote right to the problem,” said Cook County Sheriff Tom Dart.
After seeing what CBS 2 captured on camera with McFarland over the summer, Sheriff Dart has partnered with him to get more than 2,000 Zimhi doses donated. By the start of the New Year, 15 gas stations will also have their shelves stocked with the opioid overdose reversal drug – to give out in areas where the overdoses keep spiking.
In Chicago as elsewhere consistently, flooding high-risk ares with naloxone, often with training, led to otherwise unexplainable, unprecedented reductions of opioid overdose deaths. That is really good news, for the lives saved.
And,
In Chicago as elsewhere, surging opioid overdose deaths were reduced as a result of desperate, effective, targeted, successful efforts to dramatically increase use of naloxone in community settings for emergency revivals of incidences of high-risk opioid use, the reduction pointing to a worsening crisis of high-risk opioid use demanding such Narcan campaigns as a form of harm reduction.
A worsening crisis requiring dramatic harm reduction efforts while American experts’ gold standard treatments were increasing in availability and use.
And while Narcan’s days are numbered.
