IOWA, WITH NO EFFECTIVE NALOXONE RESPONSE, IS ANOTHER REVELATORY LETHAL EXCEPTION TO DRAMATIC U.S. DROP IN OPIOID CRISIS OVERDOSE DEATHS
As in South Dakota, San Francisco, Nevada, Tennessee, Utah and Washington: lack or delay of effective naloxone campaigns to reduce harm due to expert treatments predicts OD death trends
by Clark Miller
Published June 27, 2025
As late as October of last year, Iowa like a handful of other states was late to the game, late to the intensive, targeted, dramatically successful naloxone campaigns that would finally significantly reduce fatal opioid overdoses in nearly all other states.
CEDAR RAPIDS, Iowa — While most states in the U.S. have seen a sharp decrease in opioid-related overdose deaths, Iowa stands as an outlier.
According to the Centers for Disease Control and Prevention (CDC), national overdose deaths have decreased by 10% nationwide over the past year, but Iowa is the only midwestern state not following that trend, with overdose fatalities continuing to rise. ..
According to state records, Iowa has yet to allocate more than $47 million from its share of national opioid settlement funds, which were intended for prevention and treatment programs.
Lawmakers remain at odds over how to distribute the money, leaving it largely untouched. …
Naloxone Availability still lacking
Although naloxone, the life-saving opioid overdose reversal drug, is becoming easier to find in parts of Iowa—thanks to some local governments including Linn County using settlement funds to stock vending machines with the drug—it still isn’t widely available to those at the highest risk.
Dr. Weber emphasized that making naloxone more accessible is crucial to reducing fatalities.
“The most evidence-based way to use naloxone to reduce overdose deaths is really to make sure that our populations at our highest risk have it,” Weber said, adding that it should be free and widely available given the life-saving impact it can have.
Trust in Good Samaritan Law is critical
Another issue hindering Iowa’s ability to prevent overdose deaths is the limited effectiveness of its Good Samaritan law. The law is intended to protect people who call 911 to report an overdose, but Dr. Weber notes that skepticism and fear of legal consequences often stop drug users from seeking help
Iowa woefully, lethally late to implement the effective naloxone campaigns established as accounting entirely for recent (and early, back in 2018 in an Ohio county) drops in opioid overdose deaths across disparate states and locales.
Late and/or ineffective in distribution and training for use of naloxone, just as in Nevada, Colorado (upcoming post), neighboring South Dakota, Washington, Utah, and other locales and states.
As of May of this year, – last month – funds still held by legislative gridlock.
But not late, in Iowa, to dispense the street currency for fentanyl,
that currency also known as the medical cure “buprenorphine” or “Suboxone”, established as fueling overdose deaths and a worsening crisis, that harm most recently confirmed by a largest-ever NIH $344 million study.
Nor behind track on reckless dispensing of methadone, driving increasing deaths as dispensing safety standards relaxed over recent years.
In Iowa, expansion of American Medicine’s gold standard, unfortunately lethal, cure for the opioid crisis was under expansion pre-pandemic, in 2018, not relying on settlement funds, instead federal funding.
Now a new program that trains clinicians in medication-assisted treatment (MAT)—the gold standard for opioid use disorders—is available through the University of Iowa Department of Psychiatry. Training focuses on the proper use of buprenorphine, an approved medication used to treat opioid addiction, more commonly known by the brand name Suboxone. The drug targets the same brain receptors related to pleasure and memory that opioids, such as heroin, also target. Buprenorphine blocks cravings and prevents withdrawal symptoms.
“We want to provide a good, viable alternative that can potentially stabilize (our patients’) lives,” says Sharon Duclos, MD, co-medical director of the Waterloo clinic, who participated in MAT training. “It’s a great opportunity that will really benefit some people.
Duclos recently started a MAT clinic with a team of advanced practice providers. She says it’s important to integrate addiction treatment into a primary care setting.
“I’m just ready to get it started. I’m ready to write my first prescription,” Duclos says. “When you can go to your doctor and get most of your needs met, it makes all the difference in the world.”
Duclos joins a growing number of providers in eastern Iowa working to bring lifesaving treatment to their communities.
In September 2018, Alison Lynch, UI clinical professor of psychiatry and director of addictions medicine in the department, was awarded a three-year, $1.5 million grant from the Substance Abuse and Mental Health Services Administration to train clinicians in MAT. As of April 2019, she and her team had trained 89 providers, primarily in eastern Iowa. More training is being scheduled, including sessions in Mason City and at UI Health Care.
Lynch’s project not only aims to increase treatment availability in rural clinics across the state, but also in prisons and jails. The training is available to physicians, nurse practitioners, and physician assistants in a number of different specialties, including primary care and emergency medicine.
“It is great to see so many clinicians signing up for our training sessions,” Lynch says. “People who have taken our course tell us that they have a better understanding of opioid addiction and feel more prepared to treat it.”
So, Iowa isn’t an outlier at all.
Iowa follows the predictable pattern of opioid high-risk use, overdose, and fatal overdose being consistently driven primarily by the combination of 1) levels of dispersing and more recently relaxation of standards for dispensing, of American Medicine’s “proven” gold standard substitute opioid cures, established as fueling the crisis, and 2) emergence of desperate, intensive, targeted community-level naloxone campaigns necessary to moderate those lethal harms.
All that’s left is the mystification necessary to hide those truths in order to protect what must, more than anything else and at any cost, remain protected.
