MEET THE NEW OPIOID CRISIS, SAME AS THE OLD OPIOID CRISIS BUT MORE INTRACTABLY LETHAL
America’s expert/media collusion has started covering it. Don’t get fooled again.
by Clark Miller
Published December 5, 2025
Fresh from an Exclusive Revealing Analysis of what opioid epidemic trends actually mean, and following initial coverage of an emerging ominous turn of the crisis, The Guardian in true form again forays dimly and with greater harm than illumination into the depths of America’s worsening opioid crisis.
The Guardian’s 4,000-word piece is overwhelmed by 17 oversized images of daily life for two men whose high-risk opioid use and emergency revivals left them with high levels of severity of an epidemic condition: post-opioid-overdose mental impairment tied to cumulative effects of hypoxia (oxygen deprivation) and ischemia (blood flow deprivation) in overdose events, described here.
The images reinforce the day-in-the-life structure and focus of the piece, overdose survivors JB and Kyle on the severe end of the hypoxia-impaired scale, with recovery barriers, challenges, and failures that elicit our sadness, compassion, frustration, and dismay for them and for the prospects of avoiding a coming tsunami of outcomes like theirs.
The “reporting” is little more than those stories, is ultimately – in avoiding the clear forces and circumstances that led to their condition and that of the less severely yet impaired, hidden, untold millions of others – an abject failure to begin to protect against worsening of the new, insidious crisis.
It follows initial reporting here at ACD on the phenomenon, its relationship to recent desperate successful naloxone campaigns with increasingly common serial OD reversals that account entirely for widespread drops in OD deaths, and its meaning, in this September 26 post (seen first here by loyal ACD readers).
There are bits and pieces of relevant and valuable information provided, helping us understand how we got to this hidden, grave threat of dual, mutually reinforcing crises and what must be faced to escape its course. From the Guardian piece –
JB’s story highlights a cruel irony: while overdose deaths have declined, thanks in part to the life-saving drug naloxone (better known by the brand name Narcan), more people are surviving with serious, sometimes devastating complications.
This is the epidemic within the epidemic – one we rarely count. …
No one knows how many people survive opioid overdoses. The CDC’s best estimate is that for every fatal overdose, there are 15 non-fatal ones – which puts their number at well over 1m [million] annually in recent years. …
Experts believe brain injuries can occur after four or five minutes of inadequate respiration. The longer the brain and body go without sufficient oxygen, the worse injuries are likely to be – but outcomes remain a bit of a black box. …
Because fentanyl crosses the blood-brain barrier so easily, it can trigger an overdose within minutes, leading to respiratory depression and cardiac arrest. “You have a faster onset and a narrower window to intervene,” said Erin Winstanley, a professor of medicine at the University of Pittsburgh.
At the same time, naloxone has saved millions of lives: pharmacies sold 12.9m doses between October 2002 and September 2023. Yet each revived overdose also means another survivor left at risk of lasting complications.
It is also increasingly common for people to live through not just one, but multiple overdoses. Jon Zibbell, an epidemiologist who studies adverse health outcomes among people who inject and smoke street drugs, became concerned about the phenomenon as he witnessed people repeatedly overdosing on fentanyl and being revived by Narcan.
[emphasis added]
While expert treatments generate high-risk use and overdose, the single, emergency moderator of the lethality of those failed systems, naloxone, ultimately serves to leave those serially “saved” less and less capable of engaging in actual evidence-based treatments, more and more vulnerable to impulsive, compulsive, high-risk substance use.
That’s the new opioid crisis
Yes, now and increasingly, associated with intensive, widespread, successful naloxone campaigns that have saturated communities with rescue units, in the hands of peer high-risk users, passers-by, laypersons, and others more proximate to overdoses, serial saves are becoming more and more common, a way of life for high-risk users. That news has slipped into major media reports, here for example and here, its import only to be buried to protect against the unallowable disruptions and threats posed by truths revealed.
The truth that naloxone campaigns are established as the only factor and as fully accounting for all recent drops in opioid overdose deaths, no other factors supported by evidence as significantly contributing.
The truth that the desperate need for those emergency campaigns has arisen precisely due to the lethal failure of American experts’ gold standard medical treatments and failure of nonmedical “addiction treatment” to reduce high-risk opioid use, persistently increasing while naloxone campaigns reduce fatal outcomes of that high-risk use.
And the truth is that while convenient scapegoats gain intense media attention in successful efforts to hide the true roots of high-risk substance use, desperate avoidance remains a barrier to initiation of efforts and use of resources to build effective prevention programs aimed at where vulnerability to dangerous substance use begins – in childhood, in American families.
Those truths establish and foretell, incontrovertibly, the profoundly wrong and predictable lethal outcomes that follow from trusting in degraded, negligent, reckless systems of power and their media servants to protect public health with medical solutions for entirely nonmedical conditions, displacing, distracting, and robbing resources from actual evidence-based, never-developed, psychosocial treatments and prevention.
While expert treatments generate harm, the sole, emergency moderator of the lethality of those failed systems, naloxone, ultimately serves to render those serially “saved” less and less capable of engaging in actual evidence-based treatments, more and more vulnerable to impulsive, compulsive, high-risk substance use.
That’s the new opioid crisis, latent yet never recognized or faced within the 4000-word Guardian’s day-in-the-life piece, the new crisis remaining driven by the abject failures of the trusted institutions that generated it.
More from the piece –
That survival is, on its face, a triumph of advocacy and harm-reduction policy. But Zibbell now worries about the cumulative toll. People he knew often felt “off-kilter” after a single overdose; what happens after a series of them?
He hypothesizes that the repeated injuries may be somewhat analogous to what happens with a cluster of mini-strokes – or to football players who, after multiple minor concussions, develop chronic traumatic encephalopathy (CTE), a devastating neurodegenerative disease. But it is going unnoticed, he adds, because non-fatal overdoses are perceived as harmless, and because their effects are often not obvious.
He and his co-authors flagged the issue in a federal report on the health consequences of non-fatal overdoses back in 2019. “I believe it’s a silent epidemic of many non-fatal overdoses,” he told me.
There’s no need to hypothesize,
because extensive research establishes the impairing effects of brain blood flow and oxygen deprivation generally and for overdose and serial overdose.
From the post at ACD predating the Guardian piece by about a month –
- Hypoxia vs. Anoxia: While HIBI often involves anoxia (total lack of oxygen), overdose-induced breathing suppression more often causes hypoxia (insufficient oxygen). Less severe or fluctuating hypoxia may not produce the acute, visible damage characteristic of HIBI, but it can still affect brain cells.
- Subtle but persistent deficits: Even if a survivor is revived quickly, any duration of oxygen deprivation can lead to long-term cognitive and neurological problems that may not be severe enough for a formal HIBI diagnosis.
- Targeted damage: Some areas of the brain, such as the hippocampus (responsible for memory) and the cerebral white matter, are particularly sensitive to low oxygen levels. Damage to these areas may result in specific deficits without the widespread injury associated with a HIBI diagnosis.
- Cumulative effects: Research suggests that repeated opioid overdose events, even non-fatal ones, increase the risk of long-term damage due to repeated and prolonged hypoxia. This cumulative effect can cause damage to white matter over time.
That’s AI-generated, so don’t believe it. Seriously.
Except in this case, do take it very seriously, because the research supports that summary.
From this 2019 research review, for example, by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
NFOO = Non-Fatal Opioid-involved Overdose
OIRD = Opioid-Induced Respiratory Depression
Differences in Effects of Overdoses between Single, Multiple, and Recurring Opioid Overdose
Differential health complications associated with single, multiple, and recurring opioid overdose were identified. Most notable is the identification of a strong correlation between prior and future NFOO events, as persons experiencing a single NFOO event were found more likely to experience a future overdose event in their lifetime; ergo, a person’s overdose risk increases with every overdose they experience (Olfson et al., 2018; Darke et al., 2014). NFOO victims who experience multiple/recurring opioid overdose are shown to be at greater risk for long-term physical and cognitive consequences resulting from OIRD than persons experiencing a single overdose. (Darke et al., 2007). Repeatedly subjecting the brain to a deficiency of oxygen is shown to cause damage to the white matter of the brain (King, Morris, & Schahmann, 2015), and the risk for neurophysiological consequences increases with the both number of times a person experiences a hypoxic/anoxic event and the duration of each event (Beeskow et al., 2018).
In plain language and as increasingly described for American communities, (here, here, and here for example) the desperately needed, intensive, successful campaigns that have flooded locales with naloxone are having foreboding collateral effects. Rather than – as for high-risk users diagnosed with HIBI – being hospitalized, placed in a care facility, or incapacitated, opioid overdose survivors are being revived to walk away, access opioids again, overdose and be revived again.
The types of less acute and still profoundly impactful cumulative effects are messaged in a flyer produced by NASHIA, the National Association of State Head Injury Administrators.
Back to our current post and again from The Guardian –
Meanwhile, in the field of addiction medicine, cognitive dysfunction is so common it often goes unremarked.
“I’m certain we’d find a ton of neurocognitive dysfunction if we screened everybody,” said Dr Joshua Blum, an addiction specialist in Colorado. “But we don’t screen, so we don’t know how big the problem is.”
Physicians told me these impairments – missed appointments, difficulty following instructions – are an underappreciated barrier to recovery.
“It’s maddening to ask someone to commit to recovery when that part of their brain isn’t working,” said Dr Lara Carson Weinstein, who runs a Philadelphia program for patients with substance use disorders.
That should be “maddening”, it is maddening, particularly because degradation of mental capacities with each medical-“treatment”-failure-driven overdose works against effective engagement in the sole evidence-based treatments of compulsive substance use: individual talk therapies and associated psychosocial supports. And maddening because effective prevention does not exist, is something America flees from in horror and denial.
Even more maddening
is the Guardian’s headline, “The hidden victims of the opioid crisis: the ones who lived“
“victims of the opioid crisis”
How deftly that leaves out everything important, goes around everything crucial to calling out those responsible and demanding change.
Take some time to attempt to conceptualize the “opioid crisis” – that word describing the epidemiological phenomenon of millions of Americans having become trapped in compulsive opioid use, at risk of death, and dying – as something that can victimize those comprising it. How does that work exactly?
Right.
That language the perfect expression of the cowardice, evasion, and use of social capital by which America’s health and media institutions construct your reality to avoid incrimination and protect power.
Not victims of …
Not victims of the parents, other family members and other adults who inflicted on them the ACE, psychological and emotional injuries, and traumas that are established as developmentally predicting vulnerability to problem substance use?
Not victims of the medical, media and public health institutions – those trusted with responsibility for protecting public welfare against corporate depredation – who colluded to flood America with opioids? Against all relevant and available evidence? Including that opioids don’t actually treat pain?
Not victims of the cowardice of the licensed medical providers – their doctors – whose signatures were required for every opioid pill released from a pharmacy? Whose training would have provided them with every reason to know better?
Not victims of a $ multi-billion-dollar treatment industry that has never effectively treated “addiction“?
Not victims of popularizers of sham medical model lies that compulsive substance use and pain are medical conditions, absurd, never-supported lies that “addiction” is a disease of the brain?
Not victims of the persistent lies of constructed “experts” not remotely capable of forming cogent thoughts about compulsive substance use and its treatment?
Not victims of the dispensers and shills for gold standard medical cures established as causing harm, of fueling their high-risk use?
Not victims of American courts and judges along with the cultural pathology that supports their use of judicial coercion – established as in violation of the constitutional right to be free of religious coercion – to force exposure of drug-related offenders to the bizarre, established-as-countertherapeutic (with 90 to 95% failure rates) practices and prescriptions of a religious subculture?
Not victims of a “treatment” industry that is rife with depredation and sham “treatment” practices, and is staffed by legacy and cronyism hires not remotely trained or capable of providing effective treatment for behavioral health conditions, let alone the complex set of psychological, developmental, and psychosocial forces driving life-threatening compulsive substance use?
Old crisis, new crisis. The perpetrators can count on protection, at any cost.
