MINNESOTA OPIOID DATA AFFIRM EXPERT TREATMENTS ARE DRIVING HIGH-RISK USE, INCREASING OVERDOSES, NARCAN REVERSALS AN ILLUSION OF GAINS
In Minnesota as consistently elsewhere, data affirm the longstanding obvious meaning of recent drops in opioid overdose deaths and of reported 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 November 1, 2024
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 CBS news piece –
MINNEAPOLIS — Drug overdose deaths in Minnesota dropped by 8% in 2023 compared to the year before, preliminary data from the state’s health department show. That’s the first decline since 2018, mirroring national trends.
Opioids, including highly potent fentanyl, make up a majority of all overdose deaths in the state. But the decrease, experts say, is a welcome sign that a heightened awareness about substance use and the wide availability of naloxone—the overdose reversal drug—are working.
But the fight isn’t over: Nonfatal opioid overdoses increased by 11%. And the number of people who died from cocaine and psychostimulants like methamphetamine increased.
“We definitely see that as a major step in the right direction” said Mary DeLaquil, an epidemiologist at the Minnesota Department of Health. “Hopefully with better access to treatment and better education, less stigma and everything else that goes along with the many people working on this in the state—both on the community and local public health level— we’ll see decreases across all metrics.”
Those opening paragraphs effectively reveal the continuation of false messaging of false hope fabricated by America’s medical/media collusion to hide what is increasingly unconcealable – that the surging Narcan reversals of potentially fatal opioid ODs entirely account for drops in deaths and point unavoidably to a worsening crisis driven by treatment failure evidenced by increasing nonfatal ODs and other valid measures.
Let’s take a look.
So, what was going on in Minnesota
in the period ahead of and during the 2023 decrease in opioid OD deaths, “for the first time in 5 years” ?
Well worth watching is the short video of the CBS news report in which community organization director Colleen Ronnei is interviewed on Narcan’s recent surge in distribution and accessibility,
“Now, it’s everywhere, stocked in schools, over-the-counter at pharmacies, and easily available in public places. She says the latest data show that people know about the opioid overdose reversal drug and are using it”.
That makes sense and fits with what we know, that due to an intensive Narcan campaign, “people know about the opioid overdose reversal drug and are using it”.
People in community settings, where the opioid overdoses are occurring.
In 2023, the Minnesota legislature passed in time for the upcoming school year laws that require all schools, law enforcement officials, emergency responders and residential treatment programs to have naloxone on hand.
Schools complied and added training for students on Narcan administration.
Described here, groups mandated to keep Narcan on hand for use beginning mid-2023 include –
Those DHS Licensed Programs, Corrections, and Sober Homes clearly are target settings for high-risk opioid use. And, critically importantly, like schools and all other community settings they are environments in which distribution and use of naloxone surged ahead of the lethal OD drop, each reversal by Narcan representing – constituting – an incidence of high risk opioid use, incidences not formally or in any organized way reported, and not included in the data for nonfatal opioid overdoses. The importance of that will soon be clear, if it’s not already.
But those successful efforts to flood Narcan into communities in Minnesota began well before the beginning of the year of 2023.
State-provided data on naloxone units distributed in Minnesota point to high numbers, comparable to intensive Narcan campaigns in other states, immediately antecedent to and through the period of recent drops in opioid overdose deaths, including calendar years 2022 – 2023; calendar year 2023; and fiscal year 2022 – 2023.
[Remedy Alliance is an organization that negotiates with pharmaceutical companies to provide Narcan at lowest cost to community partners who distribute Narcan directly to the populace.]
The evidence makes clear
that as in other locations consistently, an intensive Narcan campaign and its use in communities was responsible for the decrease in opioid overdose deaths in Minnesota.
To rule out or dismiss that conclusion requires an explanation that takes into account the described increases in Narcan provision, training, and community outreach, also reports from community-based workers in the area, and requires making a cogent argument that the 500,000 thousand or so units placed in community settings in the year prior to and during 2023, did not result in thousands of otherwise fatal opioid ODs being reversed.
It is a near certainty that the magnitude of the increasing incidence of nonfatal overdoses over the same period is a significant underestimate. Each use of naloxone to reverse a potentially fatal opioid OD is a “nonfatal overdose”, an instance of high-risk opioid use.
High-risk opioid use that you have been asked to believe is being prevented by American Medicine’s gold standard, proven cures, the substitute opioids buprenorphine and methadone.
In Minnesota, as elsewhere, the expert view is that the drop in opioid overdose deaths points to success tied to expert treatments and to the need to increase their provision.
“We definitely see that as a major step in the right direction” said Mary DeLaquil, an epidemiologist at the Minnesota Department of Health. “Hopefully with better access to treatment and better education, less stigma and everything else that goes along with the many people working on this in the state—both on the community and local public health level— we’ll see decreases across all metrics.”
We have the metric we need to understand,
it is nonfatal opioid overdoses, each a direct measure of high-risk opioid use and treatment failure.
Whether the reported 11 percent increase in nonfatal opioid ODs for 2023 is accurate or represents an insignificant change from prior years is largely irrelevant, because the state of Minnesota data are gross underestimates, coming from emergency department (ED) records, excluding nonfatal ODs occurring in community settings.
That leaves out the thousands of nonfatal ODs occurring in communities and not reported, due to surging community use of Narcan.
That is to say, at the same time that surging naloxone use more than accounts for reduced OD deaths, mounting high-risk opioid use – measured as nonfatal ODs – is persistently mounting.
Persistently surging high-risk opioid use
over years of increased provision of America’s expert, gold standard proven treatments for opioid use and the crisis.
Over years of an increasing trend in admissions to opioid treatment programs.
And over years of increased provision of those proven “life saving” treatments to Medicaid recipients.
And over years of increased numbers of medical professionals able to dispense the substitute opioids.
Those trends would have to represent progress against the lethal epidemic.
They would have to, wouldn’t they?
