NEW YORK: SURGING HIGH-RISK OPIOID USE CONTINUES TO DEMAND EMERGENCY NALOXONE REVERSALS FOR FAILED EXPERT MEDICAL TREATMENTS
The numbers don’t lie – small decreases in opioid overdose deaths entirely due to dramatically increased emergency naloxone use and reversals, not treatments, represent a worsening crisis
by Clark Miller
Published December 27, 2024
As in each of the 4 NIH HEAL study states predictably affirming (here and here) lethal impacts of America’s expert gold standard treatments for the opioid crisis, patterns and outcomes in New York communities continue to demonstrate the harm.
A post here from 2022 detailed the inescapable conclusions drawn from trends for emergency naloxone saves increasing in communities, opioid overdose deaths, and high-risk opioid use.
New evidence reaffirms its continuation.
From a report in The Journal News for New York State’s Lower Hudson Valley –
- In Westchester County, drug overdose deaths totaled 168 in 2023, the latest county-level federal provisional data show. That’s down about 16% from the prior year.
- Rockland County drug deaths declined from 51 to 48 during that span.
- And naloxone saved hundreds of opioid overdose victims during that span. Here is what you should know about carrying Narcan.
Those are small and welcomed reductions in opioid overdose deaths in the two counties for 2023, by 3 deaths in Rockland and about 32 in Westchester, it works out.
Civilians armed with naloxone leaped into action about 150 times in Westchester County to save lives with the opioid overdose reversal medication between 2021 and early this year, state data show. . . .
Police and EMS in Westchester also reported using naloxone about 1,900 times during that same span.
That’s a lot of reversals by use of Narcan, a lot of otherwise fatal opioid ODs prevented compared to a drop of only 32 deaths.
That almost doesn’t make sense.
Actually does – we’ll get to that.
That tally, however, was an undercount, as it only captured formally reported cases of family, friends and bystanders using Narcan — or other naloxone kits — to revive an opioid overdose victim.
That does make sense, because it is supported by evidence and direct reports, consistently, from all other locales we have information for.
The critically important information is the gain, or increase, over the 2022 to 2023 period in number of naloxone reversals from all sources, including a best estimate of those increasingly occurring in community settings and not formally reported, not becoming part of a dataset.
Why?
Because each of those reversals is an incidence of opioid overdose,
each opioid overdose an incidence of high-risk opioid use,
each incidence of high-risk opioid use a measure of the lethal failure of America’s expert, gold standard medical treatment (MAT, MOUD) of dispensing substitute opioids (buprenorphine or methadone), recently with relaxed safety standards.
The intensifying, increasingly effective Narcan campaign began in New York years ago, a decade ago, and by 2018 very large numbers of informally reported saves were eclipsing any magnitudes of opioid overdose death reductions.
From this 2019 report also from The Journal News –
First responders and everyday citizens used naloxone, the overdose-reversing drug, about 17,500 times last year across New York in an urgent push to keep those gripped by opioid addiction alive.
The tally comes as early statistics show drug overdose deaths nationally declined to 68,000 in 2018, the first major decline during an addiction epidemic that has claimed tens of thousands of people this decade, the USA TODAY Network reported.
17,500 times
in one year of an intensive, intensively funded campaign to increase distribution and use in community settings
Further proof of the dire struggle to save New Yorkers addicted to opioids included the reams of citizens who received training through the state’s Community Opioid Overdose Prevention programs, which accounted for another 1,759 naloxone uses outside New York City.
Naloxone use is tracked by authorities statewide and includes breakdowns by counties, such as the thousands of reports filed last year across the Finger Lakes, Hudson Valley and Southern Tier.
1,759 naloxone uses
in one year, of potentially fatal opioid overdose reversals by laypersons, tracked by a single state program,
those informally reported saves, not in any database, universally understood as gross undercounts of such layperson reversals in community settings
Overall, there were 7,703 naloxone use reports in New York City in 2018, as well as 9,831 in the rest of the state, the data show.
The statistics will likely increase as authorities finalize reports. Thousands of additional uses by law enforcement in New York City were unavailable due to separate tracking systems. Nassau County’s police statistics were incomplete for the same reason.
as well as 9,831 in the rest of the state,
a certain underestimate due to unreported community saves and inefficiencies in data availability, collection, and organization
Those inescapable conclusions?
That the reported increases year-by-year of naloxone reversals in New York and consistently elsewhere literally leave no prevented opioid overdose deaths in those locales to possibly be accounted for by other factors, factors like America’s gold standard MAT substitute opioid treatment, or rehab, or “addiction treatment”.
The year-to-year drops in opioid overdose prevented deaths are all accounted for by increasing Narcan saves, accounted for many times over.
To dispute that requires supporting with evidence the argument that compared to prior years, many hundreds or thousands more each year of potentially fatal opioid ODs were not prevented in those years by successful, targeted provision of naloxone as described.
There is no question or uncertainty
regarding how to understand the sudden, recent fatal opioid OD decreases, correlated with Narcan campaigns. The question is how to understand that the drops were by such small magnitudes compared to the known increases in Narcan saves, when over the same periods provision of expert, gold standard treatments in the locales was also increasing.
That question, it turns out, has been answered, has been established for years.
We are led to the point of necessarily facing some incontrovertible, unequivocal facts and conclusions driven by the evidence we’ve been considering.
– Intervention communities in the NIH study successfully implemented naloxone campaigns that resulted in reversals of potentially fatal opioid overdoses by hundreds if not thousands more each year
– That would have, necessarily, reduced opioid overdose deaths in those intervention communities compared to control communities and overall for the control versus intervention groups of communities.
– That means, necessarily and indisputably – because overall, there were no differences in OD deaths between groups – that there had to have been other forces unique to the intervention communities that increased opioid overdose deaths.
That conclusion is inescapable.
Inescapable and foreseeable, predictable.
Because we know exactly why opioid deaths increased in those intervention communities, the increases masked and balanced by the effects of Narcan saves, with the net result of no statistically detected differences compared to control group. That has been established here, in hundreds of posts marshaling the relevant evidence, for years.
It turns out, as explained and established here in multiple posts, that precisely as in the avoidable – avoidable if not for the cowardice and gross incompetence of American Media – generation of the opioid crisis as we know it enabled by fabrications by America’s medical/research/media collusion, there has never, not ever, been a legitimate body of research evidence to confidently establish, let alone strongly support, the use of substitute opioids (bupe or methadone) as treatments or as beneficial for opioid dependence.
Instead, all lines of diverse evidence point to what should be obvious – the runaway dispensing of opioids that are routinely used with other, illicit opioids (methadone), and/or serve as consumable, commodity and currency in street economies of illicit high-risk opioid use (bupe) have in fact fueled the lethal epidemic.
The most potent ways in which the “miracle” doctor-dispensed pills and other magic potions predict failure is to instill in compulsive substance users the belief that passive interventions to adjust brain chemistry are “treatments”, are addressing a generic neurobiological block or deficit or disease of the brain that explains addiction, instead lethally instilling passivity, dependence and lies, and robbing compulsive substance users of the necessary factor established as central to stopping problem use, self-efficacy, the shift to belief in one’s own competence, autonomy, strength, and effective use of resources with inner psychological change to do away with the compulsion to escape distressing inner states by use of chemicals.
The anomalous and most remarkable feature of tbe reporting on opioid overdose trends in the news pieces from The News Journal, both by reporter David Robinson, is what the writer is not inhibited to convey – the obvious.
That comes through in language used to describe the intensive, dramatic, focused, targeted naloxone campaigns that have in states distributed hundreds of thousands, millions of Narcan units and naloxone kits, described by Mr. Robinson as being “in an urgent push to keep those gripped by opioid addiction alive” and a “”dire struggle to save New Yorkers addicted to opioids“.
One reporter who gets it.
He gets the obvious truth and is not afraid to express it – that there have, out of desperate necessity, emerged dramatic, well-funded, volunteer-supported, intensive campaigns to implement and support life-saving use of Narcan precisely because prior to them, without them, there was no end in sight for persistent, skyrocketing increases in high-risk opioid use and overdose deaths, while expert medical and other gold standard treatments were increasing in availability and use, pre-pandemic, through pandemic, and post-pandemic.
Naloxone campaigns represent desperate escalation of harm reduction measures to moderate a continually worsening crisis fueled by expert treatment approaches.
