NORTH CAROLINA – AS ELSEWHERE, RECENT SURGING NALOXONE OPIOID OVERDOSE REVERSALS EXPLAIN DROP IN DEATHS, AFFIRM A WORSENING CRISIS
An anomalous headline reveals the longstanding obvious meaning of recent drops in opioid overdose deaths and 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 October 11, 2024
The astoundingly accurate combination of original headline and associated feature image says it all.
The figures 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 AXIOS Raleigh news piece –
The number of fatal overdoses has declined rapidly in North Carolina over the last year — far outpacing how fast they’ve fallen nationally.
Why it matters: Overdoses kill more than 100,000 people in the U.S. a year — but the number appears to be dropping quickly, Axios’ Erica Pandey writes.
- The rate of deaths fell last year for the first time since before the pandemic, offering a hopeful milestone amid an epidemic that’s ravaged the nation for over two decades.
By the numbers: In the 12 months ending in April, there was a 10% decline in fatal overdoses nationally from the same period a year before, according to preliminary CDC data.
- In North Carolina, that figure dropped 23%.
That’s impressive!
It must mean something.
Right?
As conveyed by North Carolina Department of Health and Human Serviices (NCDHHS) spokesperson Summer Tonizzo, “Greater investment” in services to reduce deaths over the time period included “distribution of more than one million doses of naloxone (the generic name of Narcan, which reverses the effects of an overdose) to agencies serving those at highest risk for overdose.”
Let’s repeat that: “more than one million doses of naloxone” through agencies to individuals at highest risk of opioid overdose.
A focus in distribution of North Carolina’s $1.4 billion share of an opioid settlement has been “toward Narcan distribution and recovery services”.
That distribution has included getting some of the 1 million Narcan doses into schools.
The reported decrease of 23 percent is a comparison of opioid overdose deaths in the state from April 2023 to April 2024 compared to the previous 12 months.
So it appears that the decrease after years of mounting deaths is correlated strongly with the dramatic increase in getting Narcan into communities, to families, and to individuals at highest risk of overdose and death.
From a different news piece, the state reported that 50 Safer Syringe Programs across the state together distributed more than 100,000 naloxone kits over 2022-2023, getting them into the possession and living spaces of some of the most vulnerable individuals for opioid overdose.
Those programs report that provision of the kits has surged markedly over the past few years, as has the number of reversals of potentially lethal opioid overdoses by individuals receiving the kits.
Some of the recipients of naloxone kits reported their use for reversals, the 16,700 reversals reported to SSPs assumed to be an underreported amount, because “many” are simply not reported, a conclusion that cannot be reasonably doubted.
Let’s do the math.
Over a one-year period leading into the 12-month period over which North Carolina recorded an apparent significant decrease in opioid OD deaths, one type of harm-reduction program distributed to high-risk opioid users about 100,000 Narcan kits, about 1/10 (one-tenth) of the over one million kits distributed statewide immediately preceding the period of decreased deaths. The cumulative effects of dramatically increased provision of kits to individuals and families in communities would have had the effect of stocking, saturating, communities with the kits.
For just the kits distributed by SSPs, and an underestimate, the most recent increase in reported reversals (preventions of OD deaths) was about 1,400 (16.7 thousand minus 15.3 thousand) and trending up.
The data and the picture painted are imprecise, also unavoidably clear.
By any reasonable estimate based on available data and reports, use of Narcan kits to reduce deaths from opioid overdoses in North Carolina over the comparison period were more than enough to account for any and all of the decrease. That conclusion, of course, is supported also by the role of American expert gold standard opioid treatments, established as providing no benefit, instead fueling the lethal crisis, recently reinforced by the definitive outcomes of the recent largest ever NIH $344 million study invalidating benefit and affirming predictable harm.
The supported conclusions are inescapable.
Each and every Narcan reversal – increasingly occurring in community settings and not reported or publicly recorded – is a case of high-risk opioid use reflecting failure of treatment and prevention approaches.
Each and every Narcan reversal is an emergency measure to prevent a death from an underlying condition or high-risk behavior – as are instances of use of an AED for sudden heart failure – and in no sense constitutes gain against that underlying condition.
That is, each and every Narcan save and associated data point in fatal or nonfatal opioid overdose trends represents a life saved, or death forestalled, and as well represents a worsening public health crisis.
Heightening those uncomfortable and inescapable facts, nearly each day brings new reports on the predictable complication of emergence of new, more potent opioids and other drugs of abuse in opioid combinations, in lethal illicit economies including increasingly substances challenging the biochemical capacity of naloxone to continue to reverse overdoses.
In North Carolina, an advocate for reasonable, important, and valuable efforts to dispense Narcan kits through school settings suggested that
Narcan is “no different than an EpiPen or AED system or a fire extinguisher,” advocate Barbara Walsh told Wake County’s school board last spring, WRAL reported.
There is something to that suggestion and the comparisons, yet who would not see through and not be outraged by media and institutional portrayal of, for example, dramatic increases in community distribution of and use of AEDs to reduce deaths from sudden cardiac events as medical and public health triumphs through effective treatments against the condition of heart disease?
That is how America’s medical/media collusion is distorting evidence and fabricating medical misinformation for a vulnerable public on recent trends in fatal and nonfatal opioid overdoses, while continuing to push for more of the same harm-predicting “treatments” under increasingly relaxed safety standards.
The outcomes are predictable, have always been.
