OPIOID CRISIS FATAL OVERDOSE TRENDS – NOT “HOPEFUL”, NOT “BAFFLING”, BUT REQUIRING THOSE LIES TO MYSTIFY CAUSES
Evidence unequivocally establishes that Narcan campaigns account for fatal opioid OD reductions, triggering desperate lies to hide the cause of persistently surging high-risk use and overdose requiring the emergency reversals
by Clark Miller
Published June 20, 2025
From a recent NPR report –
Over the past six months, I’ve been tracking something really cool and mysterious happening on American streets. For the first time in 30 years, drug deaths are plunging at a rate that addiction experts say is hopeful — but also baffling.
It’s not “hopeful” at all, instead one type among others of evidence of a worsening crisis, because the very need and desperate implementation of intensive, successful naloxone campaigns are driven by persistently surging increases in high-risk opioid use and overdose – while Narcan’s effectiveness in complex evolving economies of street drugs is at risk.
And not “baffling” at all, those campaigns more than accounting for all drops in opioid overdose deaths across varied locales and settings consistently, the apparent exceptions to trends proving that rule.
In the past, even the most ambitious, well-funded efforts to slow drug deaths only helped a little bit. Reducing fatal overdoses by 8% or 9% was seen as a huge win.
So, the omissions and deceptions begin immediately, because they are required.
In fact, dramatic reductions in opioid overdose deaths were achieved in an Ohio county 7 years ago, by implementation of an effective Narcan campaign.
America’s medical/media collusion is adept at creating rationalizations and explanations related to lethal public health crises.
Let’s take a look.
Weaker fentanyl. Street fentanyl is incredibly potent. But in many parts of the U.S., organizations that test fentanyl doses sold by drug dealers — often in pill form — have found a significant drop in purity. No one’s sure why drug cartels have changed their mixtures. Some researchers believe law enforcement pressure in China, Mexico and the U.S. is disrupting the black market fentanyl supply chain.
Was fentanyl weaker back in 2018 when naloxone campaigns caused dramatic drops in opioid OD dealths in Utah and Ohio? Stronger?
Is today’s fentanyl weaker than heroin was back before fentanyl came along? Were opioid OD deaths dropping back then? With the commonly misused street opioid orders of magnitude weaker than fentanyl? Or were deaths mounting?
In any case, the types of supply chain disruptions that are presumed to lowered potency of street fentanyl would be generalized, across states and locales – the opposite of what is apparent for the drops in OD deaths – highly variable, with seemingly inexplicable exceptions to trends (but in fact affirming those trends).
A dangerous but less lethal street drug supply. In most of the the U.S., gangs are selling complicated “cocktails” of street drugs. The amount of fentanyl appears to be dropping (see above), while the amount of animal tranquilizers, such as medetomidine and xylazine, is rising. These chemicals are highly toxic. They cause skin wounds, severe withdrawal symptoms and other long-term health problems. But doctors and addiction experts generally agree they aren’t as immediately lethal as fentanyl. That could mean more chronic illness but fewer fatal overdoses.
There was no tranq around back in 208 in Utah and Ohio when Narcan saves drove dramatic drops in opioid OD deaths.
The evidence is clear, extensive, and consistent. Dramatic increases over time in magnitude of naloxone saves more than account for numbers of opioid OD deaths reduced, by the hundreds and thousands.
Those reduced deaths by emergency revival are directly observed and some portion documented.
A “less lethal street drug supply” because of adulterants including tranq and other animal tranquilizers? And, “That could mean …fewer fatal overdoses”?
It “could mean” ?
Would one of the “doctors and addiction experts” mind providing some concrete evidence that, say, at least 10 fewer fatal overdoses occurred in a state for a recent year due to “less lethal” drug cocktails ? Evidence of 1 fewer fatal overdose?
And the timeline exceptions prove the rule – it’s the Narcan, entirely, reducing harm predicted by gold standard medical cures.
And? Remember that stimulant + opioid “fourth wave” predominantly driving fentanyl overdose deaths? The surging trend confirmed in the massive, recent NIH study in which fatal opioid overdoses dropped only for users of stimulants contaminated by fentanyl, NOT for high-risk users of opioids with or without contamination by tranq ?
Right.
Would one of the experts endorsing this “theory” mind providing evidence that the (potentially lethal) fentanyl as contaminant in or used with stimulants of lower potency or its effects moderated by tranq also in the stimulants?
Evidence?
And in any case: street fentanyl use with or without contamination by tranq, other adulterants = high risk opioid use, and high-risk opioid use = perpetuation of gold standard expert (medical MAT) treatment failure.
Better public health. Thirty years after the U.S. opioid crisis began — and a decade after fentanyl spread nationwide — the U.S. has made strides developing better and more affordable services for people experiencing addiction. Medications that reduce opioid cravings, including buprenorphine and methadone, are more widely available, in part because of insurance coverage provided by Medicaid. In many states, roughly $50 billion in opioid settlement money paid out by corporations is also starting to help.
If that’s true … could one of the addiction experts cite some of the evidence that those “better and more affordable services” have recently or ever provided protection against or benefit for deaths and other costs of problem opioid use? Just an example or two of the evidence? An RCT or two that are NOT confounded by differential effects of Narcan provision and saves?
Maybe a Medicaid expansion study or two that shows that?
In contrast to this recent research –
And this analysis –
But … there must be some body of scientific evidence, somewhere, that establishes the unified consensus – of benefit from expert gold standard treatments – over decades of increasingly lethal crisis, that goes without saying.
The alternative, of no benefit or harm, would simply be unbearable, unthinkable, would have to be put out of mind, or mystified.
As it turns out, predictably, those “intricate and groundbreaking” outcomes on analysis incontrovertibly confirm longstanding established lethal effects of expert gold standard medical treatments fueling the worsening crisis, medication assisted treatment (MAT) lethal failure further reinforced by critical analysis of HCS post hoc secondary statistical tests intended to cover treatment failure.
The question might have arisen, a priori, what possible need there could have been for a publicly funded $344 million study needed at this point to assess what has stood for decades by universal medical, media, research and institutional consensus as the “proven” gold standard cure for high-risk opioid use and the opioid crisis?
Cures already “established” for decades as reducing opioid overdose deaths for decades by 50%, $344 million to investigate … what? Instead of using $344 million to expand access to the already proven medical cures in a lethal epidemic?
They’re counting on you to not think about any of this.
Many of the most vulnerable people have already died. This theory is discounted by some researchers I talk to, but many addiction experts think it’s a factor. Over the past five years, the U.S. has been losing roughly 110,000 people to fatal drug overdoses every year. It’s possible drug deaths are declining in part because a heartbreaking number of people using fentanyl and other high-risk street drugs simply didn’t survive.
“It’s possible …”
Many things are possible.
Including holding the belief that America’s “researchers”, expert class, medical/media collusion functionaries, and “addiction experts” possess competent adult minds capable of understanding research and forming cogent thoughts related to problem substance use and the related research. It must be possible – many seem to hold that very belief.
This useful distraction, this desperately needed mystification, is not, no more than any of the preceding, a “theory” at all, instead representation of diminished capacity for research literacy and for critical thought.
Did the same effect occur back around 7 years ago, 2018, pre-pandemic? Dramatically in Ohio and Utah, while coincidentally naloxone campaigns and saves accounted for all reduced fatal ODs ?
Have “susceptibles” (individuals remaining at high risk for fatal opioid overdose) become scarce in San Francisco ? Where recently opioid OD deaths finally dropped, now are surging again, the number of susceptibles somehow replenished over a matter of months?
Bottom line –
Susceptibles, as defined, are individuals engaging in high-risk opioid and other drug use making them vulnerable and at relatively high probability of dying due to fatal overdose, of becoming part of the count of fatal opioid overdoses. There are valid measures of drug use that is high-risk for fatal opioid overdose, and from those measures we know from the relevant evidence (for example here and here and here ) that high-risk use is persistently increasing – the persistently increasing high risk use that has required intensive emergency naloxone campaigns to moderate incidence of fatal ODs.
Evidence-free mystification, driven by culpability, delayed moral development, and diminished capacity for thought, is not “theory”.
Waning effect of the COVID pandemic. The isolation, trauma and disruption of addiction treatment programs that followed the onset of COVID in 2020 overlap with the most devastating years of drug overdose deaths. Many public health experts believe the pandemic deepened the catastrophic impacts of fentanyl. According to this theory, as the impacts of COVID continue to fade, deadly overdoses are also declining to a more “normal” level.
COVID effects dissipated by 2021 – 2022, with no evidence of continuing “isolation, trauma, and disruption” effects related to problem substance use, with at least one very significant exception.
With clearly no widespread pattern of gradual drops in fatal opioid ODs related to any “waning” covid effects that “continue to fade”, instead dramatic, asynchronous drops tied to naloxone campaigns.
WIth instead highly variable patterns and timelines of dramatic drops in opioid OD deaths that correspond tightly to naloxone campaigns and medical dispensing of street currency for fentanyl.
And with “exceptions” that prove that rule.
“isolation” ? No.
“trauma” ? as evidenced by … ?
“disruption of treatment” ? American expert medical and non-medical gold standard treatments for opioid dependence have been essentially universally available at little to no cost pre-pandemic, pandemic, and post-pandemic periods, with intensified, expanded dispensing beginning within months of pandemic onset.
And? Declines in “deadly overdoses” (= fatal opioid overdoses) do not measure severity of the epidemic, instead reflect directly measured emergency Narcan saves, not gains in treatment reducing high-risk opioid use.
And, nonfatal overdoses are undercounted and a valid measure of high-risk opioid use that is continuing to surge, as such, a valid measure of expert gold standard treatment lethal failure requiring the desperate, intensive naloxone campaigns as harm reduction that more than account, directly and quantitatively, for all recent drops in opioid OD deaths, leaving no decreases to be attributed to other causes.
People are using fentanyl (and other high risk street drugs) more skillfully. This is a common theory among people who use street drugs. They often tell me they’ve adapted to the risks of fentanyl by smoking rather than injecting the drug, which many addiction experts believe is safer (though still incredibly dangerous). People try to never use fentanyl alone and often carry naloxone or Narcan to reverse overdoses. Many people use test strips to identify unwanted contaminants in their drugs and use smaller fentanyl doses.
Please search “theory” for meaning in the context of science and scientific process – an explanatory understanding of natural phenomena or patterns based on a large body of replicated experimental and observational evidence leading to acceptance of the theory’s truth as highly probable.
Except when applied to lethal public health crises in which lives depend on accurate understanding, in which case a reporter’s having conversed with a small number of selection-biased interviewees along with what “many addiction experts believe” elevates any idiocy to “theory”.
How’s that theory of smoking rather than injecting and test strips been working out in San Francisco, in Utah, in Nevada?
“many addiction experts”
“many people”
many lies and idiocies
Gains in street smarts and survival skills dropping OD deaths would vary dramatically from state to state ?? Really? Users in some states catching on and others not even aware ? High-risk users in Nebraska, N. Dakota, and Kansas gaining drug savvy more quickly than users in more populated states with opioid hotspots like Illinois, WV, NY, Maryland ?
Check the map.
“smoking rather than injecting” – No evidence for reducing OD deaths
“test strips” – No evidence for reducing OD deaths
“smaller fentanyl doses” – No evidence for reducing OD deaths
“naloxone” in targeted, intensive campaigns – direct, consistent evidence of dramatically reduced overdose deaths by direct observation and tracking across diverse states and locales, consistently, quantitatively more than accounting for numbers of reduced deaths, consistently.
A decline in young people using drugs. Street fentanyl has emerged as a leading cause of death among young people in the U.S., age 18 to 45. But research suggests far fewer young people and teenagers are using drugs (other than cannabis). This trend matters because new users have low physical tolerance for opioids such as fentanyl, which means they’re more likely to overdose and potentially die. Fewer young users means fewer people taking that risk.
“But research suggests far fewer young people and teenagers are using drugs (other than cannabis).”
That’s probably true, right, because the NPR reporter did assure us that “research suggests” it, certainly research conducted and interpreted by America’s top public health experts, published in peer review journals, and examined by our watchdog media. Like the recent national surveys of youth substance use, discussed here and here.
If you believe that and are relieved by it, you may also appreciate knowing, on assurances from top experts and media that:
Opioids treat chronic pain.
A family that owns a pharmaceutical company caused the opioid crisis.
SSRI medications treat depression, and safely.
The COVID virus came from nature, not a U.S. funded lab leak.
Not “baffling”, not “hopeful”, instead clear and ominous.
