PHILADELPHIA – AS ELSEWHERE, RECENT SURGING NALOXONE OPIOID OVERDOSE REVERSALS EXPLAIN DROP IN DEATHS, AFFIRM A WORSENING CRISIS
In Philadelphia as consistently elsewhere, data affirm 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 25, 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.
In 2022, Philadelphia’s drug overdose deaths had mounted to a record high.
Then something happened.
In Pennsylvania funding, coordination, and intensive, targeted efforts to get the opioid OD death reversing agent naloxone (Narcan) where it was needed began to spike.
As described here, NFRP is a program dedicated to getting naloxone into communities.
(CCEs are Centralized Coordinating Entities in the role of distributing Narcan kits to local community-based organizations.)
Launching Pennsylvania’s Naloxone for First Responders Program
In November 2017, PCCD launched the NFRP in partnership with the Pennsylvania Departments of Drug and Alcohol Programs (DDAP) and Health (DOH). The program was designed to provide life- saving intranasal naloxone at no cost for first responder groups using regional and statewide distribution networks. The term “first responders” was intentionally defined broadly with the goal of getting naloxone into the hands of as many people who could potentially interact with overdose victims as possible. First responders often arrive at the scene of an overdose before medical personnel, making them critical in administering naloxone promptly and potentially saving lives.
“First Responders” in practice included anyone close enough to an overdose to benefit from Narcan training to reverse an otherwise fatal OD.
The spike in funding for 2023 appears even more pronounced, increasing by more than 200 percent for 2023.
Here’s what that looks like on a timeline.
And in “Philly” –
an intensive, targeted outreach effort, described here.
State efforts don’t capture the intensive Narcan campaign that was launched in Philly and as described by October of 2023 included door-to-door targeted canvassing that aimed to get Narcan directly into homes in areas most needed.
The new door-to-door canvassing approach aims to cut through some of that hesitancy, stigma, and shame that can come from someone openly sharing their struggles with substance use. . . .
The project focuses on Philadelphia “hot spots” with increases in overdose deaths outside of the Kensington and Allegheny neighborhoods, where street drug use is most visible and harm reduction services and resources are typically concentrated.
Canvassers intend to knock on more than 100,000 doors in Philadelphia’s overdose “hotspots” — zip codes with escalating rates of opioid overdose deaths in recent years, many in Black and brown communities. . . .
What Philadelphia is doing could be a model for many other densely populated cities and communities, according to Daliah Heller, vice president of drug use initiatives at Vital Strategies, a public health organization working with local governments in seven states to address the opioid epidemic.
“There’s something intensely personal about a human engagement,” Heller says. “And somebody knocking at your door to talk about drug use and overdose risk and that there’s something that can be done, I think is really powerful.”
Over the years, naloxone has become more accessible than ever before, Heller points out. People can order it online and through the mail, it’s available in specialized vending machines, and drug stores now sell Narcan nasal spray as an over-the-counter product.
The canvassing beginning in 2023 is just one of multiple approaches in Philadelphia that have been getting Narcan into households and other settings antecedent to the new drop in opioid OD deaths after years of increase.
Those include drop-in centers like that operated by Operation Save Our City offering free Narcan kits to anyone coming in, and Prevention Point, an organization reported to have distributed 97,000 Narcan kits last year (2023) in Philadelphia.
Let’s repeat that: one organization as part of an intensive naloxone campaign distributed 97,000 Narcan kits last year (2023) in Philadelphia.
The numbers don’t lie, instead paint with concrete evidence a picture of another community or region in which recently intensified campaigns flooded neighborhoods with the potentially fatal opioid OD reversing agent naloxone, correlated with new, predictable moderations of opioid death rates. Each Narcan reversal is a reduction of fatal overdose incidence by 1.
Narcan is a blessing and a curse, giving life and ultimately taking it away,
in the fatal deception fueled by media/medical lies that the misrepresented numbers and trends are progress provided by treatments against high-risk, life-threatening substance use. They are not, any more than a surge in prevention of fatal cardiac events by use of increasingly more accessible AEDs would represent treatment, prevention, or public health gains against heart diseases.
A curse, because what media have spun as progress against an epidemic has always been, instead, a clear case of emergency naloxone saves consistently more than explaining any apparent moderations of incidence of fatal opioid overdoses. Spun to hide from public view the established lethal failure of American expert gold standard medical cures.
A curse, because its dramatically increasing, life-saving use in homes and community settings due to intense, recent Narcan campaigns now obscures data provided and available to understand trends in fatal and nonfatal opioid overdoses, making it easier for America’s medical/media collusion to distort findings, to lie to you.
Numbers of nonfatal opioid overdoses, if accurately measured, have been a more valid measure of high-risk opioid use than lethal overdoses, lethal ODs always confounded by differential (across time or study conditions) prevalence of emergency naloxone availability and saves, precluding valid attribution of results to treatment effects. Now, nonfatal overdoses as well cannot be relied on as a valid measure of high-risk opioid use or severity of the epidemic, because so many are occurring in community settings and go unreported and thus not accounted for in studies that rely, for example, on hospital and emergency responder data. That distortion provides room for results to be spun and manipulated in ways to lie about opioid treatment outcomes, as in this recent report in America’s top medical journal, featured in the upcoming post
“TO COVER OPIOID CRISIS MEDICAL CURE FAILURE, MORE LIES IN AMERICA’S TOP MEDICAL JOURNAL”
