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UPDATE – EMERGENCY NALOXONE REVERSALS DIRECTLY ACCOUNT FOR ANY DROP IN US OPIOID OVERDOSE DEATHS IN 2018, POINTING TO A WORSENING EPIDEMIC

THE INCREASING HIGH-RISK, LETHAL OPIOID USE IS FUELED BY PROVISION OF PUBLICLY-FUNDED MEDICAL MAT “TREATMENT”

By Clark Miller

Published September 13, 2019

Updated April 14, 2021

New reports on preliminary data for 2018 compared to 2017 from the Centers for Disease Control (CDC) point to a possible 5 percent decrease in opioid-related overdose deaths in the U.S., that result affirming consistent, accumulating evidence of the crisis worsening.

Why?

 

It’s established that nationally and at local levels apparent reductions in overdose deaths are due to campaigns and increased use of the overdose death reducing opioid antagonist naloxone (Narcan) – those reductions in mortality directly observed and recorded.

Data on naloxone reversals of potential deaths by overdose point to trends of frequency of those reversals – as programs and communities have instituted campaigns to increase its availability and use – accounting in magnitude for estimates of reduced mortality, leaving no opioid-related mortality reduction that can be attributed to the invalidated medical fix for the non-medical condition of compulsive opioid use – variously termed medication assisted treatment (MAT), opioid agonist therapy (OAT), or opioid substitution treatment (OST).

naloxone nasal applicator

New evidence – from New York – affirms that the magnitude of directly observable and recorded potentially lethal opioid ODs reversed by use of naloxone would directly account for any apparent reductions in national trend of lethal opioid overdose – with 17,500 instances recorded in New York alone last year. While some portion of those may represent multiple revivals of individual substance users, and some reports may represent use of naloxone by private citizens when a user in apparent overdose was not at risk of death, the projected magnitude of naloxone use nationally based on the New York figures is remarkable and significant. The result affirms that not only are there no reductions in OD deaths attributable to the invalidated medical substitute opioid “fix”, but further that high-risk, overdose-generating use must be continuing to increase at rates that are reflected by the remarkable magnitude of increasing need for naloxone use in emergency responses.

Moderation of high-risk use is the only mechanism by which MAT could provide benefit, so decrease or increase in high-risk use serves as a measure of success or failure of the medical “treatment”.

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.

At least one outlet has noted the obvious –

If emergency treatment, rather than reduced drug use, is behind the fall, this would mean an increasing number of US adults are living with substance abuse disorders. 

Almost but not quite.

What this line of evidence affirms, as established in multiple series of posts, is that an increasing number of vulnerable Americans are becoming trapped in the epidemic of compulsive high-risk opioid use that is fueled – due to lack of benefit from, diversion and abuse of, and central use as currency and commodity in illicit economies of opioid use – by medically-provided substitute opioids including methadone and Suboxone.

Indeed, given that any and all reductions in mortality due to overdose by emergency use of naloxone for reversal of lethal respiratory depression at the same time represents – measures – incidence of high-risk opioid use, the evidence simply reinforces the failure of MAT to moderate high-risk use, instead as established by consistent and accumulating evidence reinforces the medical fix as worsening the lethal epidemic.

The mounting, consistently invalidating pattern was predictable, all along, because there has never been credible evidence to support effectiveness for OST, instead all lines of evidence disconfirm effectiveness and point to increasing harm.

See some of that evidence summarized here in a related post. 

TO SUMMARIZE,

increased use of the emergency response opioid overdose death reversing opioid antagonist naloxone (Narcan) accounts for an apparent slowing and possible reduction of opioid overdose deaths driven by steadily worsening overdose and opioid-related disease incidence due to high-risk use of opioids, those increases associated with and driven by increased provision of addictive, diverted, abused substitute opioids constructed as a form of medical “treatment”, funded by public healthcare resources.

By way of strict analogy, campaigns to increase availability and use of Automated External Defibrillators (AED) to save lives in acute emergency response to atrial fibrillation are expected to be measured as moderating acute deaths due to heart disease in America’s cardiovascular disease epidemic. Increased demand for emergency revival by use of AEDs of course would reflect a worsening heart disease epidemic, not any moderating benefit from treatments to address incidence of cardiovascular disease. Portraying any such moderation of heart disease-related mortality, moderation directly attributable to emergency use of AEDs, as progress in treatment of the heart disease epidemic that is driven largely by modifiable health behaviors would represent profound, if not pathological, deficits in capacity for research literacy, for critical thought and intellectual integrity, and for response to public health need.

That is, the new CDC data – congruently with all relevant evidence, including data evidencing mortality-moderating effects of increased use of emergency revival of potential OD deaths (increased response to increasing high-risk opioid use) – affirms worsening lethal substance use epidemics with fabricated medical “treatments” for the non-medical condition fueling addiction and high-risk use while diverting public healthcare funding away from evidence-based psychosocial treatments and supports.

That is, evidence continues to mount establishing that the substance use epidemics trapping and killing vulnerable Americans are worsening, iatrogenic, and criminal.

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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