WAIT, WHAT? IT’S NOT THE PROVEN MEDICAL TREATMENT? IT’S NARCAN?
Opioid OD deaths in Florida significantly dropped in counties with intensive Narcan campaigns and not elsewhere – signaling failed treatment that’s worsening high-risk opioid use and epidemic
by Clark Miller
Published April 29, 2024
From this report –
Naloxone, a medication designed to rapidly reverse opioid overdose, has undoubtedly saved countless lives in recent years. Its wider availability in many communities has provided a critical safety net for individuals at risk of overdose. However, it’s crucial to recognize that the successful use of naloxone may inadvertently mask the true scope of the opioid crisis.
While death totals are often used as a key indicator of the crisis’s severity, these figures certainly underrepresent the actual number of opioid overdoses that occur, as many are reversed through naloxone administration.
That bears repeating.
However, it’s crucial to recognize that the successful use of naloxone may inadvertently mask the true scope of the opioid crisis.
While death totals are often used as a key indicator of the crisis’s severity, these figures certainly underrepresent the actual number of opioid overdoses that occur, as many are reversed through naloxone administration.
Huh! You just don’t see that noted, that obvious point expressed, not anywhere – that as naloxone saves increase with campaigns to save lives by making the lethal OD reversing drug more widely available, the reduced OD deaths hide the failure of “proven” medical treatments to reduce incidence of high-risk opioid use, instead represent a worsening crisis and failed medical expert approaches.
You just don’t see that noted anywhere . . . other than repeatedly in posts here over past years.
Let’s take a look.
Nonprofit Project Opioid announced on Monday that overdoses have finally fallen and the wide availability of naloxone, commonly known by the brand name Narcan, is the reason why.
For the past 6 years, Project Opioid has been pushing police departments, mayors, commissioners, churches and hospitals – the people with influence – across Florida to study the overdose crisis and take action to solve it.
Project Opioid’s research revealed 2022 was the first year Florida saw a decrease in opioid deaths of around 2%. Orange and Seminole Counties, however, saw a decrease of more than 11%.
Project Opioid CEO Andrae Bailey credited naloxone.
“There is no factor in a community that reduces death more correlated with naloxone distribution,” Bailey said.
Seminole County Sheriff Dennis Lemma, who chairs the Attorney General’s Statewide Council on Opioid Abatement, said he’s seen a shift “from public safety professionals having to deploy this [naloxone] to now citizens actually doing it.”
Crediting the naloxone makes perfect sense.
In a different county in Florida, the focus of efforts has been on jumpstarting and expanding a “successful” and “lifesaving” buprenorphine treatment campaign, with predictable outcome – a following year 19 percent increase in opioid overdose emergency calls. The same pattern has occurred, described in this recent post, in New Jersey, North Carolina, and Houston, Texas.
Predictable because it’s established that American Medicine’s proven, gold standard opioid treatment is in fact providing no benefit, instead fueling the lethal crisis.
We’ll get to that soon, below.
From Project Opioid’s research report dated September 2023 –
The data paint a varied picture for Central Florida, encompassing Brevard, Orange, Osceola, and Seminole counties. Even as these counties continue to suffer from a high number of fatalities, some tentative signs of progress are emerging. Brevard County reported a notable decrease in overdose deaths in 2022, cutting the number by over 49%. Orange and Seminole counties also saw significant, albeit smaller, reductions in the death toll, decreasing by approximately 11%. A slight decline of 3.4% was observed in Osceola County, more in line with the 3.2% decline statewide.[8]
Despite the downward trend in these counties, the problem remains severe. Over 800 Central Floridians lost their lives to overdoses in 2022, a distressingly high figure that underscores the continued urgency of the crisis. Although the reduction in deaths in some counties, likely due to the increased availability of naloxone, is encouraging, concerted efforts must continue to further alleviate the impact of the opioid crisis in Central Florida.
Naloxone, a medication designed to rapidly reverse opioid overdose, has undoubtedly saved countless lives in recent years. Its wider availability in many communities has provided a critical safety net for individuals at risk of overdose. However, it’s crucial to recognize that the successful use of naloxone may inadvertently mask the true scope of the opioid crisis.
While death totals are often used as a key indicator of the crisis’s severity, these figures certainly underrepresent the actual number of opioid overdoses that occur, as many are reversed through naloxone administration.
Accurate and comprehensive data about non-fatal overdoses, including those reversed by naloxone, is hard to come by, often due to underreporting, the inconsistency in the collection of data across different jurisdictions, the reluctance of individuals to seek medical treatment, and the lack of standardized definitions or methodologies for identifying and classifying non-fatal overdose events.[14]
Understatement can be lethal.
In this case the reticence, or we might say more directly the cowardice, to state what is obvious for anyone paying attention to what has been established for years, described in this recent post –
While data appear to be scarce for national trends, it is apparent that over past years and decades legal and policy changes, clinical practices and broad-based community and regional campaigns have successfully and significantly increased availability, dispensing, training, and use of the opioid overdose (OD) lethality reversing drug naloxone (Narcan).
Most importantly and beneficially, that has saved lives. Additional effects include changes in how opioid users evaluate risk and make choices in their use of licit and illicit opioids; in how we evaluate and understand changes in incidence of opioid overdoses and OD deaths; and ways in which the confounding effects of emergency naloxone saves on trends in opioid related deaths are interpreted, spun, and used to generate healthcare misinformation.
In multiple posts over the past several years, data on naloxone campaigns by regions and locales including temporal trends in use and differential availability and provision to research groups, as well as comparison to appearances of slowing or reversing trends in OD deaths have revealed:
1) From the earliest reports and research on medical treatments (MAT, MOUD) for the opioid crisis, differential effects of naloxone have confounded causal links to problem opioid outcomes and treatment effects, invalidating attributions of benefit to addiction medications buprenorphine and methadone
2) Magnitudes of naloxone saves directly measured as the prevention of an otherwise lethal high-risk opioid use outcome have consistently been more than large enough to account for any temporal or comparison apparent moderations or slowing of opioid OD deaths. . . .
Let’s consider the evidence from Utah a bit further, recognizing that there are multiple unaccounted for factors involved and our estimates are approximations.
Each of the naloxone reversals represents also an incidence of high-risk opioid use, with very few imaginable and low-probability exceptions. That’s 10, 000 instances of high-risk opioid use over approximately the period of about 180 fewer opioid overdose deaths compared to what would have been predicted if OD death rates would have stayed the same. But let’s allow for the possibility that Utah deaths may have otherwise surged as in other parts of the country, West Virginia for example, where death rates nearly tripled over the comparable period.
So, let’s consider that if Utah had not implemented changes and OD deaths tripled as well, then the lives saved appears to be significantly greater over the period, 483 X 3 = 1,449 – 461 = 988, nearly a thousand prevented deaths, about 100 per year saved.
The naloxone saves estimated by by Dr. Plumb, almost certainly an underestimate, were 10,000
That can mean only one thing
Without the emergency revivals OD deaths would been much higher, representing the continuously increasing incidence of high-risk opioid use in Utah. The concerted campaign to “flood the state with naloxone” was desperately needed precisely because high-risk opioid use in Utah was mounting steadily and must still be, as evidenced by the numbers of reversals performed, each a measure of high-risk use. That is, there is no reason to think that the human condition driving the increasingly lethal opioid crisis – opioid users’ compulsive drive to engage in high-risk opioid use – is not remaining as prevalent and powerful or more so, a failure of current treatment approaches.
Each incidence of high-risk opioid use with potential for death is a failure of American Medicine’s gold standard proven addiction medicine treatments buprenorphine and methadone, whose alleged benefit and therapeutic value can only occur by reduction of high-risk opioid use by those receiving the miracle cures.
The roles of buprenorphine and methadone in fueling, rather than treating compulsive opioid use and the crisis, is established, including by the relationship between increasing medical provision of buprenorphine as treatment for opioid use and increasing incidence of opioid injection related infectious diseases, an association representing increase in high-risk opioid use as more medical treatment is provided, not confounded by naloxone saves.
Right.
Back to our current post –
Accurately and credibly interpreted and described, the consistent, accumulating outcomes and pattern of naloxone saves that more than account for any moderation of opioid crisis deaths is a signal, an urgent alert to face, discredit, and reverse the lethality of medical expert approaches to a non-medical problem.
That, of course, is precisely why those truths must remain unspoken, why an army of impaired useful idiots remain compensated, securely employed in their sheltered news shops.
