Overdose deaths are down, but vigilance must remain high

Responding faithfully to our ongoing opioid crisis

If you’re skimming this today, please take a look at the bottom! I am offering virtual opportunities to get trained in and access Narcan, and I don’t want you to miss it!!

Here’s a bit of good news!

For the first time in five years, opioid deaths decreased in 2023!

The decrease was approximately 3%, which can feel like not very much. But I’m choosing to see it as 3500 people who have life that might otherwise not, and more if you consider that we have become accustomed to this number increasing year over year rather than staying flat.

It’s impossible to know all the different things that contributed to this decline. But there are some things large scale things that are worth calling attention to that I suspect may have played a role:

• In March 2023, the FDA approved the first Naloxone (Narcan) overdose reversal spray for over-the-counter non-prescription use. (Learn more about Naloxone/Narcan here.) While many cities and states already had Narcan available through a variety of different means, it wasn’t easily accessible. While barriers still remain, this approval increased access to Naloxone dramatically.

• In July 2023, the FDA approved a second Naloxone spray for over-the-counter non-prescription use. This was significant because prior to this, there was only one pharmaceutical company producing Naloxone spray for broad use, and quite frankly they were price-gouging. Having multiple competitors (theoretically) will help drive prices down.

• In December 2021, two Overdose Prevention Centers opened in NYC—the first legally sanctioned sites of this type ever in the US—and have had continuous growth and success. In two years, they’ve reversed more than 1200 overdoses, and there has not been a single overdose on their premises. The data that they are producing may lead to this being adopted more broadly in the United States, which would be a game-changer.

• In January of 2023, President Biden by Executive Order removed the X-Waiver required to prescribe buprenorphine. Buprenorphine is a well-documented prescription treatment for opioid use disorder that, prior to this order, could only be prescribed by physicians who applied for and received training for an “X-waiver.” This barrier meant that a majority of physicians, who were fully approved to prescribe addictive opioids, could not prescribe our best medicine for treating addiction when it arose. After years of advocacy, this barrier no longer exists.

And I’m hopeful that 2024 is continuing this trend, based on a few things:

• Naloxone vending machines are spreading! More and more places are putting Naloxone and other harm reduction supplies (like fentanyl test strips) into free vending machines in high-traffic areas. While I won’t name them all, I want to call out OKC, a place dear to my heart and where resistance to this kind of thing is strong, who has installed many throughout their metro and continues to expand. Additionally, mutuals of mine (people of faith!) in Parrish, Alabama are responsible for the first Naloxone vending machine in the entire state being installed just a few months ago.

• A harm reduction resolution, put forth by the United States, was approved by the UN to recommend the implementation of proven strategies. It can not be overstated how monumental this is. To put it bluntly, the United States has for nearly a century maintained a strangle-hold on international drug policy. The War on Drugs has been a chief-export, to the extent of threatening the withdrawal of trade and support if nations passed more compassionate policies. To see the US championing harm reduction on an international level is deeply encouraging. (Though it shouldn’t be mistaken for repair for past harm. That is a reckoning yet to take place, and must.)

With all this momentum, I am daring to be hopeful. Nonetheless, we must remain vigilant. We have a long way to go in reversing these trends that are decades in the making and have been exponentially increasing the last decade. All of these positive developments are small seeds in a vast field that needs rejuvenation. We must continue to be faithful in educating ourselves in best practices, unlearning myths, and stepping into loving, not condescending or paternalistic, relationships with people who use drugs. For those interested, my friend Izzy wrote on this yesterday:

i love people who use drugs

What can I do?

This is a question I get so often in my work, but on this topic it’s easy to answer.

GET TRAINED ON NALOXONE USE AND CARRY IT AROUND!

A good training in Naloxone/Narcan use can be done in less than an hour, and can be the difference of whether or not you are able to save a life when you encounter someone overdosing.

A great way to go about this is by googling “Narcan training in [city you live in].” I recommend this in-person, local version because it will hopefully connect you with a group doing this work in your area.

But for those for whom that is not a good option, I offer virtual Narcan trainings! These are conducted via Zoom and are approximately one hour long. After completing the training, I will ensure that you have access to two doses of Narcan nasal spray to carry around for your use.

If you are interested in attending a virtual Narcan training with me in June, please fill out this form!

this could be you! (and me!) THIS COULD BE US :))))))

---

These posts will always be free.

But the rest of my work—traveling to speak and lead workshops, creating content, advocacy and direct aid—is enabled and expanded by your support. Consider becoming a Paid subscriber to enhance my reach.