Despite encouraging declines nationally over the past year, overdose deaths continue to rise in many Western states as the epicenter of the nation’s continuing crisis shifts toward the Pacific Coast, where deadly fentanyl and methamphetamine are finding more victims.
Overdose deaths have remained significantly higher since 2019. Many states are working on “harm reduction” strategies that emphasize collaboration with people who utilize drugs; in some cases, states are becoming more stringent in their prosecutions, charging dealers with murder.
As of 2019, Alaska, Nevada, Washington and Oregon were in the top 10 for overdose death rates, according to a state-by-state analysis by the federal Centers for Disease Control and Prevention data. Meanwhile, the greatest annual improvements were seen in Nebraska (down 30%), North Carolina (down 23%), and Vermont, Ohio and Pennsylvania (down 19%).
The spread of fentanyl, a synthetic opioid that can cause overdose and death even in tiny amounts, explains much of the shift in deaths from east to west, said Daliah Heller, vice president of the overdose prevention program at Vital Strategies, an international advocacy group. that works to strengthen public health.
“Fentanyl has actually entered the traditional drug markets in the Northeast, but you can see its steady movement westward,” Heller said. “We are now seeing an increase in overdoses on the West Coast and a dramatic decline on the East Coast.”
CDC interim data estimates drug overdose deaths for the year ending April 2024 were down 10% nationally, with more than 11,000 fewer deaths than the year before. However, the percentage continues to rise in 10 states and the District of Columbia, including 42% in Alaska, 22% in Oregon, 18% in Nevada and 14% in Washington state. Deaths increased by almost 1,300 in these states and others, with more moderate increases: Colorado, Utah and Hawaii.
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Experts are still debating why some eastern states that started the overdose crisis are seeing improvement.
“There is some improvement spreading from east to west, but we don’t know exactly what it is yet. Everyone sees their own little piece of the elephant,” said Nabarun Dasgupta, a researcher specializing in opioid disorders and overdose at the University of North Carolina Center for Injury Prevention Research.
In North Carolina and other states with recent improvements, “it seems like we finally put the lid on the pot, but the pot is still boiling. The situation is not really calming down,” Dasgupta said.
This may be due to greater acceptance of harm reduction policies aimed at helping people who utilize drugs, including no-questions-asked street drug testing and the provision of naloxone to prevent overdoses. Or users may simply become more wary of fentanyl and its dangers and unpleasant side effects, Dasgupta said.
“Fentanyl is very strong, but potency is not the only thing. Otherwise, we would all be drinking premium IPA (India Pale Ale),” Dasgupta said.
Alaska currently has the second-highest drug overdose death rate in the nation, at approximately 53 per 100,000 residents, second only to West Virginia (73 per 100,000). Other Western states currently in the top 10: Nevada (47 per 100,000), Washington state (46 per 100,000) and Oregon (45 per 100,000).
CDC data shows the largest enhance from 2023 was in Alaska, up 42% to 390 deaths. Republican Gov. Mike Dunleavy in August 2023 proposed legislation charging fentanyl traffickers with murder in cases of overdose deaths, writing: “Drugs and drug overdoses are having a devastating impact on our state.” The act was signed into law this year.
In May, the state launched a statewide “One Pill Can Kill” campaign. awareness campaign warning about the dangers of fentanyl.
Fentanyl, mostly in the form of counterfeit 30 mg oxycodone tablets, has become extremely profitable for smugglers in Alaska, who utilize airline passengers and air shipments of other products to smuggle drugs into the state, state Department of Public Safety spokesman Austin McDaniel said. Pills that can be purchased for less than $1 near the southern U.S. border with Mexico can cost $20 in Alaska, McDaniel said.
“We want dealers to think twice before targeting Alaska,” said Alaska state Rep. Craig Johnson, an Anchorage Republican who supported the bill signed into law on July 12.
Two years ago, Johnson’s 23-year-old nephew died of a fentanyl overdose. “It’s personal. I don’t want other families in Alaska to go through what we went through. I hope we never have to use it because that will mean no one else dies.”
Other state and federal authorities are also trying to take a more punitive approach to the fentanyl crisis: a state program in Wisconsin to track down suppliers resulted in three people being charged arrested in September and charged with first-degree reckless homicide in the fentanyl overdose of a 27-year-old man. In Michigan, two men he pleaded guilty this month, federal charges related to a mass fentanyl poisoning that left at least six people dead.
Experts say such a punitive approach could backfire if it pushes people toward more risky solitary drug utilize – where no one can see an overdose and try to facilitate – and away from programs such as free testing to detect fentanyl hidden in other drugs. drugs.
“It’s kind of nonsensical, like saying you can beat people. People will continue to use drugs,” said Heller of Vital Strategies. “This should be a call to action to wake up and really invest in responding to drug use as a health problem.”
In Nevada, health officials in the Las Vegas area are pushing for greater cooperation with residents who utilize drugs, increasing distribution of naloxone and encouraging people to have drug purchases tested so they won’t be surprised by counterfeit heroin, methamphetamine or other drugs that are increasingly being cut down with cheaper ones. fentanyl, said Jessica Johnson, health education manager for the Southern Nevada Health District.
AND government office coordinates county naloxone distribution targets based on factors such as hospital overdose reports. Larger overdoses result in more repeated distribution of naloxone to community centers, clinics, entertainment venues and even vending machines.
The puzzle in Nevada and other states is that overdoses are increasingly involving the combination of opioids like fentanyl with stimulants like methamphetamine. According to the state, nearly one-third of overdoses in Nevada are caused by the combined utilize of both substances report based on data for 2022.
There may be some people looking for a “rollercoaster of effects, using a stimulant like meth and a sedative like fentanyl or heroin,” Jessica Johnson said, but mostly she hears that unsuspecting users get cocaine or methamphetamine laced with cheaper fentanyl.
“People say, ‘Oh, I don’t need naloxone because I don’t utilize fentanyl,’ and our team is able to say, ‘Well, our surveillance data actually suggests that there may be fentanyl in your meth,’ or whatever. Is.”
Nationally, both drugs are increasingly a cause of fatal overdoses: synthetic opioids such as fentanyl, according to this year’s CDC data, contributed to 68% of overdose deaths, up from 48% in 2019. Stimulants such as methamphetamine were a cause 35% deaths, up from 20% in 2019.
Heroin and other partially natural opioids such as oxycodone have declined as agents, collectively accounting for 13% of deaths in the latest data, down from 40% in 2019.
Some experts theorize that fentanyl’s high potency makes drug users want to enhance or balance the effects of methamphetamine. Fentanyl itself is often combined with xylazine, a non-opioid animal sedative — often called “tranq” — that can cause unpleasant side effects, including extreme sedation and skin lesions, Dasgupta said.
“During the pandemic, there were many reasons why people turned to drugs more often. Now that everything has changed, people are tired of adulteration, sedatives and skin wounds,” Dasgupta said. “People can take smaller doses, which in itself can help reduce overdoses.”
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