County extends efforts to reduce drug overdoses

Paramedics, doctors, police officers and others administer naloxone in only 77% of opioid overdose cases in Gila County, according to ADHS. That’s much better than last May, when people got the antidote only 41% of the time here. But it’s still much worse than many other counties. Navajo County administers the drug 97% of the time and Coconino 95% of the time.

Gila County in 2022 reported 19 overdose deaths – which works out to 36 deaths per 100,000 population. That remains the highest death rate in the state – and close to double the statewide rate of 21 per 100,000.

Statewide, about 8% of those deaths involve people younger than 24. About 54% involve people between the ages of 25 and 44.

County Health Director Josh Beck noted that law enforcement and healthcare providers report the Naloxone numbers to the state. Since the Roundup highlighted the low rate of administration in May, the county has “worked with our network that we provide Naloxone to in order to emphasize the importance of reporting for better data and we hope this is influencing our numbers. More Naloxone was distributed in our last reporting quarter than any other,” said Beck.

The county has also distributed the antidote to hotels, bars and a few stores throughout the county. “Our goal is to educate people, train them, and most importantly get Naloxone out to the places where it can be effective.”

The money will help the county continue working with doctors to reduce over-prescribing of prescription painkillers, track prescriptions and overdoses and help people access services to cope with an addiction.

Most of the money will pay for existing county staff position, plus travel expenses for training and conferences.

Nationally, overdose deaths soared last year – hitting 107,000. More than two-thirds of those deaths are linked to fentanyl – a synthetic opiate. The federal Centers for Disease Control has issued a warning that a new trend could produce an even worse problem. Increasingly, drug dealers are mixing a powerful animal anesthetic to fentanyl-containing drug mixes – causing a new surge in deaths.

The percentage of people using illegal drugs hasn’t increased nearly as much as the overdose rate – which again reflects the influence of fentanyl. Statistics on the share of the population that has used an illegal drug in the last year include 12% for marijuana, 4% for opiates, 2% for prescription stimulants, 2.4% for prescription sedatives, 2% for cocaine, 1% for LSD, 1% for Ecstasy, 1% for meth and 0.3 of a percent for heroin, according to the National Center for Drug Abuse Statistics.

The opiate plague started after research suggested doctors were undertreating patients in acute pain. This led to an increase in prescriptions of opiates. However, prescriptions for people in chronic or low-level pain increased much faster than prescriptions for people in acute, temporary pain. This led in turn to an increasing number of patients becoming addicted to opiates – which are closely related to heroin. As doctors tried to reduce the increase in addiction, many patients turned to illegal street drugs.

Drug companies compounded the problem with misleading marketing and incentives for doctors prescribing painkillers. A number of major drug companies have since agreed to multi-billion-dollar settlements to provide addiction treatment and public education.

The rising opiate addiction turned deadly with the spread of fentanyl, a potent drug that can easily shut down the breathing reflex. Fortunately, the effects can be quickly reversed with Naloxone. Meanwhile, the manufacture of illegal fentanyl has exploded – with the potent drug now mixed into many other illegal street drugs. Many drug users don’t even know they’ve taken fentanyl.

Beck said the opioid plague has inflicted a huge economic toll as well. In 2019, Arizona doctors wrote 4.1 million prescriptions for opioid painkillers and dispensed 240 million pills in 2019. Overdoses spurred nearly 57,000 hospital visits in 2019 – at an estimated cost of $12,000 per visit – or $676 million.

The latest nightmare comes with the addition of xylazine to many street drugs. This powerful animal tranquilizer has been used to bulk up illegal fentanyl, with deadly effects. The tranquilizer causes wounds that include a scaly dead tissue called eschar, which can lead to amputations as the only effective treatment. Even if people don’t suffer death or amputation, they may wind up with horrific scaring. The drug can induce a blackout that last for hours. Naloxone cannot reverse its effects, since it’s a sedative, not an opioid.

One recent study detected xylazine in the drug supply of 36 states and the Food and Drug Administration has issued a nationwide four-page xylazine alert to doctors. The tranquilizer now figures in 7% of drug overdoses – usually in conjunction with fentanyl.

Beck said so far he hasn’t heard of any xylazine-related overdoses in Gila County.