After years of relentless rises in overdose deaths, the U.S. has seen a remarkable reversal. For seven straight months, drug fatalities have been declining. Expanded treatment, prevention and education efforts are playing a role, but drug policy experts believe there is another, surprising reason: changes in the drug supply itself, which are influencing how people are using drugs. The fentanyl on the street is starting to become weaker. Anne Milgram, who heads the Drug Enforcement Administration, said that for the first time since 2021, the agency was seeing a decline in fentanyl potency, a development she attributed to the government’s crackdown on Mexican cartels and international supply chains. Last year, seven out of 10 counterfeit pills tested in DEA labs contained a life-threatening amount of fentanyl, but that number has dropped to five out of 10. Addiction experts say that other interventions contributed to the declining fatalities, including wider distribution of overdose reversal medications like Narcan; an uptick in prescriptions for medication that suppresses opioid cravings; and campaigns warning the public about fentanyl-tainted counterfeit pills, reports the New York Times.
Harm reduction programs that offer sterile syringe exchanges and fentanyl test strips are also saving lives. Many treatment and support services that shuttered during the pandemic have become more accessible.
“They are all part of a health response to substance use that is bending the curve,” said Dr. Brian Hurley, president of the American Society of Addiction Medicine. Policy and medical experts both say that shifts in the illicit drug market are a growing factor, though some of the changes have disturbing effects. Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, attributed the decrease in overdose deaths in part to law enforcement efforts, including cracking down on the distribution of chemicals used to make fentanyl and other supplies that bring the drug more easily into the street supply. As a result, pure fentanyl is becoming scarcer and more expensive, he said. “Obviously, purity has a relationship to lethality,” Dr. Gupta said. Local officials and outreach workers are noticing a shift. “We have been seeing for a while fentanyl changing: how much fentanyl is in the supply, the kinds and the form,” said Traci Green, who leads a drug checking program in Massachusetts that collects samples from harm reduction groups and law enforcement.
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