Why local leaders aren’t celebrating a projected drop in opioid deaths

The Palm Beach County medical examiner is projecting a 38 percent drop in the number of opioid-related overdose deaths countywide this year, a trend that would represent the first decrease since the local epidemic exploded more than three years ago.

While community leaders acknowledged the projections as a rare positive development in their fight to curb the epidemic, they warned against interpreting them as an indication that the crisis is nearing its end.

“I just don’t want us to be like, ‘Yeah, we solved the problem.’ I think we just put a very, very small dent in it,” said County Mayor Melissa McKinlay, who has helped lead the county’s fight against the epidemic.

“We need to be cautious in celebrating our victories because I don’t think we have a reduction in the number of overdoses. I think we have a reduction in people dying from heroin.”

About 224 people have died of opioid-related overdoses through July 24, Dr. Michael Bell, the medical examiner, told The Palm Beach Post. If the trend continues, the county will end the year with 399 opioid-related overdose deaths — a 38 percent drop from the 647 deaths he recorded in 2017.

Opioids include heroin and prescription painkillers, such as oxycodone. The deaths have risen in recent years with the entry of illicit fentanyl, a painkiller more powerful than heroin, and its even more powerful cousins, such as carfentanil.

Bell said his projection is “kind of a guess” because he’s still waiting for results of toxicology tests. But he said it’s based on historical trends showing 80 percent of drug overdose deaths have been related to opioids. The 224 number is 80 percent of the 280 overall drug overdose deaths his office has seen so far this year.

“It’s a good thing. It’s moving into a different phase,” he said. “We are seeing less carfentanil, which is the strongest fentanyl analog. We are seeing other analogs, but they are not as potent and dangerous as carfentanil.”

The projections confirm a trend announced earlier this month by State Attorney Dave Aronberg, who cited medical examiner statistics showing 88 opioid-related deaths over the first four months of the year compared with 233 over the same period in 2017.

And they would mark a dramatic change for an epidemic whose toll has only crept up since 2012 when Bell reported that it had killed 143 people in the county. The numbers rose every year, topping 500 in 2016, until reaching 647 last year.

The projected decrease is probably the result of a combination of factors, including the wider availability of Narcan, a drug used by first responders to revive overdose patients, said Assistant State Attorney Al Johnson.

Other factors include prosecutions by the Sober Home Task Force of “bad actors” in the addiction treatment industry and fewer addicts coming to Palm Beach County for treatment, Johnson said.

“We need to remain vigilant,” said attorney Jeffrey Lynne, who serves on Aronberg’s Sober Homes Task Force. “I just don’t want there to be ‘Oh, great, we are winning the war on drugs,’ so to speak, and that people don’t need help.”

Bell agreed. Although the current projections show a positive trend, he said, “it can turn on a dime.”

Bell’s overdose death projections will be discussed Tuesday at a community meeting hosted by McKinlay. Called “Facing the Crisis,” the forum will offer updates on the county’s Opioid Response Plan and how community leaders across the county have been addressing the crisis’ latest challenges, including treatment needs and recovery trends.

“I don’t want our community to become complacent on the issue,” McKinlay said. “It is still an epidemic. We should celebrate that success and figure out what made that happen.”

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