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Drug use remains dangerous and debilitating for many people in the US. An addict begged for help on a street corner in Burlington, Vermont.

Carol Guzy for NPR

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Carol Guzy for NPR

Drug use remains dangerous and debilitating for many people in the US. An addict begged for help on a street corner in Burlington, Vermont.

Carol Guzy for NPR

Kevin Donaldson uses fentanyl mixed with a powerful and dangerous animal tranquilizer called Xylazine in Burlington, Vermont. He knows how risky this type of drug addiction can be.

“I feel like some of us have learned to deal with the overdoses a lot better,” Donaldson tells NPR.

But he’s still alive. And he says fewer of his friends are dying.

For a while, Donaldson said it was impossible not to hear about the Fentanyl crisis in his community every day.

“But who was the last overdose we heard about?” he asked, consulting a friend. ‘Maybe a few weeks ago. That’s kind of far and few in between.”

The data supports Donaldson’s experience. The Vermont Department of Health shows a 22% drop in drug deaths in the first half of this year. And the decline in deaths extends beyond Vermont.

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What the data shows

Dennis Cauchon is an advocate for addiction treatment in Ohio, where fatal overdoses have fallen by nearly a third.

“The number of deaths just went down and the data has never changed so much,” Cauchon told NPR.

In the Pacific Northwest, Brad Finegood is leading the response to the overdose crisis in Seattle, where the latest data shows drug deaths are down 15% this year.

“A year ago, as overdose deaths continued to rise, I really struggled with hope. But today I have so much hope,” Finegood said.

The data shows a national downward trend for opioid overdoses. But what many experts have not been able to figure out is why exactly this is happening.

NPR’s addiction correspondent Brian Mann has tried to uncover the story behind this promising trend.

“This has been a crisis that has escalated and escalated starting in the 1990s and then gotten even worse during the fentanyl era over the last five years. Now there’s a pivot point and we’re not sure why this is happening. “

Mann says one theory is that the United States has flooded the field with Naloxone, the anti-overdose drug that helps people who have overdosed on fentanyl.

“There’s also better medical care for people out there,” Mann explained to Consider This host Ari Shapiro.

“Drugs like Suboxone (are available) that can help people lower their risk of overdose,” he added.

Another darker possibility that Mann shares is that many of the vulnerable people may simply have already died.

Stanford University researcher Keith Humphreys explained:

“During (the) COVID (years), many people who would otherwise have died, say this year, the next year, the year after that, had already died. And so that’s terrible, but it does mean that the number of people left to die is smaller.”

Mann emphasizes that this is just one theory and that it is controversial.

“So the short answer right now is that this is something that researchers are trying to understand, in part because they want to build on it. They want to keep this trend going. So they’re trying to understand why we’ve seen this very hopeful improvement.”

I look ahead.

One of the main reasons for this trend is what experts thought wouldn’t be possible: supply has simply started to dry up.

“The fentanyl that arrives at street level, this illegal drug, is weaker,” Mann said. “Other chemicals are being heavily cut, including an industrial chemical called BTMPS.”

Morgan Godwin is a researcher from California who has taken to the streets to talk to people who buy and use fentanyl.

“People report getting dope sick and having withdrawal symptoms despite smoking fentanyl because what they’re using is such a low percentage of fentanyl,” Godwin said.

“And everyone is looking and sifting through different suppliers. The daily amount they spend to stay healthy has skyrocketed.”

One theory as to why the supply has declined is that the Biden administration and other countries around the world have increased their targeting of the Mexican drug cartels that provided the supply.

“Later this month, a number of top drug lords will appear in court in New York City, where they will face sentencing and a hearing as very high-level arrests have been made,” Mann explained.

The Biden administration claims it is making real progress there, in addition to massive seizures of street fentanyl across the country.

“In the past, people thought the supply chain was so resilient that this probably wouldn’t have much of an impact,” Mann said.

“But we’re now starting to hear from people that these drug cartels may actually be affected to some extent, that it’s going to be harder and more expensive to find fentanyl on the streets. If that happens, if that kind of disruption works, it could save lives.”