Through the first six months of 2021, 796 Missourians died from opioid overdose, well over half the total deaths recorded in all of 2020. The Centers for Disease Control and Prevention projects a nearly 20% increase in overdose deaths by the end of the year.
Public health experts and law enforcement put the blame for the uptick in deaths on the synthetic opioid fentanyl, which has grown in prevalence across the country.
A rash of overdose deaths in Columbia — 14 in the past four months — prompted the police department to organize an emergency briefing. The meeting, held on a Tuesday night in the Hickman High School cafeteria drew around 100 community members who heard from a range of speakers, including Willie McCurry. The St. Louis native spent much of his life in and out of prison, as he struggled with opioid addiction.
As he told the crowd, McCurry intentionally overdosed on fentanyl at a transitional facility last September. A police captain at the facility saved his life using naloxone — a medicine that can reverse opioid overdose.
McCurry said he awoke to the captain on his chest, in tears. "When I saw him, that's actually what changed me," he said.
McCurry has been clean since, and recently started sharing his story through public speaking. The crowd at the community briefing was the biggest he'd ever spoken to, and he was nervous. But he said audiences have generally been receptive.
“People tend to understand; even those that haven't struggled with addiction," McCurry said. "They still can feel the pain, you know."
Naloxone — also known by the brand name Narcan — is part of an approach to drug addiction known as harm reduction. The idea is, if people are going to use drugs anyway, providing tools for them and others to do that more safely can help prevent deaths.
In the past, opponents of this harm reduction have equated it with enabling drug abuse, but there’s been a significant cultural shift towards the approach.
The Columbia Police Department organized the event alongside the local health department in response to a rash of overdose deaths in the community. In the past four months, 14 Columbia residents have died from overdose; a majority connected with fentanyl.
In addition to Narcan, the health department provides free test strips, to allow people to test drugs for the presence of the synthetic opioid.
Fentanyl is what brought Jim Haynie out to the briefing. Haynie organizes the local chapter of Narcotics Anonymous for families and friends of those struggling with or lost to substance use disorder.
Every Wednesday night, he shows up to the local Methodist church to listen. "We don't give advice, we tend to just express ourselves," Haynie explained. "And hopefully that helps somebody else.”
Haynie lost his son, Scott, three years ago, to a fentanyl overdose. He said Scott had struggled with substance abuse most for most of his life, but had finally gotten clean for 10 months before overdosing.
Haynie supports harm reduction strategies including test strips, and said his son likely didn’t know he was taking fentanyl.
“He probably thought he was buying heroin," Haynie said. "It was nothing but straight fentanyl. They say it probably killed him instantly.”
That’s a problem, as experts say fentanyl has progressively spread into new states, which means there are more people encountering it for the first time. The drug has also shown up in popular stimulants such as cocaine and meth.
Dr. Dan Ciccarone, who studies drug use at the University of California, San Francisco, has seen fentanyl expand across the country.
“It's kind of the Wild West, you know, it's doing different things in different places,” Ciccarone said.
Ciccarone has worked with the past two presidential administrations and says the adoption of harm reduction has grown in recent years. It took 20 years for mainstream adoption of naloxone, and he points to the much quicker uptake of test strips as a sign of change.
“The fentanyl test strips have gone from underground, literally five years ago, to being on the FDA hit list for for promotion," Ciccarone explained. “It shows you that harm reduction is no longer a dirty phrase.”
Ciccarone characterizes the Biden administration's approach so far as the most progressive stance on harm reduction strategies he has seen and he believes it will continue.
Nevertheless, Ciccarone and others predict fentanyl is here to stay. And as the drug spreads, increasing awareness will only become more critical.
