Say bye to being a bystander

Overdoses are at a record high in Iowa despite being ranked as one of the states with the lowest rates of drug overdose deaths

In the 2023 Condition of the State address, Iowa Gov. Kim Reynolds highlighted the opioid crisis, focusing on overdoses and overdose deaths, specifically. While Iowa fares well nationally, as one of the lowest-rated states for drug overdose deaths (ranked 47th), according to the Center for Disease Control, Reynolds is right to draw attention to these skyrocketing rates over the course of the last two years or so. The opioid crisis in Iowa and the United States needs to be taken seriously, as they remain a leading cause of injury-related death in the nation — and the majority of overdose deaths involve opioids.

One of Reynolds’ claims from the address: “Overdoses are up by more than 34 percent, and for Iowans under 25, they’re more than double. In 2021, illicit fentanyl was implicated in 83 percent of all Iowa’s opioid-related deaths, compared to just 31 percent five years ago.” The Gazette’s fact-check team determined, “While it’s true that opioid deaths increased in the time period, as the governor claimed, the number of Iowans who died and the percentage of an increase that represents reported from other sources — including numbers from the state government — differ from the data she reported in July.” Most of it comes down to the nitty-gritty of word choice and not using overdoses and overdose deaths synonymously. To read the full analysis of that fact check, the report can be read here.

The real killer that people have been hearing about more lately is fentanyl. The National Institute on Drug Abuse describes fentanyl as, “a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent.” At the prescription level, pharmaceutical fentanyl was developed to manage severe pain, such as cancer patients undergoing treatment or post-surgical operation. Unfortunately, drug traffickers and dealers have synthesized the drug and mixed it with others like heroin, cocaine, methamphetamine, and MDMA to make them at a cheaper rate and increase their profit.

Fentanyl is the leading cause of death for Americans between the ages of 18 and 45. And here’s something that might shock you: Fentanyl has killed more young Americans than COVID-19, car accidents or suicide, according to the latest Fentanyl by Age Report from Families Against Fentanyl. “Fentanyl is the single deadliest drug threat our nation has ever encountered,” U.S. Drug Enforcement Administration Administrator Anne Milgram said. “Fentanyl is everywhere. From large metropolitan areas to rural America, no community is safe from this poison.”

And even more disturbingly, CDC data shows that 66.8 percent of drug overdose deaths, at the national level, could have been prevented with at least one potential opportunity for intervention. That means the person who died was currently in a treatment program, was witnessed using the fatal drug, had a mental health diagnosis that should have been taken more seriously, bystanders were present, the victim had a prior overdose, and/or the victim was recently released from an institutional setting. It’s imperative that we as Iowans check in with the people we care about in our lives on a regular basis and not just ask the polite questions we usually do but push to be supportive in whatever way we can. It’s true that you can’t help someone if they don’t want to be helped, but oftentimes, all it takes is one person who shows they care even in the darkest of times. That’s easier said than done, but so are most things in life.

Now, we can’t talk about drug overdoses without talking about mental health. Researchers from a 2021 Iowa State University study found in their Small Towns Project that people in the smallest Iowa towns were more likely to report both worsening mental health and relationships as a direct result of the pandemic, including a fifth of respondents which said they showed signs of depression and another 15 percent that reported signs of anxiety. What’s more, access to resources for substance use and mental health treatment has been strained during the pandemic, making it more difficult for people to access treatment and services due to safety protocols, transportation barriers, and a workforce shortage of counselors.

So, the first thing that one should do when attempting to help someone struggling with drug use and abuse is recognize that drug addiction is a disease. Drug addiction, also known as substance use disorder, “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences,” the National Institute on Drug Abuse reports. “It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs. Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable. If left untreated, they can last a lifetime and may lead to death.”

People start taking drugs to feel good, relieve stress and/or pain, to improve their focus or even satiate their general curiosity. But that can lead to a slippery slope where one becomes dependent on a drug and that’s where it’s important loved ones step in to intervene and show their support without attacking the user. Try the approach of understanding what’s going on rather than attacking.

The next thing one should do is get a drug testing kit — even if you don’t use drugs yourself, having one on hand is crucial, as it could save the life of a loved one or even a stranger if you can identify the symptoms and act quickly. When people overdose on fentanyl, their breathing can slow or stop, increasing chances of hypoxia, which can lead to a coma, permanent brain damage and even death.

As a result, scientists created naloxone, which is “a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. But fentanyl is stronger than other opioid drugs like morphine and might require multiple doses of naloxone,” the National Institute on Drug Abuse reports. One of the easiest ways to administer this lifesaving medicine is a nasal spray called NARCAN.

So, what’s being done to combat these overdoses and overdose deaths as a state? Reynolds is launching a campaign aimed to educate parents and young Iowans alike about the dangers of counterfeit pills and fentanyl, led by the Iowa Department of Health and Human Services. Luckily, Iowa is one of the states that is looking to deploy naloxone use and post-overdose outreach and referral. In 2016, Reynolds signed a law allowing pharmacists to dispense naloxone without a prescription to Iowans. Iowans can also request naloxone through the University of Iowa’s Tele-Naloxone program by visiting www.naloxoneiowa.org. Iowa businesses, restaurants, bars, community organizations, etc., can also request free naloxone to be available to them.

All that said, check-in with the people around you — and not because you have to, but because you care and want to see the best for them. If you are someone struggling with substance use and or abuse, I encourage you to ask for help. You might be surprised at the support you have at your fingertips.

Nichole Shaw is a Gazette editorial fellow. Comments: nichole.shaw@thegazette.com

Opinion content represents the viewpoint of the author or The Gazette editorial board. You can join the conversation by submitting a letter to the editor or guest column or by suggesting a topic for an editorial to editorial@thegazette.com