〽️Service Stats & Updates
As of Tuesday April 22, 2025:
12,225 samples analyzed
Serving 168 harm reduction programs
Reaching 248 counties in 41 states
411 unique substances identified
Click below to see Live Reports on cafentanil, (dex)medetomidine, nitazenes, BTMPS and more.
☠️ OD Numbers
You'll notice that the monthly refresh of predicted overdose counts is still being posted by CDC, though it seems to take a bit longer. There are important data, despite the limitations we've pointed out. Before you even ask, let's look into what's happening in South Dakota, Nevada and Alaska.
South Dakota
This was clocked as a 2.3% increase for the 12-months ending in November 2024, compared to the 12-months ending November 2023. The absolute difference +2 deaths, 87 versus 85. So this is well within background fluctuation.
Nevada
Using our data app, we can see that the predicted 💜 OD deaths (purple line) are consistently a ~25% overestimate from actual 💙 deaths (blue line). Nevada exhibits a spikey pattern, with outbreaks in March and July 2023, and June 2024. As we previously explained, these spikes create inertia that will keep the 12-month predicted rate high artificially. The distance between the purple 💜and orange 🍊 lines is the combined impact of these two reporting artifacts, a whopping 33% monthly overestimate. Still the general upwards trend is concerning.
But hospital emergency department non-fatal overdoses don't always pick up the deaths spikes. The two data systems concurred in July 2023, but not in June 2024. There has been a general downward trend since last summer, with some end-of-year fluctuation. It is also worth looking at regional patterns (Reno vs. Las Vegas vs. rural areas). So what do we conclude when fatal vs. non-fatal ODs don't align in time? It could well be that people are using alone, don't have naloxone, or are otherwise dying before they can be helped by EMS or peers. How do we prevent these deaths?
Alaska
Alaska OD deaths reported by CDC remain artificially high, due to the December 2023 and January 2024 spike. In those 2 months alone, n=92 people died, compared to n=309 for entire 2024 year. Just like Nevada, the CDC predicted 💜 annual count (n=400) is a substantial 33% overestimate.
That 2023/24 spike shows up in the hospital ED non-fatal OD data below. What is encouraging is that in 2024, hospital visits dropped for 15-24 year-olds substantially throughout the year; the greatest drop among any age group. But it wasn't until early summer that OD deaths started dropping for younger adults (25-44), who make up more than half of deaths.
So who is dying? Overdose deaths occur mostly in Anchorage, n=220/309 for the 12-months ending October 2024. About 70% are male. Historically, OD rates are about 2x higher for Alaska Native People, than Alaska Non-Native People.
📊 Explainer
Dr. Nab sat down with DPA to explain the leading ideas on why OD deaths have been declining. Here's a video playlist of the highlights. While the overall decline in overdose deaths is really encouraging, this is a fragile recovery.
📈 Department of Data
At the UNC Street Drug Analysis Lab, our primary mission is to provide an accurate, affordable, low-barrier, and rapid drug checking service so that people can make better decisions about what they put in their bodies. We also realize that the data generated has value. We have made a commitment (in our Terms and Conditions) to let y’all know when we use our drug checking data to answer questions “research” questions posed by our service users. We do this by posting a pre-registration, which describes the rationale and methods for the research. Importantly, the plan is public, non-editable, and hosted by an independent Open Science organization, meaning it’s a permanent record to hold researchers (us!) accountable to our community. Here are examples-
- Our friends at Prevention Point Pittsburgh asked us to investigate whether (dex)medetomidine could be causing hallucinogenic side effects that their participants are experiencing. Dr. Adams Sibley on our team has registered this study. It’s an interesting question because (dex)medetomidine is widely used in US hospitals to sedate people after surgery if they are having episodes of agitation, psychosis, or hallucinations. But there are many reports of hallucinations in the dex(medetomidine) samples we’ve tested, enough to warrant a study.
- RTI International provided a link to the federal grant record that contains a description of Dr. Jon Zibbell’s exploration of skin wounds and drug supply in North Carolina. Future studies will be preregistered before the start of sample collection.
Government Affairs
There is a lot happening at state and national levels with new bills proposed at the NC General Assembly, and myriad federal agency cuts.
- The White House Statement of Drug Policy Priorities was released with naloxone distribution, expanding access to MOUD, peer recovery, and (implicitly) drug checking were listed, among standard Drug War priorities. We think it's smart that policies that have worked to bring down overdoses are continuing.
- The Public Health Emergency on opioid overdose has been renewed, thankfully. This wonky designation is really really really important, as Blaire Bryant from NACo explains. This administrative act also helps make low-barrier bulk naloxone distribution easier. Please keep this going, as too many people we love are still dying.
- If you want to read excellent commentary on national drug policy, subscribe to Regina LaBelle's Substack, where she mentions here recent actionable roadmap for this pivotal moment as we face down overdose deaths.
- On the international front, former president Duterte of the Philippines is facing justice for a years-long exaggerated "War on Drugs" that led to thousands of extrajudicial killings. Here's an audio story, and the Human Rights Watch report. It's a rare rebuke of political leaders who use the spectre of drugs problems for political gains.
🤗 Opportunities for Impact
Job postings, conferences, proposals, and other events for you harm reduction baddies! If you have a job posting or event you'd like us to highlight, please be in touch.
There is a ton of cool and exciting things happening in the Harm Reduction community (as always 😜) -Take a look ⬇️
- Turn complex data into life-saving public health insights—Vital Strategies is hiring a Technical Manager, Substance Use Data Communicator in NC. If you’re passionate about translating overdose prevention data into impactful messages for policymakers and communities, click to learn more and apply.
- Join Remedy Alliance's comprehensive drug checking training in Minneapolis from June 25-27, 2025, designed for new technicians and programs with FTIR spectrometers seeking formalized instruction. Participants must have lab verification contracts, equipment, and sample collection capabilities before attending this three-day intensive training. Click here to complete the registration form and learn more about pricing options.
- There's a new Drug Policy Archive! A comprehensive digital collection of 2,600 books on drug policy, harm reduction, and addiction studies resulting from a collaboration between DPA and the Substance Abuse Librarians and Information Specialists. This free online resource, available at the Internet Archive, preserves rare materials from Ethan Nadelmann's personal collection and serves as an invaluable tool for researchers, educators, advocates, and the general public. Access the complete collection and learn how to navigate it with this step-by-step guide and explore this unique repository of knowledge to advance your teaching, research, or advocacy work.
- Join the UNC IPRC Opioid Student Research Group on Thursday, April 24th, 2pm-3pm (today!) to hear Dr. Shabbar Ranapurwala, an associate professor of Epidemiology, president-elect of the SAVIR, and faculty mentor for the UNC IPRC speak about overdose deaths among formerly incarcerated people, either in person or via Zoom. Click here to attend this presentation you don't want to miss!
- Durham County DPH is hosting "Together in Faith and Hope: Strategies to Prevent Overdose Conference" on Saturday, April 26 from 12:30-4:00pm, bringing together faith communities, substance use disorder experts, and community leaders to explore overdose prevention strategies. Register here!
- Check out Guilford County's Harm Reduction Hangout!
📖 Reading Room
A place for things that taught us something new and maybe you will learn something too!
NC Health News: Discover how three rural North Carolina counties are utilizing opioid settlement funds to implement community-driven strategies aimed at reducing overdose deaths.
We were saddened to hear of the passing of Howard Josepher, a harm reduction legend. Read Tony Newman's tribute: How One Man Helped 10,000 People With Serious Drug Problems
🤓 Scientific Literature
- "Four decades of overdose prevention centres: lessons for the future from a realist review” – This is a handy review of the evidence around Overdose Prevention Centers from around the world. It also has a compelling model of how OPCs improve health beyond preventing overdose.
- We found this fascinating! Olinde, A., et al. (2025). A survey study of urban retailers selling alkyl nitrites (“poppers”) in the New York City area which led to public health interventions. Clinical Toxicology, 1–5.
🏆 Box of the Month
Sometimes our amazing partners write us a warm message, doodle or draw a picture on the return boxes we send out. This is in no way a requirement (♻️ we reuse the boxes), but we love receiving the random surprises!
Each month, we will showcase boxes we love.
👋 Meet our Team Members
Each month will feature different team members 😊
