TEXAS VIEW: Texas’ fentanyl problem is far worse than we know

THE POINT: Experts estimate 70% of largely nonfatal overdoses go unreported in Texas.

An opioid crisis has engulfed the U.S. for over a decade. We’ve been in a federally declared public health crisis since 2017. But if you ask, “Where are the areas in my community that need the most help?” you won’t get a great answer.

A data desert exists for timely, statewide overdose numbers. A reliable national count for overdose survivors doesn’t exist, either. The federal government aggregates emergency room nonfatal overdose data, but misses large swaths of people who do not go to the hospital. And the official data we do have is often available months later, making it difficult to pinpoint present-day hot spots into which to pour resources.

It’s a problem that needs a solution as quickly as possible.

The University of Texas is trying to form a solution, and we are thankful for its efforts, especially after seeing a record number of drug overdoses in 2021 that killed over 100,000 people in the country. For the most part, the death trends have only gone up since the ’90s, with a brief and modest dip in 2018. This problem is persistent.

The UT project, called TxCOPE, works through community crowdsourcing to provide an instant understanding of nonfatal and fatal overdoses in neighborhoods and regions. Harm-reduction groups, which often informally track overdoses commonly recorded for wandering populations, can pool information with health care workers, families and drug users to report overdoses and get immediate help to high-need areas.

For example, if a particular batch of drugs laced with fentanyl drives up overdoses in an area, community groups can step in with education or extra naloxone, a drug that reverses an opioid overdose. A formal launch is planned in September that will begin rolling out the program statewide, in stages.

El Paso and Austin are already running pilot programs, and advocates there say the data allowed them to find at-risk populations to target for treatment, according to Kaiser Health News. While the numbers are unofficial, experts say the data is vastly better than currently available overdose information.

Working with what we have now, communities would only see the effects in data months after people die. We need to shift from reacting to deaths to preventing loss of life. And the actual need necessary to match the scope of Texas’ and the nation’s overdose problem is vastly understated with current statistics.

Kasey Claborn, the lead researcher on the TxCOPE project, estimates up to 70% of overdoses go unreported because many users fear criminal consequences. Nationwide, experts believe, about 50% go uncounted. So in essence, we have no idea how bad our situation actually is, but we know it is significantly worse than what the data shows us. Fentanyl poisoning is the top cause of death for Americans 18 to 45.

Those who worry about facing repercussions for reporting nonfatal overdoses should know the federal government protects TxCOPE data from court orders, and program leaders do not share raw data with the state.

While there’s debate over the myriad ways to prevent overdose deaths, one thing is certain: A clear picture of the numbers is necessary for deploying an effective lifesaving campaign.

We hope state health officials learn from and imitate UT’s efforts. Texas has more than $1.6 billion from recent opioid settlements. Some of that money should also go to better understanding the depth of our state’s opioid addiction crisis.

The Dallas Morning News