You can see it getting slightly worse almost every year, then rising more dramatically starting in the 90s, mainly driven by overdoses on prescription opioids.

Overdose deaths accelerate in a second wave through the 2000s, and starting in 2013, a catastrophic third wave emerges, kicked off by highly potent synthetic opioids like fentanyl.

But by the end of the 2010s, the fatal overdose epidemic in the U.S. almost looked like it was starting to take a turn.

The annual number of deaths dropped for the first time since the crisis started.

But then…

Stay at home.

That is the order tonight.

Coronavirus emergency.

Living in lockdown.

As daily life became more isolated, U.S. overdose deaths reached new heights.

In 2021, the annual death toll from drug overdoses crossed the 100,000 mark for the first time, killing more Americans that year than firearms and fatal car crashes combined.

Historically, America's strategy for reducing drug use has been broad prohibition and criminalization of both selling and using drugs.

But you can see that criminalizing drug use hasn't stopped the overdose death rate's upward trend.

But gradually, the U.S. is starting to turn to different methods to fight the ongoing overdose epidemic.

And one of them is something you and I can do, starting today.

Over the last 10 years, the most significant cause of fatal overdoses by far are cheaper, stronger, and widely distributed synthetic opioids, namely fentanyl.

Elicit fentanyl is up to 50 times more potent than heroin and is often mixed into other drugs to make them stronger and more addictive.

The result is that it's often consumed unknowingly.

So if we look at overdose deaths involving stimulants like cocaine and methamphetamine, you'll see that for years, the number of documented fatal overdoses on these drugs consistently ran below 10,000 annually.

When fentanyl got mixed in starting around 2013, these deaths surged higher year after year.

Elicit fentanyl is also sold on the street disguised as less harmful prescription drugs like Xanax and oxycodone, which is thought to be the main reason why adolescents are now dying of opioid overdose at unprecedented levels.

Opioids bind to specific receptors in our brain called opioid receptors, and block pain messages between the brain and body.

They do this by numbing our central nervous system.

But opioids also numb our respiratory system.

They slow our breathing.

Taking too many opioids slows breathing to dangerous levels, or stops it completely.

Which is why signs that an unresponsive person may be having an opioid overdose, also called opioid poisoning, include slow, shallow breathing, small pinpoint pupils, and cold, blue, or pale skin.

But this entire process can actually be reversed, if help arrives soon enough.

The life-saving medication.

Opioid overdose antidote.

An effective way to reverse an overdose.

This is naloxone, also known by the brand name Narcan.

Naloxone has been in the toolkits of first responders since the 2010s.

And ever since the FDA approved it to be sold over-the-counter in 2023, naloxone is probably stocked in more places you go than you might think.

It's in coffee shops.

Bars and restaurants.

And at public libraries.

Spray bottles of Narcan are now kept inside overdose emergency kits in schools, installed next to other emergency first aid equipment like heart defibrillators.

The way this nasal spray can reverse an opioid overdose is simple.

Naloxone is an opioid antagonist.

It binds to opioid receptors too, but has an even stronger affinity for them than opioids do.

So it can dislodge opioids that are there already, and block any more from binding to the receptors.

This process reverses and temporarily blocks the effect of opioids.

Which is why people in the middle of an opioid overdose can be revived by naloxone.

It's also harmless to use, since all it does is block opioid receptors in the brain.

If naloxone is used on a person with no opioids in their system, it does nothing at all.

And as more American workers who regularly interact with the public, like restaurant servers and transit officials, train to use Narcan in case of emergency, some medical experts are urging everyone to carry naloxone with them too.

Now you might be watching this video and thinking, OK, well, I don't use drugs.

So why would I carry naloxone?

There's substance use happening.

We don't have to pretend like it's not.

We don't have to pretend like it's not.

I don't know who's sitting around me who is managing themselves.

Shredda Walden is the executive director of the Kentucky Harm Reduction Coalition.

And she routinely hands out free Narcan to bars and restaurants in Louisville.

Narcan should be everywhere.

If I give a person a tool that can potentially prolong their life, they're going to think about their decisions now.

Shredda's describing a strategy that has gained ground in the U.S. in recent years, harm reduction, creating environments for people with substance use disorder to find support rather than punishing them.

We just say we know what's happening.

I don't want people to have to live with an unnecessary pain, losing someone that could have potentially been preventable.

What is the biggest obstacle right now standing in the way of reversing the overdose epidemic in the U.S.?

I guess if I had to pick one thing that makes this difficult to solve tomorrow, it would be stigma.

Dr. Bobby McCamilla is the chair of the American Medical Association's Substance Use and

Pain Care Task Force.

There's the legacy of that stigma that affects everything from law enforcement's approach to it, to the community's approach to it, to individuals' willingness to deal with it.

We need to promote and facilitate the intersection of the use with the resources to help curb that use.

We cannot criminalize our way out of this epidemic.

We've never been able to criminalize our way out of addressing substance use disorder.

Accidental opioid overdoses, especially in the era of fentanyl, can happen anywhere.

One pre-pandemic study from the CDC found that in a six-month period in 2019, almost 40 percent of fatal overdoses occurred with a bystander present.

We will run into strangers that are blue on the ground.

Whether or not it's somebody we know or a stranger, we want to be able to save that person's life.

I picked up this naloxone kit for free from a nearby coffee shop.

It's got two doses of Narcan, plus instructions on how to use it, and additional recovery resources inside.

If you live in the U.S., there's probably overdose prevention resources nearby where you are, too, including in free vending machines being installed in cities across the country, distributed by local harm reduction organizations and municipal public health departments.

They also offer free trainings on how to recognize an overdose and how to administer naloxone.

I'll put some helpful links for that in the description of this video.

Expanding access to naloxone isn't a silver bullet for reversing the opioid overdose epidemic, but it's saved tens of thousands of lives so far.

Preliminary data from 2023 shows that overdose deaths in the U.S. dropped for the first time since 2018.

This overall drop was mainly driven by a decrease in deaths from fentanyl.

This tiny dip could be the beginning of reversing the overdose epidemic in the U.S.

And it's why I'm going to start carrying naloxone with me wherever I go.

Because you just don't know when you'll come across someone in your community who needs help.

Thanks for watching this episode of Even Better.

I want to take a moment to thank the sponsor of this video, Brilliant.

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