Fatal overdoses have fallen in most areas of the country. Worcester, Massachusetts, has seen a sharp decline in deaths. Officials praise the hands-on approach to helping drug users where they are.
LAUREN FRYER, HOST:
Overdose deaths have dropped sharply across much of the country, and no one knows exactly why. But Worcester, Massachusetts, offers clues. Member station WBUR reports.
MARTHA BEBINGER, BYLINE: A few years ago, Worcester had one of the highest overdose death rates in New England. Then, last year, police reported a startling change: 49% fewer people died after overdosing. What has changed? Let's start with a van that delivers help through the city streets.
A local drug program called Spectrum sets up a mobile clinic behind a Catholic church. Trina, a 60-year-old former nurse, comes here for her daily dose of a cherry-red medicine called methadone.
TRINA: I'm getting 50 milligrams. I try not to get up.
Thank you.
BEBINGER: Methadone helps patients like Trina resist cravings for fentanyl. It's been around for decades, but most patients have to go to a designated methadone clinic every morning to get their dose. What's new for Worcester is delivering methadone directly to Trina or very close to it.
TRINA: From where I live, I can almost throw a stone. I love the people here. I see very sick people coming here and being treated quickly. And then they have hope.
BEBINGER: Trina says methadone makes her feel like her life is worth something again. NPR agreed not to use Trina's full name because she still buys illegal drugs from time to time.
TRINA: My biggest salvation is that I no longer hate myself, rather than just experiencing my existence. That's where I'm doing well.
BEBINGER: The hospital in Worcester has another van offering a variety of drugs for addiction treatment and ambulances with those drugs. But even with easier access to treatment, people still overdose. So last year Worcester made a second change. He covered overdose sites with a drug that could bring people back to life.
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UNIDENTIFIED NARRATOR: Narcan nasal spray is a rescue medication designed to quickly reverse the effects of a life-threatening opioid emergency.
BEBINGER: Narcan is now available in libraries, train stations and parks.
MATTIE CASTEEL: Narcan is the biggest thing we've had in Worcester that has led to a reduction in overdose deaths.
BEBINGER: This is the recently retired Worcester Health and Human Services Commissioner, Dr. Mattie Castiel.
CASTILLE: We talk about Narcan like CPR, and everyone should carry it with them and know how to use it.
BEBINGER: Last year, Worcester made a third big change that offers a surprising theory about why fewer people are dying from overdoses. Street outreach workers like Kevin Davila began testing samples of illicit drugs.
KEVIN DAVILA: Yes. I'm cleaning the car to make sure there's nothing on it or…
BEBINGER: Davila wipes down a $55,000 drug-testing machine and reaches for another client sample.
DAVILA: They think they bought fentanyl. But when we test it, does it turn out to be fentanyl?
BEBINGER: This sample actually contains the animal tranquilizer xylazine. Sixty-four percent of samples tested last year in Worcester contained traces of xylazine. That's why it's important. Xylazine can put a person into a deep sleep for eight hours, much longer than fentanyl alone. Therefore, people taking xylazine are less likely to use drugs. Tracy Green oversees the street drug testing program in Massachusetts.
TRACY GREEN: That doesn't mean there's zero risk. This simply means there is potentially less fentanyl or fewer opportunities for overdose.
BEBINGER: Xylazine is terrible in its own way, causing deep wounds and infections. Drug testing has helped doctors understand xylazine-related injuries. Drug testing in Worcester, Narcan and treatment vans rely on federal funding from agencies that have been cut. But so far, Worcester's programs are working, and overdose deaths continue to decline.
For NPR News, I'm Martha Bebinger in Worcester, Massachusetts.
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