Spotlighting a National Crisis

The United States is in the grips of an epidemic of drug overdose deaths. Stemming the tide of this crisis is a massive undertaking for the nation’s scientific and health-care communities, with the state of Louisiana being no exception. According to the Centers for Disease Control and Prevention (CDC), the rate of overdose deaths in Louisiana increased by 11.4% from 2018 to 2019 alone. Nationally, opioids like fentanyl and some pain medications are the leading cause of overdose deaths. However, deaths due to psychostimulants such as methamphetamine are on the rise. Both classes of drugs have wreaked havoc on the communities in Northwest Louisiana and across the state.

The Louisiana Addiction Research Center (LARC) at LSU Health Shreveport leads a multidisciplinary effort to study and understand the impact of substance use on our citizens. The goals of the LARC are to:

1) Advance human understanding of best practices and the optimal implementation of therapeutic models that maximize compassionate care to patients suffering from addiction.

2) Elucidate the neurobiology of addiction as a disease and particularly the role of stress and trauma in that disease.

3) Work through active partnerships with our local and state-wide community to improve knowledge and understanding of addiction as a public health issue.

The need to study this issue and act is critical. With the rate of substance-related hospitalizations and overdose deaths increasing, the ability to provide effective interventions may prove lifesaving to countless Louisiana residents.

The Louisiana Department of Health (LDH) maintains the Louisiana Opioid Data and Surveillance System, which tracks several metrics related to this epidemic. According to these data, opioid-involved deaths increased from 470 in 2018 to 588 in 2019 (a 25% increase).

At the same time, stimulant-involved deaths in the state rose from 276 in 2018 to 372 in 2019 (a 35% increase in just one year). These numbers highlight the real and present danger of the misuse of these powerful substances, as well as the need to address this crisis for the sake of our neighbors and our communities.

An important front in the war on overdose deaths is the legislative arena. The Louisiana State Legislature has enacted laws that establish medical amnesty for those who are suffering from an overdose or those who seek help for these individuals. La Revised Statute 14:403.10 protects those who have overdosed and need medical assistance and/ or those who seek help on their behalf. Under these laws, those who seek help are protected from prosecution for possession of dangerous controlled substances. These laws make it possible for individuals to seek medical care after an overdose without fear of criminal charges, thus eliminating a significant barrier to receiving potentially life-saving treatment. In 2017, the state of Louisiana also enacted a “standing order” for Naloxone, which is a medication that can be used in the event of an opioid overdose. This order allows pharmacists in the state to dispense Naloxone to laypeople, including those who use opioids and their family, friends or others. This greatly enhances the availability of this medication in the community and increases the likelihood that it will be available when needed.

Although much attention is paid to the rise in opioid overdoses, there has been a distinct upward trend in the rate of psychostimulant overdoses. This drug class can be defined as a psychotropic substance with the capacity to speed up signals into the brain, and examples include cocaine, methamphetamine, prescription stimulants and ecstasy. The emerging crisis has prompted the introduction of a bipartisan bill called the Methamphetamine Response Act of 2021. According to Senator Feinstein, one of the sponsors of the bill, “In a single year we’ve seen psychostimulantrelated overdose deaths, which include meth, spike by 42 percent. … The meth available on our streets is pure, potent and cheap, and law enforcement is seizing more of the drug than ever ... and in just a five-month period, U.S. Customs and Border Protection seized more than 75,000 pounds of methamphetamine.”

International Overdose Awareness Day will be recognized on Aug. 31, presenting an annual occasion to draw attention to the growing problem of drug overdoses and the tragic outcomes. Although researchers, physicians, lawmakers and community advocates are hard at work fighting this uphill battle, truly transformative change requires that our community become educated about this epidemic. By engaging persons with addiction in a meaningful way and supporting those adjacent to the addicted, working together, we can reduce the drug use plaguing our society.

Shawn E. McNeil, MD, FAPA, is clinical assistant professor of psychiatry and behavioral medicine, associate program director of the Psychiatry Residency Program, director of neuroinformatics research at LSU Health Shreveport.

Kevin Murnane, PhD, is associate professor of pharmacology, toxicology and neuroscience; associate professor of psychiatry; director of basic science research for Louisiana Addiction Research Center at LSU Health Shreveport.

Nicholas E. Goeders, PhD, is chairman of pharmacology, toxicology and neuroscience; professor of psychiatry and behavioral medicine; executive director of Louisiana Addiction Research Center at LSU Health Shreveport.

James C. Patterson II, MD, PhD, professor and chair of psychiatry and behavioral medicine, and professor of pharmacology, toxicology and neuroscience at LSU Health Shreveport.