LAUREN FRAYER, HOST:
Overdose deaths are down dramatically across much of the country, and no one knows exactly why. But Worcester, Massachusetts, offers clues. Martha Bebinger from member station WBUR has this report.
MARTHA BEBINGER, BYLINE: A few years ago, Worcester had one of the highest rates of overdose deaths in New England. Then last year, police reported a startling reversal - 49% fewer people dying after an OD. What changed? Let's start with a van that delivers treatment on city streets.
A local addiction program called Spectrum parks 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 get 50 milligrams. I try not to go up.
Thank you.
BEBINGER: Methadone helps patients like Trina resist cravings for fentanyl. It's been around for decades, but most patients have to find their way to a designated methadone clinic every morning to get their dose. What's new for Worcester is bringing methadone right to Trina, or very close.
TRINA: From where I live, I can throw a rock, almost. I love the people in here. I see people very sick coming in here, getting put on it quickly. And then they have hope.
BEBINGER: Trina says with methadone, she feels like her life is worth something again. NPR agreed not to use Trina's full name because she still occasionally buys illegal drugs.
TRINA: My biggest saving grace is not hating myself anymore, not just testing my existence. That's where I'm doing good.
BEBINGER: A hospital in Worcester runs another van that offers a different addiction-treatment drug and stocks ambulances with that medication. But even with easier access to treatment, people still overdose. So Worcester made a second change last year. It blanketed overdose hotspots with a drug that can bring people back to life.
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UNIDENTIFIED NARRATOR: Narcan nasal spray is an emergency treatment designed to rapidly reverse the effects of a life-threatening opioid emergency.
BEBINGER: Now Narcan is available at libraries, train stations and parks.
MATTIE CASTIEL: Narcan is the biggest thing that we've had in Worcester that has caused the decrease in overdose mortality.
BEBINGER: This is Worcester's recently retired commissioner for Health and Human Services, Dr. Mattie Castiel.
CASTIEL: We talk about Narcan as being like CPR, and everybody needs to carry it and know how to use it.
BEBINGER: Worcester made a third big change last year, one that offers a surprising theory about why fewer people are dying from overdose. Street outreach workers, like Kevin Davila, started testing samples of illegal drugs.
KEVIN DAVILA: Yes. I'm cleaning the machine to make sure there's nothing on it or...
BEBINGER: Davila wipes down this $55,000 drug-checking machine and reaches for another client sample.
DAVILA: They think they bought fentanyl. But when we test it, does it come out as fentanyl?
BEBINGER: In fact, this sample contains the animal tranquilizer xylazine. Sixty-four percent of samples tested last year in Worcester included traces of xylazine. Here's why that matters. Xylazine can put someone in a deep slumber for eight hours, much longer than fentanyl alone. So people taking xylazine use drugs less often. Traci Green oversees the street drug-checking program in Massachusetts.
TRACI GREEN: This doesn't mean that there's zero risk. It just means there's potentially less fentanyl or fewer opportunities to overdose.
BEBINGER: Xylazine is awful in its own way, creating deep wounds and infections. Drug-checking has helped doctors understand xylazine-related injuries. Worcester's drug testing, Narcan and the vans that offer treatment all rely on federal funding from agencies that have been cut. But so far, Worcester's programs are intact, and overdose deaths continue to drop.
For NPR News, I'm Martha Bebinger in Worcester, Massachusetts.
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