$350 million, 4 states and virtually no impact

Also: The link between ancestry genes and brain disease [Donate ❤️]( [View in Browser](  June 18, 2024 Hi CommonHealth reader, I'd like to take you back, briefly, to 2019. I’m at my desk at WBUR, reading a press release with some big news: Massachusetts and three other states will share a $350 million federal grant. The goal is to reduce overdose deaths among the states by 40%. Wow and wow, I thought. This would be a historic investment in tackling the opioid crisis. One researcher said the news brought tears to his eyes. I set up regular calls with researchers at Boston Medical Center, the epicenter of the Massachusetts project. In January and February of 2020, I attended meetings in a few of the eight communities selected to receive the first round of funding. Then COVID-19 hit, the state shut down, and progress stalled. It was hard to meet, hire staff, purchase materials and start programs. But researchers and their local partners soldiered on. I [spent months in Brockton]( a community that received $1.6 million from the grant. The money funded staff for a mobile treatment program, better addiction care coordination in a local hospital, support groups and dozens of other projects. Overdose deaths among Black men in particular surged during the pandemic. Researchers provided Brockton's coalition close to real-time data about overdoses, and street outreach workers heard more frequent reports of fentanyl killing unsuspecting crack and cocaine users. Leaders of the Brockton project knew they had to find a targeted strategy. They gathered Black residents who use drugs in a church basement to ask what they needed. They produced public affairs shows with local Haitian and Cape Verdean hosts to explain treatment options and the risks of fentanyl. They worked with Black-led community and business groups to distribute naloxone and hold trainings about how to administer it. No one I spoke to thought the goal of reducing overdose deaths by 40% — in Brockton or elsewhere — was realistic, but there was a lot of energy and determination and hope. So last week, when I opened the [announcement]( with the [study results]( I had to read the headline several times. It said that — across all four states in the study — the inventions had [virtually no impact on the rate of fatal overdoses](. I called Dr. Jeffrey Samet at Boston Medical Center, someone I’d talked to regularly during the three-year study. After all that money and all that effort, was he disappointed? In short, Samet said you can’t expect to reverse the course of a drug overdose crisis in the middle of a pandemic. Many of the interventions launched with less than a year remaining in the study. As one example, Samet said only 38% of the programs that were supposed to help reduce overdose deaths were in place when the comparison period started. “I would have loved to have seen a 40% decrease in overdose deaths,” he said. “But between COVID and the relative brevity of the time for these changes in practice to be carried out, we understand what needs to be done going forward.” In a twist, Massachusetts has just [reported a significant decrease]( in fatal overdoses. It happened in 2023, the year after the study’s comparison period ended. There’s no proof that the $82 million Massachusetts received contributed to last year's decline, but some participants said it deserves credit. “There are a lot of projects you have to evaluate over a longer term," Allyson Pinkhover, the director of substance use services at the Brockton Neighborhood Health Center, told me. 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