Using public health research to save lives

More than 106,000 people died of drug overdoses in the United States in 2021. That’s more than the number of people who died due to firearm-related injuries (48,830), falls (44,686) or motor vehicle crashes (42,939). These are all considered preventable causes of death, and as such, they are a public health problem. Reducing the toll requires research to identify risk factors and then the development of interventions that make the environment safer and discourage unsafe behavior.

Motor vehicle crashes make for a good case study. From 1972 to 2019, the death rate from crashes dropped by more than half in the United States, from 26.9 per 100,000 people to 11.9. It took multiple interventions to make that happen, including laws requiring seat belts and lower speed limits, graduated driver’s licenses for teens, safer roads, new technologies like airbags and advocacy from groups like Mothers Against Drunk Driving.

Some simple interventions are remarkably effective. Just using a seat belt, for example, reduces the risk of death for people in the front seat of a car by 45 percent compared with those without seat belts. New technologies like forward collision avoidance may do more. Research by the AAA Foundation for Traffic Safety estimates that these technologies could potentially prevent more than 2.7 million crashes a year if they were on all cars and properly used by drivers.

In this issue, we explore one effort to prevent deaths from drug overdoses. In the 1990s, use of prescription opioids like Oxycontin fueled a rise in overdoses, according to the U.S. Centers for Disease Control and Prevention. Over the last decade, powerful synthetic opioids such as fentanyl have greatly increased the risk of overdose and death — so much so that annual deaths from opioid overdoses have more than doubled since 2015. Addiction is a disease; the goal here is keeping people alive so they can get treatment and rebuild their lives.

Access to naloxone, a medication that reverses an opioid overdose, is one tool. Another is overdose prevention centers, where people can use drugs in a supervised setting. As freelance science journalist Tara Haelle reports, the United States lags behind some other countries in opening overdose prevention centers, despite data showing their effectiveness in saving lives. Only two officially sanctioned overdose prevention centers currently exist in the United States, both in New York City. To see how well these centers might work across the country, researchers are gearing up to study the impacts of the New York sites, as well as one that is scheduled to open in Rhode Island later this year.

Current barriers to opening more overdose prevention centers include addressing legal obstacles and local concerns, Haelle notes. But as the opioid crisis grinds on, some government officials and communities appear increasingly open to whatever tools that can save lives.

The work of confronting public health threats never ends. New risks emerge, whether it’s the advent of synthetic opioids or the use of mobile phones while driving. Research helps gauge the effectiveness of new public safety approaches, as well as how best to implement interventions that save lives.

Nancy Shute is editor in chief of Science News Media Group. Previously, she was an editor at NPR and US News & World Report, and a contributor to National Geographic and Scientific American. She is a past president of the National Association of Science Writers.