Finally! Good News on US Overdose Deaths

“When I realized it wasn’t an oddity, I cried, because every one of these deaths is a story with children and loved ones. To me, they’re all stories. They’re not just numbers.” The speaker is Dennis Cauchon, founder and president of Harm Reduction Ohio. He’s been tracking preliminary drug overdose data for nearly seven years and has seen small declines. “It would have just been small numbers — instead of 40 deaths in September, it was 20, and it wasn’t enough to go on,” Cauchon told me. But by early 2024, as that line continued to decline, Cauchon said the data showed him more than small incremental changes. These were Real changes.

National studies compiled by the Centers for Disease Control and Prevention (CDC) show an unprecedented 10.6 percent drop in drug-related deaths, a dramatic turnaround from recent years, when fatal overdoses regularly rose by double digits.

“The trends are definitely positive,” said Keith Humphreys, a leading researcher on drug policy at Stanford University. “This is going to be the best year we’ve had since this all started.”

While many have offered theories about why the drop in deaths is happening at an unprecedented rate, most experts agree that the data doesn’t yet provide clear answers. Fentanyl may be harder to find and less pure in some areas due to law enforcement efforts targeting Mexican drug cartels.

Naloxone, Buprenorphine and Methadone helped

Many people who abuse fentanyl now carry naloxone (Narcan), a medication that reverses most opioid overdoses. Also, most friends of drug users carry the life-saving medication and are prepared to use it if a friend overdoses. Many drug abusers have been saved by naloxone and have entered treatment programs with medication-assisted treatments such as buprenorphine or methadone. While in treatment, the risks of overdose and death are significantly reduced.

Maybe Xylazine too

Another possible reason for the drop in overdose deaths is that the chemical xylazine is being laced with fentanyl by drug gangs. While xylazine is toxic to humans and causes zombie-like behavior in addicts and serious long-term health problems, xylazine may be affecting deaths by diluting the amount of fentanyl users ingest. Experts also point to the end of the COVID pandemic, combined with the incredibly high number of people who have already died from drug overdoses (and were at high risk), as possible reasons for the abrupt change.

More about Ohio

Jessica Hulsey, CEO, Founder, Advocate

Source: Addiction Policy Forum

A few states had much higher death rates

Surprisingly, Washington and Oregon experienced remarkable increases in overdose deaths. Washington and Oregon experienced the highest percentage increases in overdose deaths in the U.S. from September 2022 to September 2023, with Washington seeing a 41.4% increase and Oregon 41.5%. Efforts in both states to decriminalize drug possession have not reduced the number of overdose deaths.

Methamphetamine and cocaine deaths on the rise

According to preliminary data from the CDC, opioid overdose deaths fell from 84,181 in 2022 to 81,083 in 2023. However, deaths related to psychostimulants (such as methamphetamine) and cocaine increased during that time. This divergence underscores the complexity of the drug crisis, which some experts have dubbed the American Disease; as we move from one substance to another, we never learn that we are unlikely to find the next perfect drug.

Cautious enthusiasm: it’s not over yet

Of course, it’s not over yet. The U.S. still has about 100,000 overdose deaths each year. Canada has the second highest number of overdose deaths in the world, with 7,000; the U.K. has 4,500; Australia and Germany have about 2,000. In the U.S., street drug cocktails, including fentanyl, methamphetamines, xylazine and other synthetic chemicals, are more toxic than ever. Young people are dying from taking pills laced with fentanyl, and intravenous injected or smoked speedballing is rampant in the U.S.

Summary

Based on preliminary data from the CDC, opioid overdose deaths decreased from 84,181 in 2022 to 81,083 in 2023. Many people who abuse fentanyl, and their friends, have turned to Narcan (naloxone), the life-saving medication, and are willing to use it if a friend overdoses. Many drug users have been saved by Naloxone and have entered medication-assisted treatment such as buprenorphine and methadone. While users are in treatment, their risks of overdose and death are significantly reduced.

The data is encouraging, a step in the right direction. However, 100,000 overdose deaths per year is still alarming and unacceptable. While the average state saw a marked decline in deaths, increases were reported in Oregon and Washington. Furthermore, while opioid overdoses declined, the switch to psychostimulants (such as methamphetamine) continued, and meth and cocaine deaths increased simultaneously.