U.S. Overdose Death Rates Rapidly Decline

Data Shows Overdose Rates Are Decreasing, But It’s Unclear Why

Preliminary data from the Centers for Disease Control and Prevention (CDC) national survey show an unprecedented drop in drug overdose deaths of 10.6% – the steepest decline seen in decades.

This is overwhelmingly positive, if not surprising, news since drug overdose rates have been increasing steadily for years thanks to several factors, including the opioid epidemic, the rapid spread of fentanyl use, and the COVID-19 pandemic.

Still, provisional data at national and state levels show a sudden drop, which is getting researchers and harm reduction proponents excited about what this could mean.

In speaking with NPR, Dr. Nora Volkow, Director of the National Institute on Drug Abuse, couldn’t contain her delight over the data and the belief that these trends will continue. “This looks real. This looks very, very real.”

State-Level Data Helps Reveal Larger Trend

While researchers hope to see an even larger drop when the CDC’s national data is updated at the end of the year, they are encouraged by the decline already being seen at the state level, especially in hard-hit and eastern U.S. states.

In his data analysis, Dr. Nabarun Dasgupta, a researcher at the University of North Carolina with two decades of experience in harm reduction and overdose prevention, noted 20-30% declines in some state’s data collection systems.

The data shows that so far in 2024:

• In Vermont, overdose deaths have dropped 22%
• In Ohio, overdose deaths were down 31%
• Missouri saw a 34% drop (increasing from the 10% seen in 2023)
• In North Carolina, fentanyl overdoses were down 31%

Dr. Dasgupta highlights that while these numbers themselves are encouraging, the true impact is in the number of lives saved. He believes that these numbers translate to as many as 20,000 fewer drug overdose fatalities this year.

Harm Reduction Strategies

Experts quickly point out that it is too early to pinpoint one leading cause for this decline. Instead, they credit many factors, including the widespread accessibility of naloxone, community-specific prevention efforts, and even changes in drug use patterns and the current drug supply.

For her part, Dr. Volkow credits naloxone (brand name Narcan) for much of this decline. She states, “Expansion of naloxone and medications for opioid use disorder – these strategies worked.”

In fall 2023, naloxone, an opioid overdose reversal drug, was made available to be purchased over the counter at many drugstores and pharmacies, making it easier than ever to disrupt an opioid overdose without waiting for emergency medical assistance. Additionally, some states require nightclubs and bars to maintain naloxone on the premises, further reducing instances of fatal drug overdoses.

Researchers also say changes in the drug supply could be a determining factor, with fentanyl being harder to attain due to law enforcement efforts targeting Mexican drug cartels. Moreover, fentanyl is increasingly being mixed with other substances like xylazine, a dangerous tranquilizer intended for veterinary use. Xylazine, while potent and deadly in its own right, can stave off withdrawal symptoms, leading people to use fentanyl less frequently, resulting in fewer overdoses.

Lastly, studies show that those who habitually use drugs have also adjusted their patterns of use. Data from the Seattle area found that up to 85% of high-risk drug users now carry naloxone with them when planning to use fentanyl. They also purposefully use the drug with others nearby in case overdose interventions are necessary.

What Needs To Happen Next?

While so much remains unclear, experts agree on one thing: this trend needs to continue.

With over 100,000 drug overdose deaths still occurring every year, they warn that the problem is still far from over and that this decline, while encouraging, should not downplay the significant need for continued harm reduction efforts.

Experts continue to encourage more focus and funding on addiction treatment and harm reduction strategies at both the national and state levels, specifically in underserved communities where overdose rates are still particularly high.

Despite differing opinions on what specific strategies to take, what’s most important is saving the lives of those most vulnerable.

Dr. Dasgupta sums it up succinctly: “If interventions are what’s driving this decline, then let’s double down on those interventions.”

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