Hopeful Decline in Drug Overdose Deaths Across the U.S.

For the first time in decades, public health data shows a sudden and hopeful drop in drug overdose deaths across the U.S.

"This is exciting," said Dr. Nora Volkow, head of the National Institute on Drug Abuse (NIDA), the federal laboratory that studies addiction. "This looks real. This looks very, very real."

National surveys compiled by the Centers for Disease Control and Prevention (CDC) indicate an unprecedented decline in drug deaths of roughly 10.6 percent. This is a significant reversal from recent years, when fatal overdoses increased by double-digit percentages.

Some researchers believe the data will show an even larger decline when federal surveys are updated, particularly in the eastern U.S., where state-level improvements are most noticeable.

"In the states with the most rapid data collection, we’re seeing declines of twenty percent, thirty percent," said Dr. Nabarun Dasgupta, an expert on street drugs at the University of North Carolina.

According to Dasgupta's analysis, state-level mortality reductions mirror sharp declines in emergency room visits related to overdoses. He estimates that the national decline in street drug deaths is now at least 15 percent, which could translate to 20,000 fewer fatalities annually.

"Today, I Have So Much Hope"

After years of relentless drug deaths, many addiction researchers, frontline workers, law enforcement officers, and street drug users have been cautiously optimistic about this trend.

Roughly 100,000 drug-related deaths still occur each year, and the street drug mix, including FYL, methamphetamines, XYL, and other synthetic chemicals, remains highly dangerous.

"I think we have to be careful when we get optimistic and see a slight drop in overdose deaths," said Dan Salter, head of a federal drug interdiction program in the Atlanta-Carolinas region. "The last thing we want to do is spike the ball."

Nevertheless, many public health experts and people battling addiction told NPR that the catastrophic rise in drug deaths since 2019 seems to have ended, at least temporarily. A broader shift seems to be underway.

"Some of us have learned to deal with the overdoses a lot better," said Kevin Donaldson, who uses FYL and XYL in Burlington, Vermont.

According to Donaldson, many FYL users now carry Naloxone, a medication that reverses most opioid overdoses. People are also using drugs in groups, ensuring help is available when overdoses occur.

These changes have made a difference, he said. "For a while, we were hearing about [drug deaths] every other day. When was the last one we heard about? Maybe two weeks ago? That’s pretty few and far between."

This improvement aligns with Vermont Department of Health data, which shows a 22 percent drop in drug deaths in 2024.

"The trends are definitely positive," said Dr. Keith Humphreys, a drug policy researcher at Stanford University. "This is going to be the best year we've had since all of this started."

"A Year Ago, I Was Struggling With Hope"

Deaths in King County, Washington, linked to all drugs have dropped by 15 percent in the first half of 2024, and fatal overdoses caused by street FYL have fallen by 20 percent.

"Today, I have so much hope," said Brad Finegood, who directs the overdose crisis response in Seattle.

Why the Sudden Shift? A Mystery

While some theories have emerged to explain the decline, experts agree that there isn’t a clear answer yet.

Many point to rapid improvements in the availability and affordability of medical treatments for FYL addiction. "Expansion of Naloxone and medications for opioid use disorder — these strategies worked," said Dr. Volkow at NIDA.

Finegood added, "We've almost tripled the amount of Naloxone out in the community." A Seattle survey found that 85 percent of high-risk drug users now carry the overdose-reversal medication.

Dr. Rahul Gupta, the White House drug czar, hailed the drop in drug deaths as a sign of progress, calling for more funding for addiction treatment, especially in marginalized communities.

Still, some experts argue that public health strategies alone might not explain such a rapid decline in deaths.

Dasgupta noted, "We don't have anything that would predict this magnitude of effect this quickly." He speculated that changes in the street drug supply could also be playing a role.

In some areas, FYL may be less pure due to law enforcement targeting Mexican cartels. Additionally, drug dealers are mixing FYL with XYL. While toxic, XYL may delay withdrawal symptoms, possibly leading to fewer lethal doses of FYL per day.

Other experts point to the end of the COVID-19 pandemic and the tragic reality that many people who were at high risk have already died as potential contributors to the drop in deaths.

Overdose Deaths Plummet in Ohio and Missouri

In some states, the decline has been dramatic. "This year, overdose deaths [in Ohio] are down 31 percent," said Dennis Couchon, a harm reduction activist. "The deaths were just plummeting."

Missouri has seen a similar trend, with drug deaths falling by 34 percent in the second quarter of 2024.

While public health experts caution that overdose deaths are still too high, there’s cautious optimism. "It feels wonderful and great," said Dr. Mark Levine, head of the Vermont Health Department, "but there’s still plenty of work left to do."

Keeping People Alive: The First Step

Eric Breeyear, a resident at a recovery shelter in Vermont, was repeatedly given Naloxone after overdosing on FYL. In recovery now, he credits the increased availability of medical help for saving his life.

"I'm happy people's lives are being saved, but on every street I see somebody in the middle of an overdose that could potentially be fatal," Breeyear said. He hopes more can be done to help people move from addiction to recovery.

Dasgupta agrees, noting that while keeping people alive is crucial, "A fifteen or twenty percent [drop in deaths] is a really big number." He calls for more research to determine how to sustain this hopeful trend.

"If interventions are what's driving this decline, then let’s double down on those interventions."

Source: NPR