Are We Winning the Drug Overdose War?

Dr. Adi Jaffe

New research shows the first decline in overdose deaths in over a decade.

In 2018, 67,367 people died from drug overdoses in the U.S. alone (1)

That number doesn't even account for the approximately 88,000 deaths from alcohol. (2)

Yet still, even with over 150,000 drug-related deaths in 2018, for the first time since 2011, these numbers should be taken as good news.

Why?

The first overdose decrease in a decade

The fact is that these most recent statistics show a slight decrease in overall overdose rates. Actually, a 4.6 percent drop compared to 2017. That might not sound like much, but with about 3,000 less dead, it's a win we're going to take somberly.

But more importantly, it's the first sign of a downturn we've had for nine years. And so any relief is a good sign. And the good news is that 2019 rates seem (for now) to be holding steady. So there is the potential that we will at least remain at this reduced level of drug-related mortality instead of continuing to rise as we have for nearly a decade.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2018 on CDC WONDER Online Database, released January, 2020

What does this decrease in overdoses mean?

Honestly, it's not very clear yet.

We do know that there has been an aggressive and sustained campaign to combat overdose that's been including constant media messaging, more robust access to overdose-preventing medication (i.e., naloxone) campaign, and a substantial change in prescription practices and pharmacy loopholes.

At least for now, it seems like these efforts are paying off. And that is just wonderful.

Because until the release of this recent report, it wasn't very obvious whether our efforts had been paying off.

The CDC reports that some of the states that have been hardest hit historically—Alaska, the District of Columbia, Florida, Georgia, Indiana, Iowa, Kentucky, Maine, Minnesota, New York, North Carolina, Ohio, Pennsylvania, West Virginia, and Wisconsin—are showing reductions in their overdose rates.

I've spoken at a number of these states and have talked with, and looked at, hundreds of parents who have lost loved ones, especially children, during this time. It's devastating. And this is the relief for which those states have been hoping and waiting for a very long time.

Three thousand less lives lost means thousands of families spared the devastation and grief of an overdose death.

Cautious optimism and sober celebration

But many of those same states—West Virginia, Ohio, Pennsylvania, and Maine—are still at the top of the overdose struggle list... Which means we have a long way to go. Especially since, even though the overall overdose rate has decreased, synthetic opioids (like fentanyl, fentanyl analogs, and tramadol) are continuing to kill more people.

These are the drugs that we saw responsible for at least some of the massive quadrupling of overdoses in the past decade alone.

And some of the patterns we've been observing historically are still present, including the fact that men are still at twice the risk of dying from overdose than women (I'm going to have a lot more to say about men, masculinity, mental health, and drug use in this forum).

Finally, we've been down this path before, and it's important that we don't misconstrue a drop for a victory. There is still a good bit of concern, especially in regard to the increase in stimulant use and related overdose. For perspective, cocaine and stimulant overdose rates have quadrupled in the last decade, and there are reports of these chemicals now being mixed with synthetic opioids as well.

As usual, this game of whack-a-mole is a deadly one.

It's important that we celebrate our wins while paying attention and being diligent about the future.

References

1. Centers for Disease Control and Prevention (CDC; 2020). Drug Overdose Deaths in the United States, 1999–2018. NCHS Data Brief, 356.

2. Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Average for United States 2006–2010 Alcohol-Attributable Deaths Due to Excessive Alcohol Use. Available at: https://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=8E1C5233-5640-4EE8-9247-1ECA7DA325B9&F=&D=. Accessed 1/18/17.