The number of fatal overdose deaths in the United States peaked in May 2023 and started to decline in the latter half of the year, according to the most recent data from the Centers for Disease Control and Prevention.
An estimated 107,500 people died from fatal overdoses in the US in 2023, down from an estimated 111,000 overdose deaths in 2022. That is a 3.1% decline in overdose deaths in one year. This is the first decline in overdose deaths since 2018. The decline is modest and the data are preliminary. One might argue overdose deaths are plateauing, but it’s better news than another annual increase. Unfortunately, the US still has more fatal drug overdose deaths per capita than any other high-income nation.
Drug overdose declines are not equally distributed across our nation. All states east of the Mississippi saw a decline, except for Alabama, West Virginia, and Washington DC. Preliminary data show that Georgia saw a 5.58% decline in overdose deaths over the past year. Most states west of the Mississippi saw increases. Alaska, Oregon, Nevada, and Washington experienced over 25% increases in annual overdose deaths.
Two years ago, I wrote a column in this space about skyrocketing overdose deaths amid the COVID-19 pandemic. Many pandemic-era causes of overdose deaths have subsided. Social distancing and social isolation came to an end. Stress associated with living through a global pandemic has waned. Public health has moved beyond a myopic focus on COVID-19. All of these conditions should improve care for those struggling with addiction and reduce overdose deaths.
The US overdose crisis was once driven by prescription painkillers, then it was heroin, and in recent years fentanyl (a synthetic opioid) has been a primary cause of overdose deaths in the US. Fentanyl can be injected, but it’s often smoked, consumed in pills, or mixed in with other illicit drugs.
With deadly fentanyl now widespread, what’s causing overdose deaths to decline nationally? Shifts in the supply of available illicit drugs impact overdose deaths. Much of the 2023 increase in overdose deaths in western states coincides with the availability of fentanyl in the regional illicit drug supply. It’s possible that overdose deaths are declining overall because the overdose epidemic has already claimed such a significant percentage of the illicit drug using population in eastern states. On a more hopeful note, the US could be reaping the benefits of overdose prevention efforts and addiction treatments.
I suggested some reforms to address overdose deaths in my 2022 column. At least one suggested reform has been implemented—increasing access to naloxone/Narcan. In March 2023, the FDA approved over-the-counter naloxone nasal spray. My other policy recommendations have not been implemented in a meaningful way, at least not in Georgia.
Opioid manufacturers and distributors are paying billions in restitution for their roles in the opioid epidemic. These funds should be invested in evidence-based programs and practices.
Effective drug education and other prevention programs are critical to reducing overdose deaths. Prevention programs are more likely to succeed if paired with consistent messaging from family, public health departments, community organizations, and religious institutions.
Drug interdiction efforts must be improved. It is essential to slow the illegal smuggling of fentanyl into our nation. Similarly, state and local police must disrupt drug distribution in our communities.
Access to quality healthcare combats addiction and prevents overdose deaths. It is essential to expand access to a range of addiction treatment programs, including inpatient rehab, outpatient rehab, and medication-assisted treatment. These programs remain out of reach for many folks living with addiction due to cost, limited providers in one’s area, or a lack of insurance coverage.
Georgia is one of ten states that have not accepted expanded Medicaid coverage, which would provide healthcare for all adults earning up to 138% of the federal poverty line. Expanding Medicaid coverage provides one avenue for improving access to addiction treatment programs and reducing overdose deaths.
Roscoe Scarborough, Ph.D. is chair of the Department of Social Sciences and associate professor of sociology at College of Coastal Georgia. He is an associate scholar at the Reg Murphy Center for Economic and Policy Studies. He can be reached by email at rscarborough@ccga.edu.
Reg Murphy Center