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Sunday, May 18, 2025

How the US turned the tide on drug overdose deaths


In 2020 and 2021, earlier than I got here to Vox, I labored as the longer term correspondent at Axios — sure, that was the precise job title — and I discovered myself writing virtually solely in regards to the Covid-19 pandemic, or main tendencies that seemed to be pushed by the pandemic.

A kind of tendencies was an alarming rise in drug overdose deaths. The trajectory was already unhealthy earlier than Covid: Between the widespread prescription and misuse of authorized opioids after which the introduction of the ultra-powerful drug fentanyl to the illicit drug provide, overdose deaths within the US started taking off within the early 2010s. However the closure of remedy amenities throughout the pandemic and the isolation of customers led to a sudden spike in deaths: Within the 12 months main as much as September 2020, as I wrote in April 2021, greater than 87,000 People died of drug overdoses, a better complete than any 12-month interval of the opioid epidemic as much as that time.

Chart showing US drug overdoses are finally declining

After publishing that piece, I acquired a letter from a reader, who stated her son had been a kind of 87,000 deaths. She begged me to provide this subject extra protection, to remind my readers that behind the Covid pandemic, there was a shadow epidemic of drug deaths, of misplaced little kids and husbands and wives. Individuals needed to cease closing their eyes to the toll of demise and ache.

Within the years that adopted, the toll solely continued to develop, nonetheless, with deaths reaching 110,000 in 2023. There appeared to be no reply for one of many worst public well being crises in a era.

However now, in the end, we lastly look like turning the nook on the drug overdose disaster.

Provisional figures from the Facilities for Illness Management and Prevention’s Nationwide Very important Statistics System launched this week present that some 27,000 fewer People died of a drug overdose in 2024 than in 2023. That year-on-year drop is the steepest single-year decline because the authorities first started preserving observe of overdose deaths 45 years in the past. It signifies that drug deaths are actually lastly coming again right down to pre-pandemic ranges — and that we will make progress on what can appear to be essentially the most intractable social ills.

To place that 27,000 drop in deaths into perspective, consider it this fashion: It provides as much as three lives saved each hour for a whole 12 months.

What’s outstanding in regards to the speedy drop in overdose deaths is simply how widespread the development is. Forty-five states recorded declines in deaths, with Ohio and West Virginia — two states which have suffered greater than virtually some other from the opioid epidemic — main the best way. Solely a handful of states, principally within the Northwest, the place the epidemic began later, skilled will increase.

Whereas artificial opioids, which principally means fentanyl, are nonetheless accountable for the overwhelming majority of overdose deaths, deaths from such medicine are falling quicker than some other, declining by 36 p.c 12 months over 12 months.

Reversing the overdose epidemic

One of many greatest components behind the decline is the rising availability of naloxone, an opioid antagonist. If administered within the fast aftermath of an overdose, naloxone has been proven to be near 99 p.c efficient in stopping demise. The bottom line is pace — even the quickest emergency medical responders might not make it to the scene in time to save lots of somebody struggling an overdose. However current insurance policies to make naloxone accessible over-the-counter, and to advise customers to have it readily available, have made it potential to deliver again hundreds of people that in any other case would have died.

Whereas the pandemic instantly led to a big spike in overdose deaths, insurance policies that got here out of Covid have helped curb the toll, together with telehealth entry to medicine-based remedy choices for dependancy like buprenorphine. All of those applications have been paid for partially by the billions of {dollars} in opioid-settlement money from drug firms like Johnson & Johnson, which started flowing to state and native governments in 2024. More durable enforcement on fentanyl has performed a task as properly.

Lastly — and fewer positively — the sheer variety of overdose deaths prior to now few years has depleted the variety of individuals at highest threat. Like an infectious illness epidemic that slows down because it begins to expire of recent individuals to contaminate, the overdose epidemic burned so scorching and killed so many who drug customers who have been left have been much less weak to deadly overdoses.

The information isn’t all good. Whereas artificial opioids like fentanyl look like in a steep decline, deaths really rose final 12 months from stimulants like meth and cocaine, with manufacturing of the latter surging to new highs. The rise in deaths in a handful of states like Alaska and Washington demonstrates that in some components of the nation, at the very least, there are nonetheless populations that stay extremely weak to deadly overdoses.

Most worryingly, the Trump administration’s draft finances proposes main cuts to naloxone distribution, which might take essentially the most potent software for stopping overdose deaths out of the arms of those that want it most.

Nonetheless, we must always acknowledge this new information for what it’s — proof that, with effort, we will reverse the course of one of many greatest public well being threats the US faces. 1000’s of persons are alive at the moment who, if nothing had modified since I used to be writing about this epidemic in 2021, might need suffered a worse destiny.

Drug dependancy is a horrible illness that may destroy futures, households, and lives. However the place there’s life, there’s hope. Each overdose sufferer introduced again by a twig of naloxone has one other likelihood to alter their future, and make sure that they gained’t turn into one other statistic.

A model of this story initially appeared within the Good Information e-newsletter. Enroll right here!

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