US Drug Overdose Deaths Decline in 2023 for the First Time in Five Years

In 2023, the US experienced a decline in drug overdose deaths for the first time in five years. This significant decrease marks a turning point in the battle against the opioid crisis and highlights the impact of ongoing public health efforts.

CNN - After a steep increase during the COVID-19 pandemic, preliminary data indicates that drug overdose deaths in the United States decreased in 2023 for the first time in five years.

Approximately 107,500 people died from a drug overdose in 2023, according to data from the US Centers for Disease Control and Prevention’s National Center for Health Statistics — about 3,500 fewer than in 2022.

Last year’s decrease is the first since 2018, but the 3% drop is far less significant than the surges that pushed overdose deaths to record levels in recent years. Overdose deaths spiked 30% between 2019 and 2020 and rose another 15% between 2020 and 2021, according to CDC data.

Preliminary data may change as death certificates are reviewed and records assessed, but estimates suggest that despite the decline, overdose deaths in 2023 were still nearly twice as high as five years ago, according to CDC data.

“It is a hopeful trend in some ways,” said Dr. Katherine Keyes, a professor at the Columbia University Mailman School of Public Health whose research focuses on substance use epidemiology. “We know that this drug epidemic is dynamic and changes quite quickly, so any time you see a leveling off or a slight decrease, it is promising. It is certainly not a sign that we need to take the foot off the gas of overdose prevention.”

The US Department of Health and Human Services launched a coordinated national strategy to prevent overdoses two years ago.

“This progress over the last 12 months should make us want to reinvigorate our efforts, knowing that our strategies are making a difference,” CDC Chief Medical Officer Dr. Deb Houry said in a statement. However, she noted, “there are still families and friends losing their loved ones to drug overdoses at staggering numbers.”

“Our thoughts remain with those who have lost loved ones and those who are struggling with addiction or know someone who is. Our country is committed to ending this epidemic and preventing unnecessary death and suffering,” she said.

Fentanyl has been driving the latest wave of overdose deaths, with synthetic opioids involved in more than two-thirds of these fatalities. These highly potent narcotics continue to play a significant role, being involved in nearly 70% of overdose deaths in 2023. However, the new data shows there were about 1,500 fewer overdose deaths involving fentanyl and other synthetic opioids in 2023 compared to 2022.

Still, the deadly threat of fentanyl—about 50 times more potent than heroin—remains significant. A study published Monday highlights its pervasiveness, showing that law enforcement seizures of illicit fentanyl have surged in recent years.

More than 115 million pills containing illicit fentanyl were seized by law enforcement in 2023, compared with about 71 million in 2022 and less than 50,000 in 2017.

“Fentanyl has continued to infiltrate the drug supply in communities across the United States, and it is a very dangerous time to use drugs, even just occasionally,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, said in a statement. Although she was not directly involved in the new study, the research was funded by her federal agency. “Illicit pills are made to look identical to real prescription pills but can actually contain fentanyl. It is urgently important that people know that any pills given to someone by a friend, purchased on social media, or received from any source other than a pharmacy could be potentially deadly—even after a single ingestion.”

"The number of deaths due to fentanyl remains alarmingly high," Keyes said. However, the more promising trends reflect significant, multi-pronged efforts from various sectors, including the use of treatments for opioid use disorder, expanded access to naloxone and other harm reduction programs, and reducing opioid prescribing.

"I think that has been a real success story for public health," she added.

While overdose deaths involving opioids declined, those involving cocaine and psychostimulants like methamphetamine increased, according to preliminary CDC data.

In 2023, there were over 36,000 deaths involving psychostimulants, a 2% increase from the previous year. Deaths involving cocaine rose by 5% to nearly 30,000. About a third of all overdose deaths in 2023 involved psychostimulants, and cocaine was involved in more than a quarter.

Much of this increase is likely due to the proliferation of fentanyl throughout the drug supply, Keyes said. “We know that when stimulants mix with opioids, it’s particularly lethal,” she noted. However, expanded surveillance can help those addressing the overdose crisis understand its rapidly changing epidemiology and adapt their efforts in real-time.

Significant disparities in overdose deaths persist, including state-level differences. The latest CDC data shows "notable" increases in some Western states such as Washington and Oregon, with overdose deaths rising at least 27% year-over-year. Conversely, in states like Nebraska, Kansas, Indiana, and Maine, overdose deaths dropped by at least 15%.

“State-to-state differences point to the need for continued expansion of these efforts,” Keyes said. “But I think the trends you see nationally are indicative of how it can work. We can address the opioid epidemic. This is not inevitable.”

For many state and local governments, funds from opioid settlements have been “instrumental” in overdose prevention efforts and increasing access to treatment and recovery support, said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, in a statement.

“Moving forward, jurisdictions will continue to prioritize investments in harm reduction, prevention, and addressing the social determinants of health in communities hardest hit by the overdose crisis,” he said. “State and territorial health agencies will continue to coordinate with partners to build a comprehensive response to this complex public health issue. Lastly, jurisdictions will continue to monitor and prepare to respond to changes in overdose rates and emerging threats within the drug supply.”

Recent surveys suggest that drug use among teens in the US has been relatively low and trending downward. However, overdose deaths have been rising in this age group, and millions of adults and adolescents have a drug use disorder.

“Research has shown that delaying the start of substance use among young people, even by one year, can decrease substance use for the rest of their lives. We may be seeing this play out in real time,” Volkow said. “This trend is reassuring. Though, it remains crucial to continue to educate young people about the risks and harms of substance use in an open and honest way, emphasizing that illicit pills and other substances may contain deadly fentanyl.”

Source: CNN