For the first time in nearly three decades, the number of drug overdose deaths in the United States may have gone down last year from the year before.
The Centers for Disease Control and Prevention posted preliminary data for 2018 last week, reporting 68,000 drug overdose deaths compared to 2017’s all-time high of 70,000. While that number may climb a bit as officials complete investigations, the agency expects the final tally to fall short of the previous year’s total, representing the first yearly decrease since overdose deaths started ramping up in 1990.
“Lives are being saved, and we’re beginning to win the fight against this crisis,” Health and Human Services Secretary Alex Azar tweeted. “By no means have we declared victory against the epidemic or addiction in general. This crisis developed over two decades, and it will not be solved overnight.”
Opioid overdoses have claimed more than 430,000 lives in the United States since 2000, according to the CDC. The overdose death rate is still seven times higher than a generation ago. And while the number of deaths caused by heroin and prescription painkillers decreased, those involving fentanyl and non-opioid drugs like cocaine and methamphetamine continued to rise. Researchers don’t think last year’s decline is part of a trend, given the data they have analyzed from the first months of 2019, said Farida Ahmad of the CDC National Center for Health Statistics.
Additionally, the decrease is not consistent with data from several states. In both Ohio and Pennsylvania, overdose deaths were down by 1,000 or more last year, but Missouri saw an increase of about 17 percent, with more than 200 deaths over the previous year.
According to Christian addiction psychiatrist Mark Duncan, many professionals are “guardedly encouraged” by the data, adding that while any reduction is better than none, it is not entirely clear what last year’s lower numbers mean.
The biggest question for many is what drove the decrease. Valerie Hardcastle, who oversees research on regional health issues at Northern Kentucky University, suggested wider availability of Narcan, a nasal spray version of the overdose medication naloxone, played a role.
Awareness about and availability of overdose reversal medication also isn’t uniform from state to state, Duncan noted. Some states have more readily embraced treatment options than others. He also suggested that a significant drop in how many opioid prescriptions doctors write influenced the decline in overdose deaths. The CDC reported the number of opioid prescriptions peaked in 2012 and then dropped steadily until hitting its lowest rate in a decade in 2017, with a total of more than 191 million prescriptions. Duncan expressed concern that some medical clinics have swung too far the other way. He said opioid therapy is not effective for everyone but still has a “place in the tool kit for pain management.” Again, the rate of prescribing varies greatly by state.
The medical profession has undergone a “huge culture shift” when it comes to researching and treating opiate addiction, Duncan said, adding, “We’re talking about, what does it mean when a person is addicted to substances, what are some of the evidence-based treatments that we have, and there’s much more interest and acceptance around using some of these treatments.”