CDC data shows that after two major epidemic increases, drug overdose deaths in the United States increased little last year. Until late 2022, the figures remained unchanged. Experts aren’t certain whether this flattening out is a sign that the worst drug overdose epidemic in American history is finally approaching a peak, or it’s just a pause that will be followed by new surges in deaths.
Despite the apparent flattening out, the figures remain alarmingly high, with an estimated 109,680 overdose deaths in 2022. This represents only a marginal increase of around 2% from the 107,622 recorded in 2021. While the overall national figures were relatively static, figures from individual states showed dramatic changes. Overwhelmingly, states reported either fewer or increased overdose deaths. Twenty-three states had a decrease in overdose deaths, one saw no change, and the remaining states saw an increase.
Eight states, including Florida, Indiana, Kentucky, Maryland, Michigan, Ohio, Pennsylvania and West Virginia, reported notable decreases of around 100 deaths or more compared to the previous year. These states had been widely regarded as having some of the highest overdose death rates during the epidemic, suggesting that years of concentrated work to address the problem may have contributed to the declines. State officials cited a variety of factors for the positive outcome, including social media and health education campaigns, expanded and improved addiction treatment and wider distribution of the overdose-reversing medication, naloxone.
Fentanyl and other synthetic opioids were responsible for the deaths of 75,000 persons in 2022, a 4% increase from the previous year. Deaths from cocaine increased by 11%, while deaths from meth and other stimulants increased by 3%. Overdose deaths can often be attributed to multiple drugs and officials point out that inexpensive fentanyl is increasingly being cut into other drugs, frequently without the knowledge of the buyer.
University of California, San Francisco drug policy expert Dr. Daniel Ciccarone predicts a decline in fatal overdoses as a result of recent initiatives to increase access to addiction counseling and treatment, the distribution of naloxone, and legal settlements totaling more than $50 billion. Ciccarone said, “We’ve thrown a lot at this 20-year opioid overdose problem. We should be bending the curve downward. We have been here before.”
In 2018, overdose deaths dropped by 4%; in 2019, they reached a record high of 71,000; in 2020 and 2021, they skyrocketed during the COVID-19 epidemic, reaching highs of 92,000 and 107,000, respectively. Lockdowns and pandemic-related restrictions had isolated people with drug addictions, making treatment harder to obtain.
There are concerns that a similar pattern will repeat itself with increased detection of veterinary tranquilizer xylazine in the illicit drug supply and proposals to scale back prescribing addiction medications through telehealth. Katherine Keyes, a Columbia University epidemiology professor, said, “What the past 20 years of this overdose crisis has taught us is that this really is a moving target. And when you think you’ve got a handle on it, sometimes the problem can shift in new and different ways.”