Overdose Deaths Begin to Sustain Decline After Decades Long Increase
In 2023, drug overdose deaths sustained declines, but there are still disparities that need to be addressed to continue to decrease these numbers.
Investigators find a new wave of sustained declines in drug overdose deaths in 2023 after nearly 2 decades of increases. According to results of a study published in JAMA Network Open, the decline is encouraging, but there are still disparities that will require more targeted interventions and understanding of underlying drivers.1
In 2023, drug overdose deaths sustained declines, but there are still disparities that need to be addressed to continue to decrease these numbers. | Image Credit: Victor Moussa - stock.adobe.com
According to the National Institute on Drug Abuse, over 105,000 people in the US died from a drug-related overdose in 2023, which did decline from 2021 and 2022. For synthetic opioids, the overdose-related deaths decreased from 73,838 in 2022 to 72,776 in 2023; however, cocaine-related deaths increased to 29,449 deaths in 2023. In a study published in the Journal of the American Pharmacists Association, pharmacies that adopted practices to reduce opioid-related overdoses showed potential, with about half of pharmacies interested in enrolling as a distributor of state-subsidized naloxone. Only approximately 26% of pharmacies in the study that reported frequent buprenorphine or naltrexone dispensing expressed interest in subsidized naloxone dispensing.2,3
The investigators of the current study aimed to determine when drug overdoses started to sustain decline by addressing the absence of monthly population denominators, the need for annualized monthly estimates, and the ability to differentiate plateaus and trends from abrupt changes, according to the study authors. Death rates were collected from January 2015 to October 2024, and geographic regions—Midwest, Northeast, South, and West—were used. The analysis also included deaths from overall drug use, opioids, cocaine, and methamphetamine.1
Investigators found that 800,645 patients died from a drug overdose in the time period, with 31.7% being female and a median age of 42 years. In total, 11.2% were Hispanic. From 2018 through 2024, 1.4% were American Indian or Alaskan Native, 1.1% were Asian, 18.3% were Black or African American, 0.1% were Native Hawaiian or Pacific Islander, 1.5% were multiracial, and 77.6% were White. The study authors said that the 12-month moving sum of the drug overdose death rate ranged from 14.54 per 100,000 population in January 2015 to a peak of 33.24 in August 2023. Between January 2015 and September 2017, monthly drug overdose deaths increased steadily but plateaued from September 2017 to September 2019. However, this was followed by a significant surge through October 2021, where the drug overdose death rate reached 32.15 per 100,000 population. From August 2023 to February 2024, the drug overdose death rates began to decline, and then in February 2024, the rate of decline doubled to –0.84 per 100,000 population. The investigators wrote that the drug overdose deaths “decreased for 15 consecutive months, and the post–February 2024 deceleration was nearly twice the rate of the previous surge between 2019 and 2021.”1
The monthly opioid-related overdose death rate began to decline in August 2023 and then that decline steepened in February 2024. Similarly, cocaine-related deaths declined in August 2023 and further declined in February 2024. However, monthly methamphetamine-related deaths began to decline in September 2023 and began to decline more in February 2024.1
As for regions, the West had the lowest drug overdose death rate, but it accelerated rapidly in October 2023. Although it did decline, it still had the highest annual drug overdose death rate at 28.72 per 100,000 population in October 2024. The Midwest and Northeast declined to prepandemic levels at 21.58 and 21.03, respectively, in October 2024. As for race and ethnicity, American Indian or Alaska Native had the highest drug overdose death rate in 2023. In 2023, Black or African American patients had the highest drug overdose death rate of any racial group since 1999, according to the study authors. Native Hawaiian or Pacific Islanders had the largest acceleration in 2023 with a year-over-year increase of 5.77 per 100,000 and a total of 23.23 in 2023. For Hispanic or Latino patients, the drug overdose death rate increased after 2015, but the year-over-year rate slowed in 2023.1
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