Overdose deaths saw a sharp decline in the US. Experts hope it is not ‘a blip’

New figures from the U.S. Centers for Disease Control show a sharp decline in overdose deaths, offering a rare glimmer of hope in the fight to curb the opioid crisis.

“I’ve been studying overdose mortality data for more than two decades, and I don’t think I’ve felt so hopeful in decades,” said Naburan Dasgupta, an epidemiologist and street drug scientist at the University of North Carolina Injury Prevention. Research center.

Dasgupta’s research has contributed to the CDC’s findings, published in September. The data showed that drug overdose deaths in the US fell by 10.6 percent between April 2023 and April 2024. Some states showed even bigger declines, up to 30 percent.

In an update this week, the CDC predicted that the decline in fatalities would be large between May 2023 and May 2024. even larger, namely 12.7 percent. That decline includes overdoses of both stimulants such as cocaine and opioids such as heroin and fentanyl.

The CDC has described the decline as “the first annual decline in drug overdose deaths since 2018.”

Dasgupta said frontline workers began reporting a downward shift in mid-to-late 2023, but he remained cautious as he has seen death rates rise and fall in the past.

Now that more data has been collected, he said, “This doesn’t feel like a blip. … This feels like an actual trend that’s going in the right direction.”

In Canada, the latest numbers from Health Canada show a total of 1,906 opioid-related deaths in the first three months of 2024, an eight percent decrease compared to the same period in 2023.

But in a statement emailed to The current oneHealth Canada said fluctuations between quarters are normal and it is too early to determine whether that three-month decline will turn into a trend.

“Multiple factors may contribute to any observed decline, including jurisdictional actions and investments, fluctuations in the supply of illicit drugs, or changes in substance use patterns,” the statement said.

Despite the decline on both sides of the border, the number of deaths remains at crisis levels. There were 81,083 opioid-related deaths reported in the US in 2023, and 8,049 opioid-related deaths in Canada for the same year, which corresponds to 22 deaths per day.

Noting that the decline in mortality is not seen equally among different racial groups and between urban and rural environments, Dasgupta said it is time to think about “who is being left behind.”

Stephen Murray, harm reduction program manager at Boston Medical Center, said he continues to see these devastating results firsthand.

“Before August, I went almost an entire year without losing someone I knew well to an overdose,” says Murray, who is also director of the Safe Spot Overdose Hotline, a drug crisis line available in both the U.S. and Canada.

“And now there have been six deaths in just two and a half months.”

What could reduce the number of deaths?

Dasgupta said it is difficult to pinpoint what is driving the U.S. decline, but that it is likely related to a number of factors.

One of those is the illegal drug supply itself, which he says is shifting and becoming less deadly.

“We often hear the question: Why would a salesperson want to sell a product that kills their customers, right?” he said.

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He also pointed to efforts by federal and state governments last year to increase the availability of naloxone, a drug that temporarily reverses an overdose, allowing time for life-saving medical treatment.

He said the work was not only to ensure there were enough reversible drugs available, but also to ensure people who use drugs knew they had access to them, which could potentially mean the difference between life and death would mean.

Brad Finegood has also seen a “steady, slow decline” in overdose deaths in Washington state.

“We’re really working to lower the barriers for people to access treatment,” said Finegood, who leads the Overdose Prevention and Response Unit at Public Health for Seattle and King County.

Finegood said this also means establishing mobile clinics that provide better access to medications and treatment for opioid addiction. It also means removing conditions, such as requiring patients to agree to a detox program before accessing treatment, he said.

“Now people can just walk into behavioral emergency care and get the help they need, right on demand, without jumping through hoops,” he said.

Finegood’s work has a personal element: his brother died of an overdose twenty years ago.

“Even though it’s been quite a long time since my brother passed away… so many of the lessons we learned from 20 years ago still hold true,” he said.

“[That includes] Carrying naloxone, understanding what an overdose looks like and truly reducing the stigma of drug use so people can access the help and treatment they need,” he said.

Could Canada see a similar trend?

In Canada, different provinces have taken different approaches to addressing the opioid crisis, ranging from limited to limited decriminalization of illegal drugsUnpleasant harm reduction efforts such as safe consumption sites, to a focus on treatment and abstinence.

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Fewer Albertans died from an overdose in May and June 2024 compared to the same periods last year, newly released data shows. The province’s Minister of Addictions and Mental Health is cautiously optimistic, but some critics expect the number of fatalities to rise.

But epidemiologist Dan Werb said there is a “bizarre discourse” pitting harm reduction services against a focus on treatment, while many experts now think both approaches are needed to tackle the crisis.

“These two sectors are not opposed to each other, but are in fact part of a comprehensive approach to meeting the needs of people who use drugs and are at risk of overdose,” said Werb, director of the Center on Drug Policy. Evaluation at St. Michael’s Hospital in Toronto.

“Unless we invest in both sectors, we will not be able to build on the gains we have already made.”

Looking at the decline in deaths in the U.S., Werb said his first thought was “Thank God.”

“We’re talking about thousands and thousands of people who might otherwise be dead, who are still alive,” he said.

“Whatever the reason for that, I just think it’s something to celebrate.”