Forty states have seen drug overdose rates decrease over the past year as the epidemic strangling the US for decades appears to have loosened its grip.
Nationally, overdose deaths fell about 10 percent in the year ending in April 2024 compared to the period a year a before, from more than 112,000 to about 101,000.
North Carolina and Nebraska led the charge, with declines measuring 23 percent and 30 percent, respectively. Alaska bucked the trend, with overdoses increasing 42 percent. The reasoning is unclear but could be due to remote areas having less access to treatment.
The national decline is believed to be linked with increased access to addiction-busting medications such as buprenorphine and Narcan and the public health messaging blitz about the dangers of fentanyl.
Still others have put forth a more morbid theory – that the fentanyl crisis has been so catastrophic it has simply run out of people to kill.
Dr Rahul Gupta, director of the White House Office of National Drug Control Policy, told the Washington Post: ‘This has not happened by accident.’
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Overdose rates skyrocketed during the Covid pandemic when millions suddenly lost access to in-person counseling and access to medication-assisted treatments.
The forced isolation also likely exacerbated people’s cravings combined with mental health issues.
Prepandemic, in 2019, about 72,000 people died from overdoses in the U.S.
In 2020, that number skyrocketed to around 94,000. In 2021, it climbed again to 109,000, and again in 2022 to about 111,000.
But in 2023, the figure dropped slightly to about 108,000.
The latest drop is the most recent since a slight decline in the early spring of 2022.
Behind Nebraska and North Carolina showing the steepest declines in overdose deaths were states that have been ravaged by opioids. Vermont came in third with a 19.4 percent decline.
After Vermont came Ohio, with a 19.3 percent decline followed by Pennsylvania with an 18.6 percent drop and then Indiana, with an 18 percent drop.
States in the west did not fair so well. In addition to Alaska seeing a 42 percent rise in overdose deaths, Oregon saw a 22.3 percent increase, and Nevada saw an 18.2 percent increase.
Washington came in fourth place with a rise of 13.8 percent followed by Utah with 8.1 percent.
More people are aware – and fearful – of the dangers of fentanyl than ever, according to Austin Wynn, who runs Never Alone Recovery, a free source for people dealing with addiction to find rehabs and intervention assistance.
Public health messaging, whether it comes from officials in the government, advocates, or the media, appears to be having an impact.
He told DailyMail.com: ‘I do think that fear has been a driver in seeing some people take different measures. I’ll just tell you what I tell parents, the likelihood of you dying from any illicit street drug now, I would argue, is, at minimum, 10 times greater than it was a few years ago.’
Mr Wynn added: ‘You get a lot of sensationalism in the news, which I don’t particularly agree with all the time.
‘But this is one thing that it is ironic as it is, I don’t feel has been sensationalized enough.
‘You’re hearing stories now like in California, there’s a big patch of stuff maybe two, three years ago, where kids were buying weed, and it was laced with fentanyl. I know of cases in Chicagoland area where it’s cocaine.’
Doctors are also increasingly prescribing medications like buprenorphine and suboxone, which reduce cravings for opioids by only partially activating opioid receptors in the brain, though not as strongly as heroin or fentanyl would.
By doing this, the user still feels some pain relief and euphoria but at much lower levels, which ends up reducing cravings for more.
Access to this type of medication is scattered, though, and uptake is still too low considering how many people would benefit.
Still, prescriptions are on the rise. Between 2016 and 2021, buprenorphine prescriptions increased by 36 percent, reaching nearly 13.9 million, while the number of doctors prescribing buprenorphine rose significantly by 86 percent, reaching about 59,000.
Philadelphia’s inner city has long been a magnet for drug users seeking their next high, but the scale of problems caused by xylazine is shocking even to locals who have become accustomed to such distressing scenes
Buprenorphine has a ‘ceiling effect,’ meaning that once a specific dose is reached, taking more won’t intensify its effects.
As a result, if someone uses a more potent opioid while taking buprenorphine, they won’t experience the usual high.
Additionally, since buprenorphine partially activates opioid receptors, it helps to prevent withdrawal symptoms, making it easier for people to stop using more potent opioids.
Healthcare workers have historically been hesitant to use medication to treat addiction due to a general lack of resources as well as a shortage of professionals qualified and knowledgeable enough to prescribe them.
For those who have not sought out medication-assisted treatment, the overdose reversal drug Narcan has already saved around 27,000 lives, according to the National Institute on Drug Abuse.
Narcan, also known as naloxone, is an opioid antagonist. It is used by inserting the nozzle of the drug into the nose and spraying it when someone is in the early stages of an overdose.
Narcan was made available without a prescription in March 2023. Since then, the lifesaving nasal spray has been stocked in vending machines, at nightclubs, bars, and even schools.
When inhaled, the medicine is absorbed through mucous membranes in the nose, rapidly entering the bloodstream and traveling to the brain.
Once there, the medicine competes with opioids, attaching themselves to receptors in the brain. It attaches to the brain’s receptors, replacing the opioid.
This blunts the effects of opiates on the brain, stopping an overdose from progressing.
The CDC graph shows a 10 percent drop in deaths during the 12-month period ending in April 2024, with about 101,000 people succumbing to overdoses
Public health experts posit that a combination of messaging, better awareness, and improved access to recovery resources is driving this downward trend.
Another factor posed by Dr Caleb Banta-Green, an addiction expert at the University of Washington, is the possibility that fentanyl has surpassed its peak victim count.
He told local news station KUOW: ‘There are only so many people who are using a drug, and when it has that high of a lethality rate, it will eventually — in a really horrific way — start to self-extinguish itself like a forest fire.
‘So, it’s literally burning out the fuel. The horrible thing in this instance is the fuel is people.’
Mr Wynn, for his part, believed this theory is too simplistic.
He told DailyMail.com: ‘At the end of the day, less fentanyl in the world means, ideally, fewer deaths. But could the argument be made that then more people would be willing to try and use drugs because there are fewer deaths? So it is sort of like a Schrodinger’s cat situation.
‘And I think it could be a dangerous question because even if it’s true, does it matter? Because what we don’t want is people to say, well, it’s going to happen anyway. Let’s just wait it out.’
