The numbers are still horrifically high, but dropping fast, for a variety of reasons. 

[image:1 align:left caption:true]Fatal drug overdoses have declined dramatically, according to the latest data from the Centers for Disease Control and Prevention. (CDC). The provisional drug overdose count for the 12-month period ending in April shows a 10 percent decrease in overdose deaths. While overdose deaths appear to have plateaued in 2021-2022, they declined by three percent between 2022 and 2023, a decline that has only accelerated. 

Drug overdose deaths, which had been on the increase during the century's first two decades, exceeded 100,000 per year by mid-2021 and peaked at more than 111,000 per year in the summer of 2023. But by April of this year, the toll had dropped to 97,309.

"This is exciting," said Dr. Nora Volkow, head of the National Institute On Drug Abuse [NIDA]. "This looks real. This looks very, very real," she told National Public Radio (NPR). 

"The trends are definitely positive," said Dr. Keith Humphreys, a nationally respected drug policy researcher at Stanford University. "This is going to be the best year we've had since all of this started," he told NPR.

The CDC's provisional data did not include any breakdown by substance, but according to NIDA, in recent years, fentanyl and its derivatives have been implicated in between two-third and three-quarters of all overdose deaths, followed by cocaine and methamphetamine, which are each involved in about one-fifth of overdose deaths. 

There could be even better news coming. Some researchers think that an even larger decline in overdose deaths will become evident once the provisional data is updated.

"In the states that have the most rapid data collection systems, we’re seeing declines of 20 percent, 30 percent," said Dr. Nabarun Dasgupta, an expert on street drugs at the University of North Carolina. The decline could be saving "roughly 20,000 lives" per year, he told NPR. 

Different factors are at play to account for the decline. Part of it is users simply growing familiar with fentanyl, part of it can be attributed to harm reduction measures such as the widespread access to the opioid overdose reversal drug naloxone. And part of it probably has to do with the ending of pandemic era isolation and social dislocation. 

"Expansion of naloxone and medications for opioid use disorder — these strategies worked," said Dr. Volkow at NIDA.

"We've almost tripled the amount of naloxone out in the community," said Brad Finegood, who directs the overdose crisis response in Seattle "A year ago when overdose deaths continued to rise, I was really struggling with hope," he told NPR. "Today, I have so much hope," Finegood said.

"This is the largest decrease on record and the fifth consecutive month of recorded decreases," said Dr. Rahul Gupta, head of the Office of National Drug Control Policy (ONDCP—the drug czar's office), calling for more money treatment and health services in poor Black and Native American communities where overdose deaths remain high. "There is no way we're going to beat this epidemic by not focusing on communities that are often marginalized, underserved and communities of color," Gupta said told NPR. 

Still, the decline in overdose deaths already has been striking—especially in the eastern and central US. In Vermont, they are down 22 percent. In Ohio, they are down 31 percent. In Misssouri, 34 percent. 

"While the mortality data for 2024 is incomplete and subject to change, Ohio is now in the ninth consecutive month of a historic and unexpected drop in overdose deaths," said Harm Reduction Ohio in a statement.

"A fifteen or twenty percent [drop in deaths] is a really big number, an enormous impact, said Dasgupta, calling for more research to determine how to keep the trend going. "If interventions are what's driving this decline, then let's double down on those interventions."