One Year of Overdose Death Decreases: How Good is This News?

For the first time in decades, the number of Americans lost to drug overdoses has begun to decline. Is this cause for celebration? Not yet. Not when you know the reason for the decline.

Did you hear about this? For the last year, the number of overdose deaths has been declining. The decline has not been steep but it was a profound relief when the graph of these deaths stopped climbing, year after relentless year.

Before this decline, here’s what the numbers looked like for all of America through 2017. This chart also breaks down the increases for men and women.


National Drug Overdose Deaths—Number Among All Ages, by Gender, 1999-2017.
National Drug Overdose Deaths—Number Among All Ages, by Gender, 1999-2017. Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2017 on CDC WONDER Online Dtabase, relased December, 2018.

The Numbers Begin to Tip

The very first signs of improvement showed up in December 2017. Out of the blue, the numbers began to decrease. Only a little bit at first.

Who distributed these declining numbers? They came from the Vital Statistics Rapid Release (VSRR) service from the Centers for Disease Control and Prevention (CDC). Prior to the CDC setting up this service, it was necessary to wait well into the next year to learn how many fatal overdoses had occurred in the prior year. The VSRR webpage updates overdose statistics month by month.

Two statistics are provided for each month: the total number of reported overdose deaths for the prior twelve months, and predicted overdose deaths for the prior twelve months. It takes about eight months for these statistics to be totaled and added to the chart.

If the CDC tried to provide numbers in real-time, those figures would be wildly inaccurate because of the length of time it takes to complete crime investigations, autopsies and toxicology reports.

Here’s what that tipping point looked like. Remember, each month's figures represent the prior twelve months of losses.

  • June 2017 Reported: 69,153. Predicted: 70,789
  • July Reported: 69,504. Predicted: 71,130
  • August Reported: 69,988. Predicted: 71,610
  • September Reported: 70,599. Predicted: 72,216
  • October Reported: 70,690. Predicted: 72,284
  • November Reported: 70,723. Predicted: 72,287
  • December Reported: 70,699. Predicted: 72,224
  • January 2018 Reported: 70,125. Predicted: 71,204
  • February Reported: 69,746. Predicted: 71,104
  • March Reported: 69,364. Predicted: 70,919
  • April Reported: 69,040. Predicted: 70,542

Here’s what the CDC chart of these figures looks like based on information available early August 2019.


12 Months-ending Provisional Number of Drug Overdose Deaths graph

I remember staring at these numbers rather stupidly when the December 2017 figures first appeared. After all, I had been watching the numbers climb steadily for ten years. It took me a few moments to realize that the numbers had finally begun to tip. I returned to this chart again and again to make sure it wasn’t a single dip.

The numbers are not changing a lot. But they are changing.

So Should We Start to Celebrate?

I’m not celebrating. Yet. But any improvement is a slight relief. When the numbers continued to climb, it meant we had no control at all over this problem.

Why would the numbers be dropping? According to the CDC as reported in the Los Angeles Times, it’s largely due to increased availability of naloxone/Narcan, the opioid antidote. A huge effort has been made by many states to make sure that their first responders have enough of this drug to reverse overdoses.

From 2017 to 2018, the number of naloxone prescriptions distributed by pharmacies doubled, going from 271,000 to 557,000. Since about two-thirds of overdose deaths are caused by an opioid of some type, naloxone is a vital tool to save the lives of those overdosing.

A person overdosing on a stimulant or other type of drug will not respond to naloxone.

This information on the number of doses of naloxone might make you shiver with a little dread, as it did me. How many lives would we lose if we didn’t have this one life-saving technique? Would we be over 100,000 lives lost each year?.

Fentanyl comes into the picture right at this point. If there were no illicitly-manufactured fentanyl being distributed by drug dealers in this country, we would have fewer people overdosing—fatally or non-fatally. Fentanyl in its many forms is so powerful that it is easy to overdose. And the drug dealers obtaining illicit fentanyl and mixing it into their heroin, methamphetamine or cocaine supplies, or pressing it into pills that look like legitimate prescriptions, are not careful professionals by any means. They could make a batch of counterfeit pills or bags of fentanyl-contaminated heroin so powerful that an unwary user could easily overdose.

In this chart, you can see how much drugs from the fentanyl family have contributed to overdose deaths (yellow line).


National Drug Overdose Deaths—Number Among All Ages, 1999-2017.
National Drug Overdose Deaths—Number Among All Ages, 1999-2017. Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2017 on CDC WONDER Online Database, released in December 2018.

So Much Work to Be Done

Why? First, because not every state is seeing improvement. Loss of life has increased more in Missouri and Delaware than anywhere else, plus there have been lesser increases in California, Arizona, New Mexico, Idaho, Montana, Kansas, Tennessee, South Carolina, Virginia, Maryland, Hawaii, New Jersey, Rhode Island and Vermont.

Second, because we actually don’t have a handle on the opioid crisis or the willingness of Americans to start using drugs. We only have a way to keep those who inadvertently overdose from dying.

Third, because it could be missed that the number of individuals we are losing to overdoses is astronomically higher than it was a generation ago. Most government charts look like those above—they track back to about 1999. But what if we look further back? A generation ago?

In 1970, only a little more than one person for every 100,000 Americans was lost to overdose death. By 2017, we were losing 21.7 people per 100,000. That’s an 1800% increase.

This chart from the CDC shows you the increase between 1970 and 2006. Of course, the numbers kept going up after 2006. (The red boxes show the influences of specific drugs during those marked time spans.)


Unintentional Drug Overdose Deaths United States, 1970–2007.
Unintentional Drug Overdose Deaths United States, 1970–2007. Source: National Vital Statistics System. http://wonder.cdc.gov

Take a slightly longer view of the problem and take into account our small decreases and it is obvious that we are still far from a solution.

Each Individual Can Help Make a Difference for the Future

A person is walking toward sunshine.

There’s going to have to be more naloxone distributed and more rehab centers built and more drug prevention services in school classrooms and communities. But each individual American can start making a difference right now. How? Here are some ideas.

  1. Stay drug-free yourself. Set a good example. If you drink, only drink in moderation and never before driving or doing any job that requires sobriety to be safely done.
  2. Encourage others to be drug free, especially any young people you are in contact with.
  3. Be alert for changes in the appearance or behavior of teens and young adults so you can identify drug use. There is a chart showing you the signs of drug use on this page of the Narconon blog.
  4. Attend and support community events that encourage drug-free living.
  5. Also support community groups that encourage productivity and healthy attitudes.
  6. If you know of someone struggling with drugs, see if you can find a way to help. Maybe their family doesn’t know and would like to help, or their pastor could reach out to them. Maybe you know of a community program to help them and you could let them know.
  7. Avoid stigmatizing someone who is addicted or who has been to rehab. Many people became addicted after taking medications exactly as prescribed. Many others who are addicted can once again become productive, positive persons if they can only get the right help.
  8. Discourage the popularity of music, movies or other entertainment that glorify drug use or excessive alcohol use.
  9. If you have a co-worker or employee who is using drugs or influenced by alcohol while at work, enlist the assistance of human resources to help the person get straightened out.
  10. If you have a child who is a student athlete who might suffer an injury or a teen getting their wisdom teeth removed, carefully monitor any medications given to them. Find out if it is possible to provide pain relief without drugs oxycodone, hydrocodone or other opioids. If they are going to take these drugs, ensure an adult hands each pill out and locks up the rest of the pills.

One of the best tools we have to fight drug abuse and losses to overdoses is a pervasive, consistent attitude that life goes best when we are sober. And it really does. You can actually make a difference by representing this attitude in your own sphere of influence and encouraging others to do the same thing.


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Reviewed by Claire Pinelli, ICAADC, CCS, LADC, MCAP, RAS

AUTHOR

Karen

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.