Drug Overdose Deaths Drop in US for First Time in Five Years

Drug overdose deaths in the US declined last year for the first time since 2018, even as overall drug use-related deaths remained well above pre-Covid pandemic levels, according to new figures from the Centers for Disease Control and Prevention.

The CDC estimated 107,543 drug overdose deaths occurred in 2023, a 3% decrease from 2022 when 111,029 such deaths were estimated to occur. The US has recorded a dramatic increase in such deaths for the past 25 years, only seeing dips in 2023 and 2018.

The CDC estimates overdose deaths based on mortality data from state offices.

“We’re not out of it yet,” Sheila Vakharia, deputy director of the department of research and academic engagement at the Drug Policy Alliance, a nonprofit that advocates for harm reduction policies, said. “If anything, we’re seeing a regional shift and drug involvement shifting.”

Drug overdose deaths in the US have skyrocketed: in 2015 fewer than 54,000 people died from overdoses, according to the CDC. The increase has been fueled by opioid overdoses and the rise of synthetic opioids, such as fentanyl, in the illicit drug supply, according to the data.

Combating the epidemic of drug addiction and overdose deaths in the US has become a major goal of the last two presidents, who are poised to face each other again in the November elections.

President Joe Biden made curbing deaths related to fentanyl part of his “unity agenda,” and Biden promised to put resources into addiction treatment programs and rewriting drug control policy. The White House boasts it has spent $100 billion to try to cut the supply of illicit drugs in the US and expand access to addiction treatment and the overdose-reversal drug naloxone.

Former President Donald Trump, seeking reelection this year, has taken a more law enforcement-focused stance, vowing to use tougher immigration and border security policies to restrict the import of drugs like fentanyl into the US.

The rise in fentanyl-related overdose deaths even prompted lawmakers to try to stock naloxone at the Capitol: Rep. Buddy Carter (R-Ga.) late in 2023 urged the organizations that oversee congressional buildings to stock the overdose-reversing drug.

Drug overdose deaths declined by about 3,000 between 2017 and 2018, during the Trump administration, but the fall was short-lived and preceded a surge in deaths. The Covid pandemic prompted a major rise in drug-related deaths in 2020 and 2021, pushing the total number over 100,000.

Shift in Deaths

The reduction in overdose deaths is not evenly distributed across the country and the drugs involved in these deaths are changing, according to the CDC data. Overdose deaths rose in northwestern states such as Oregon and Washington, according to the data, while states in the Midwest and Northeast saw reductions.

The number of deaths involving synthetic opioids fell by 1,524 year-on-year to 74,702 in 2023, according to the CDC. However, deaths involving cocaine rose by nearly 1,500 during the same period to 29,918.

Researchers who study drug deaths say it’s unclear what might have caused the slight decline in overdose deaths, but the broader availability of naloxone and addiction treatment medicines could be paying off.

“Perhaps now we’re seeing the return on that investment,” Katherine Keyes, a professor of epidemiology who studies the drug overdose epidemic at Columbia University, said. She cautioned that there’s far more work to be done, though.

“It’s not time to declare victory and take our eyes off the prize,” she said.