Drug OD Deaths Down... It's Okay News, I Guess
It's better than the alternative
Drug Overdoses
Let me start with the news hook.
NPR: NPR Exclusive: U.S. overdose deaths plummet, saving thousands of lives
For the first time in decades, public health data shows a sudden and hopeful drop in drug overdose deaths across the U.S.
"This is exciting," said Dr. Nora Volkow, head of the National Institute On Drug Abuse [NIDA], the federal laboratory charged with studying addiction. "This looks real. This looks very, very real."
National surveys compiled by the Centers for Disease Control and Prevention already show an unprecedented decline in drug deaths of roughly 10.6 percent. That's a huge reversal from recent years when fatal overdoses regularly increased by double-digit percentages.
Some researchers believe the data will show an even larger decline in drug deaths when federal surveys are updated to reflect improvements being seen at the state level, especially in the eastern U.S.
"In the states that have the most rapid data collection systems, we’re seeing declines of twenty percent, thirty percent," said Dr. Nabarun Dasgupta, an expert on street drugs at the University of North Carolina.
According to Dasgupta's analysis, which has sparked discussion among addiction and drug policy experts, the drop in state-level mortality numbers corresponds with similar steep declines in emergency room visits linked to overdoses.
I’m sorry, y’all.
10.6% is not a “plummet”.
This is a sad attempt at selling an okay decrease after a horrific climb as some fantastic breakthrough.
Let me give you the CDC report that they’re reporting on.
Recent Decrease in Drug ODs as of April 1, 2024
Remember that external causes of death are censored for 6 months, so basically they’re using estimates for drug OD deaths through April 2024.
CDC: Provisional Drug Overdose Death Counts
The counts below do not show monthly deaths, but the 12-month cumulative count ending that month.
For the number to go down 10% as you see means the monthly number needs to have decreased quite a lot for several months.
I don’t know what the hell is going on in Nebraska.
The states with large increases still… I have some theories, but I’d rather say nothing right now. These could be too sensitive to the predictive models.
Look back at Storyline on Drug Overdoses
Let’s jump back five years:
1 Sept 2019: Mortality with Meep: Some Mortality Trends in the Storyline Game
Before we do the following, why don’t you go to Storyline and play a little game?
Let’s play a game — guess some death statistics!
In the Storyline game above, there are 5 different mortality-related graphs you’re challenged to draw, and you’re given one point on the graph. Yes, I gave the stats in these graphs (and all the sources… I didn’t make these up from nothing, you know.)
To be sure, in the 1 September 2019 post I discuss the answers a bunch of people gave, how they compared to the true answers, and what this (potentially) meant.
So go and play the game… because yes, there is a graph about drug overdose deaths.
I’ll wait.
Okay, long enough.
Here is the real answer from the Storyline game and how people answered back then:
This is what I said 5 years ago:
The main driver in this increase has been increased deaths from opioids, and primarily illegal ones at that. The Centers for Disease Control and Prevention noted that 2/3 of drug overdose deaths in 2017 were from opioids, and there was a 12% increase in the rate of opioid overdose death rates between 2016 and 2017. However, the number of deaths for prescription opioids remained level, synthetic non-prescription opioids like fentanyl used illegally, greatly boosted the number.
According to the CDC, overdose death rates are highest among men age 25-44, but the rates are also greatly increasing over many age ranges and for both sexes.
As noted in the hint, fentanyl was part of the mixture of drugs that killed Prince (and also Tom Petty). Prescription fentanyl is often used for pain relief, in the form of slow-release patches. However, many people have gotten fentanyl in the black market (or, sometimes, heroin has been laced with fentanyl for a more potent high). Fentanyl has surpassed heroin as the leading cause of drug overdose deaths.
Hopefully, this trend will turn around, as with the cancer and heart disease cases. As we’ve seen with these trends, things don’t always just keep going up or keep going down.
Well.
Let’s see how it’s been going.
Update on Drug OD deaths through 2023
For simplicity, I will start in 1999, instead of 1979.
The simplified version:
1999-2017, when everybody did their first freak-out… (and note, it really had one trend up to 2015, but let’s ignore that) - driven by oxycontin and the like, there was a 9% per year average increase in the unintentional drug overdose death rate.
2019-2021: the first two years of the pandemic, there was a cumulative 57% increase in drug OD deaths. That’s a 22% per year increase.
2021-2023: the plateau… there was a 1% per year decrease
Even if there were a decrease on the magnitude they mention, the death rate due to drug overdoses would be far above 2017 levels.
That would be magnificent, of course.
We want the drug OD death rates to start going down.
However.
I would not call a small “correction” to drug OD deaths “plummeting”.
“Plummeting” drug OD death rates would be death rates back at 2017 levels.
We’ve got a long way to go before we get there again.
