The New York Times reports today that the CDC reports that drug overdose deaths have plummeted recently. Sure enough, they have:
The Times article provides a bevy of possible reasons for the decline, but I have my own theory. One of the most consistent findings of drug research is that drug use is faddish. In the last 50 years it's gone from heroin to cocaine to crack to marijuana to meth to fentanyl. Now fentanyl use is finally dropping off. It's never clear why a particular drug falls out of favor, but it probably has something to do with generational shifting: youngsters watch their elders dying in huge numbers and eventually turn to something else when they get old enough to use drugs themselves.
It probably also has something to do with the stark decline in all drug use among teens. If you don't pick up the habit in high school, it's less likely you'll pick it up later.
In any case, good news.
The fact that Narcan is readily available (OTC) and free in many places has to have had an effect.
The basic hypothesis has a flaw since few people are choosing to take fentanyl. Instead, it is used to lace other drugs or even being sold as other drugs, i.e. you think you are buying cocaine or even heroin but are getting something mixed with fentanyl.
was about to say this. we now have narcan and cheap testing strips, so it’s easier to avoid drugs laced with fentanyl.
And the chart is ODs, not use!
Should've scrolled.
I and my partner carry a couple of cartridges of narcan in our bags at all times. Never know what you're going to see on the Red or Green lines, or any other for that matter.
My first thought.
It’s possible that a majority of the reduction is due to widespread use of naloxone which prescriptions have doubled since first responder personnel are required to have it. The website long.live.dc.gov reports that MPD use the drug treatment over 5,000 times in a recent six months period. If you extrapolate these numbers it could easily explain the massive reduction in deaths. Because fentanyl is so deadly (onetime use can easily kill you, so it is just not long term addicts), this explanation at least needs to be considered.
Fentanyl is a synthetic opioid. CDC shows that the surge in OD deaths was highest among opioid users, followed by synthetic opioid users.
I think the key is the opioid settlements involving the Sackler family in 2020 which slashed the number of prescriptions. That in turn slowed the number of new addictions. Meanwhile, those already addicted just kept dying, but the widespread availability of Narcan, etc., meant that the peak of OD deaths were flattened and widened across several years.
The settlement had nothing to do with the reduction in proscriptions which goes back to 2011, The fentanyl crisis was mostly driven by the fact that illegal drug users didn't have access to non0fentanyl illegal drugs. If you are a Trump apologist, your best arguement is that drug deaths have plummeted under Biden to levels that predate Trump is to claim that fewer people are dying of fentanyl because so many fentanyl addicts have already died.
To the point that the reduction of prescriptions started in 2011 (specifically due to PDMP), I stand corrected. But not all persons were driven to Fentanyl; to reiterate the CDC chart, opioid OD deaths were higher than synthetic opioid OD deaths, and remains so, today.
You'd have to be an idiotic troll to think I'm a Trump apologist, though. And it still stands that the culmination and its flattening of deaths is because of the widespread availability of Narcan and other treatment options, some of which were funded by the Purdue Pharma settlement with states. Whereas the recent downward trend reflects the tail end of what remains of the people caught in opioid addiction. Or alternatively, it's correlated to COVID shutdowns and the reopening of markets.
I actually think it’s more likely that suppliers have gotten more used to working with an opioid that is 100x* more potent and therefore must be diluted by 100x which is not as trivial as it sounds, given varying sophistication of drug operations.
* Or 10x. I can’t remember off top of head
Decline in drug overdoses does not necessarily decline in usage, does it?
They're strongly correlated. They do differ as in recently when there was a systemic and nationwide increase in adulterated drug supply. I know of no evidence that illegal drugs have seen less cutting with fentanyl in the last three years.
no, they are not strongly correlated.
https://www.ama-assn.org/delivering-care/overdose-epidemic/why-overdose-deaths-declined-barriers-sud-treatment-and-ending
"It's never clear why a particular drug falls out of favor"
I remember during the height of the crack epidemic, a doctor said that things would get better because everyone who was using the drug would be dead.
Once again highlighting the numerical illiteracy of even elite americans.
https://sfist.com/2024/11/22/fatal-drug-overdoses-in-sf-may-be-declining-because-fentanyl-user-population-may-be-dwindling/
This has been my theory; the fentanyl problem would largely take care of itself as the number of people hooked on prescription opiods should be going down with tighter controls and a drug that kills its best customers is going to eventually lose customers. The rest is having an effective rescue medicine.
Illicit drug use is more based on availability rather than fad based on my observation. Drug fads require a well distributed supply. Falling overdose death incidence may not signal declining usage. Fentanyl producers may be providing accurate dosage information with their product to prevent accidental death of customers or users are being more cautious since accidental OD has become notable. If Narcan usage is increasing, that might explain some decline of OD deaths. If Narcan usage is increasing, that would indicate opioid usage has not fallen.
Perhaps suppliers stopped spiking the drug supply. Perhaps lots of users died and there just aren’t many left. It seems bad for business if your customers are dying or getting mad at you for trying to kill them.
the article literally says
"changes in the drug supply itself, which are, in turn, influencing how people are using drugs. The fentanyl on the street is starting to become weaker"
and dealers now cut fentanyl with xylazine, which apparently makes people use less fentanyl
Old enough to have seen many a drug fade from use. My generation followed the heroin generation and none of my friends or I would have touched that shit with a ten foot pole. I asked my sons how in the world it came back? They said it was easily available in pill form, it hooked some immediately, most not at all. There generation is littered with OD’s, very sad. I told my wife, it shall fade greatly in the next generation as the kids will see the ravages of the previous one.
Re: high school
I bounced around schools from the 6th to 8th grade. When I returned to my original school, all my old friends were smoking. I never started the habit. That said I did start drinking. One blind drunk experience turned me off to drinking for just a buzz. Now in my dotage, I have no interest in alcohol.
I remember going to see Reefer Madness and thinking I needed to find a source. Anti-drug campaigns only peak the imaginations of dumb kids.
The hot new drug is smartphones. Super addictive, but no overdose deaths.
There is phone use while driving to replace overdoses as a source of fatality. Smaller numbers, but it remains a problem.
To those saying that no one actively seeks out fentanyl, I highly recommend two episodes of the podcast Search Engine. It disabused me of this notion.
Part One: https://pjvogt.substack.com/p/why-are-drug-dealers-putting-fentanyl
Part Two: https://pjvogt.substack.com/p/why-are-drug-dealers-putting-fentanyl-97a