OPIOIDS
After years of relentless death and devastation, America has finally seen a decline in drug overdose deaths. The Centers for Disease Control and Prevention (CDC) reports there was a 14.5 decrease in fatal overdoses from June 2023 through June 2024 – the first drop since 2018.
Experts and law enforcement officials maintain there are many possible explanations for this – including expanded treatment; increased access to Medications for Opioid Use Disorder (MOUD), which uses FDA-approved medications like methadone, buprenorphine and naltrexone to manage and/or suppress opioid cravings; harm reduction techniques; the enforcement of laws; and improved educational and public health messaging campaigns – but another likely reason is a significant change in the drugs themselves. In November 2024, the U.S. Drug Enforcement Administration (DEA) announced that, for first time since 2021, they have seen a decrease in the potency of fentanyl pills. The agency reports that “the latest DEA laboratory testing indicates 5 out of 10 pills tested in 2024 contain a potentially deadly dose of fentanyl. This is down from 7 out of ten pills in 2023 and 6 out of ten pills in 2022.”
The DEA attributes this diminished potency to pressure the U.S. has put on the criminal networks that supply fentanyl to the U.S. – namely the Sinaloa and Jalisco cartels – and other international supply chains. But experts also say there may be a hidden consequence of this shift that we must watch closely. As people have become more aware of the dangers of synthetic opioids like fentanyl, they may be simply replacing them with other drugs like methamphetamine or cocaine.
The decline in fatal overdoses is welcomed news given that, in the 12-month period ending April 2021, the CDC reported there were over 100,000 drug overdose deaths reported in America. This was the first time in history that drug-related deaths passed the six-figure mark in a twelve-month period. However, the numbers continue to be alarmingly high. There were still 97,000 overdose deaths in the 12 months that ended in June 2024.
Breaking the numbers down by race brings even more alarm. State-by-state data shows that black people suffer far worse outcomes than white people when it comes to overdose deaths. A study from Georgetown University found that, while the number of fatal overdoses among white Americans often decreased between 2022 and 2023 in the 22 states that track drug overdoses by race and ethnicity, overdose deaths among black Americans generally increased.
This is a continuation of a distressing trend that has occurred for years. In Washington, D.C., “the city’s medical examiner identified fentanyl in 95 percent of the 87 overdose deaths through March of 2021, a number that had risen steadily in recent years; 281 overdose deaths in 2019; and 411 in 2020.” Black residents, who were then 46 percent of the city’s population “were disproportionately affected.” More than four out of five people who had fatal overdoses in Washington, D.C. during that time were black.
In Baltimore – where close to 6,000 people have died of drug overdoses over the past six years, far higher than any other American city – black men in their mid-50s to early 70s have been hit hard. Although this group accounts for only seven percent of Baltimore’s population, they make-up almost 30 percent of its drug deaths. This is TWENTY TIMES the fatality rate of the rest of the country.
The Pew Research Center reports that “while overdose death rates have increased in every major demographic group in recent years, no group has seen a bigger increase than black men… As recently as 2015, black men were considerably less likely than both white men and American Indian or Alaska Native men to die from drug overdoses. Since then, the death rate among black men has more than tripled – rising 213 percent – while rates among men in every other major racial or ethnic group have increased at a slower pace.”
Likewise, fatal overdoes among black women “rose 144 percent between 2015 and 2020, far outpacing the percentage increases among women in every other racial or ethnic group during the same period.”
Dr. Allison Arwady, the director of the CDC’s National Center for Injury Prevention and Control, put it this way: While the recent decline in fatal overdoses is a positive development, “it comes with the risk that people will say, ‘We’re doing okay now on drug overdoses, we’re making progress.” However, “there are entire communities that are not seeing that progress. Many families continue to be impacted by it every day. So, it has to remain a priority for the CDC and public health across the country.”