Overdose Deaths Declined in 2024 but Progress Is at Risk

Source: Jane van der Wolf / Pexels

Earlier this month, the CDC announced that there was a 27% decline in fatal overdoses last year: 80,391 people died of a drug related overdose, compared to more than 100,000 the year prior. This is undoubtedly a sign of progress in the fight against overdose deaths and there are a few lessons we can draw from it. But we must also be cautious with interpreting these results and not take them for granted.

First, let’s get into what might be driving these steep declines. As epidemiologist Nabarun Dasgupta of the Univeristy of North Carolina-Chapel Hill has pointed out, these declines are part of a broader trend of declines occurring in states across the country over the past few years; some states were just quicker to decline than others. It’s hard to identify one specific reason why drug overdoses are declining, but one reason is definitely sustained investment in overdose response tools.

These tools include naloxone, the opioid antidote drug that can be used to bring someone back to consciousness and prevent death. Millions of dollars have been spent on naloxone distribution and education, with the result that many people —both first responders and people who use drugs — have been administering this drug to prevent overdoses from becoming fatal. This, alongside investments in treatment and harm reduction services, has had an impact and kept people alive.

There’s also the fact that fentanyl is not necessarily novel anymore. People are aware of it being in the drug supply and know to adjust their use accordingly or avoid using at all. People who use drugs regularly know about its potency and what steps they should take to mitigate risk — not using alone, for example.

Still, none of these are a panacea; more can and needs to be done to reach people, as 80,000 people is still a disastrous number. It should also be noted that these declines are not distributed evenly: of Black Americans and Native Americans continue to face higher rates of drug-overdose deaths. Data from 2024 has yet to be analyzed on this question but recent data suggests that these disparities will persist.

The drug supply is also constantly changing. Just as fentanyl was introduced into the street supply of drugs in the 2010s and replaced heroin, so too another drug may come on the scene. Stimulants like cocaine and meth may become mixed with more potent opioids. This dynamic situation means that trends can yet again change, so it’s not time to take the foot off the pedal.

Unfortunately, despite this progress, experts are warning that proposed budget cuts for the Department of Health and Human Services put forward by the White House could reverse this progress. These include cuts to naloxone distribution programs, to overdose prevention groups, to research, and to drug treatment programs – particularly through cuts to Medicaid, which is a major payer for addiction treatment in the United States.

As Congress debates the proposed federal budget, it’s important that we don’t take recent progress for granted and forget the 80,000 who died last year. Congress must continue to invest in a robust overdose response.