Between April 2023 and April 2024, drug-related deaths across the country appear to have fallen more than 10 percent. Provisional data published by the Centers for Disease Control and Prevention show a sharp drop-off in most states that’s unprecedented in the United States overdose crisis, putting the fatality rate back around where it was before the COVID-19 pandemic.
The data became publicly available September 1, but began picking up steam following an NPR story published September 18. In it Drug Czar Rahul Gupta credits the Biden administration for the overdose crisis turning a corner. If it keeps getting attention, Biden will say something about his historic investment in harm reduction and how expanded access to naloxone and medications for opioid use disorder is paying off. The Drug Enforcement Administration will say it’s all the fentanyl pressed pills taken off the streets. Customs and Border Protection will say it’s all the fentanyl shipments seized before they could come in from Mexico. Prosecutors will say it’s all the fentanyl homicide legislation. Local law enforcement will probably say it’s Opvee.
The CDC prediction is that once the rest of the data is in for that 12-month period, the death count will be 101,168. In the previous 12-month period, it was 112,470. NPR announced that this is “saving thousands of lives.” NBC said the same thing. Not sure how that tracks—the fact that 112,470 people died from April 2022 to April 2023 doesn’t mean 11,304 people have been saved. It means an additional 101,168 people have since died.
Mother Jones wrote that fatality rates in some states dropped by 40 percent, which is super not true. At the local level, where death data originate and are often available a few months ahead of the CDC’s version, some jurisdictions are seeing drop-offs even steeper than 10 percent. The most dramatic reduction, based on the provisional count, was Nebraska at 29.8 percent. Here are some other pieces of information about Nebraska.
Nebraska is the only state where all death investigations are done by a county attorney.
Nebraska’s previous 12-month overdose count, 218, was one of the lowest in the country. So its decreased rate looks as stark as it does mainly by virtue of the only three states with lower overdose numbers (North Dakota, Wyoming and South Dakota) not experiencing much change. Percentages often look more dramatic than numbers.
Ideally all death investigations would be done by a qualified medical examiner, and in some states they are. In others they’re performed by coroners, who are elected to their positions and don’t have to have any medical training. In some states it’s a mix, depending on the county. Nebraska is the only state where all death investigations are done by a county attorney. Or a deputy of a county attorney, since they’re allowed to delegate.
Lastly, the state health department hasn’t updated its public overdose dashboard since 2020.
Each of those points is I think helpful to know individually, but if they sounds like they add up to something it’s just because I’ve strung them together as if they’re connected. The thing to remember about media coverage of overdose data, and the overdose crisis in general, is almost all of it is just a series of unrelated sentences—often from cops, and objectively incorrect—strung together by reporters who are just reciting information without understanding what any of it means. This isn’t data that should ever really be taken too literally.
In some parts of the country, overdose does seem to be going down—for some communities, while disenfranchised ones remain vulnerable. In nine states, as well as Washington DC, data show overdose deaths going up. Alaska saw the biggest change at 41.8 percent more deaths compared to the previous 12 months; 390 deaths, up from 275.
California, the state that consistently sees the most overdose deaths due to its population size, saw a 5.3 percent decrease, with 11,993 fatalities from April 2023 to April 2024. Or 666 lives saved, if you prefer.
Image (cropped) via Centers for Disease Control and Prevention
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