Deaths by overdose of drugs in the United States have dropped unprecedented to the lowest that they were in five years, according to a new estimate of the federal government published on Wednesday.
During the COVVI-19 pandemic, drug overdose death had reached record levels. The new data show that the decline that started in the second half of 2023 continued until 2024.
There were around 80,391 overdose deaths in 2024, according to provisional data from the Centers for Disease Control and Prevention American – a drop of 27% in one year, with approximately 30,000 less deaths than in 2023.
Synthetic opioids – mainly fentanyl – continue to be involved in most deaths by overdose, according to data. But these deaths fell at an even higher pace, down around 37% between 2023 and 2024.
Overall, more than 48,400 deaths by overdose – around 60% of overdose deaths in 2024 – involved synthetic opioids, according to new CDC data. There were around 29,500 deaths involving psychostimulants such as methamphetamine, around 21% less than in 2023, and deaths involving cocaine dropped by 28%, to 22,200 deaths in 2024.
Experts say that it is difficult to determine exactly what stimulates the promising trend, but it is probably the result of a wide range of persistent efforts that are starting to have an impact – and these efforts must continue to avoid returning to the progress that has been made.
“We are still at very high overdose levels,” said Dr. Daniel Ciccarone, professor at the University of California in San Francisco whose research focused on illicit drug trends in the United States. “We need constant pressure.
The size of the population at risk of drug overdose in the United States is probably much greater than we think, said Ciccarone. But the number of people leaving the risk pool – either due to a deadly overdose, or because they have found a treatment that works for them – can be higher than the number of new drug addicts that join the risk pool.
“On the one hand, the epidemic may be exhausted or that there is a certain regression on the average after the tip of deaths by overdose during the pandemic of Covid-19,” he wrote in an editorial published in the New England Journal of Medicine last year. “More optimistic, we can start applying enough financing and efforts to scale up responses based on evidence to the size of the problem.”
Population changes would be relatively progressive changes, said Ciccarone, but net slowdown suggests that there must have been a shock for the system. The supply of fentanyl could be disrupted at the end of 2023, he said, he said, but the supporting evidence that is far from convincing.
Nabarun Dasgupta and Adams Sibley, researchers from the University of North Carolina who are part of the opioid data laboratory, in disagreement with the theory that a sudden shock for the supply of drugs could have been an engine factor in the drop in overdose deaths. Instead, they followed the gradual decreases, the cities and the states seeing the change start at different times in the last three years which have finally started to end in a quarter of work seen at the national level about a year and a half ago.
In addition to changes in the population of drug consumers, they identify two other key factors down overdoses: the characteristics of the drugs themselves, in particular the cost and the effects and behaviors, both consumers of drugs and the communities around them.
“General dissatisfaction with the supply of illegal opioids at the moment is surprisingly high,” said Dasgupta, referring to Xylazine in particular, an animal sedative commonly known as “Tranq” which can cause serious skin injuries. “This is not what people have registered. It is much more attractive. It is much more unpredictable. It is not as pleasant. ”
Many drug consumers are now reaching a “inflection point” in their drug consumption because of the supply, said Sibley, and the dollars of opioid settlement and federal funding have helped support a range of harm reduction efforts ready to help them.
“The only thing that drug addiction providers and people who consume drugs will tell you is that people are ready when ready, and there are a lot of people ready at the moment,” he said. “We want to say that it is time to double efforts to educate and recruit people in reducing and treating harm, regardless of their safer version.”
Although a large part of the work to combat the epidemic of overdose of drugs occurs at the local level, the support of the federal government is essential to success, according to experts. The Mixed Messaging of the Trump administration raises concerns about the potential of the promising trend of the death by overdose to continue.
In March, the United States Ministry of Health and Social Services renewed a public health emergency on the opioid crisis, an official declaration which was initially published in 2017 under the first Trump administration. It allows extended authorities to devote resources and promulgate regulatory flexibilities to combat the overdose epidemic.
And last month, the Trump administration exercised its drug policy priorities for 2025, which include a mixture of objectives of prevention, processing and application of the law.
But uncertainty concerning the federal budget and the significant reductions in federal health agencies threaten the viability of some of these objectives.
The first strategy listed under the first objective of the Document of the President of the National Drug Control Policy reads as follows: “To fight against the drug crisis and the epidemic of opioids, largely motivated by fentanyl, the administration will extend access to education to the prevention of overdose and to opioid reversal drugs to the opioid.
The County of Mecklenburg de Charlotte has automatic Naloxone distributors, an epidemiologist focused on opioid trends, a robust data dashboard that helped public health agents identify target response areas and develop an infrastructure to do so – all financed by the subsidy of overdose data that flows from the CDC National Center And control of injuries.
But the CDC Center has been strongly targeted by federal job cuts earlier this year and is one of those who, according to the Trump administration, should be deleted to eliminate “duplicate, dei or simply unnecessary programs”, depending on the budget proposed for the 2026.
“Any change or impact on these financing flows would mean that we must either find other funding to support the team working in this department, or we had to set them up. “Experts (at the injury center) work hand in hand with us on the strategies that we choose to implement in the field, then how we assess what works, then how we share these best practices. This technical assistance is also as precious as the real dollars we receive. ”
In a declaration on the latest data on overdose deaths, the CDC specifically stressed the importance of “sustained financing to support prevention and monitoring activities such as the action data program”.
“Despite these global improvements, an overdose remains the main cause of death for Americans aged 18 to 44, stressing the need for continuous efforts to maintain this progress,” said the CDC declaration. “The CDC remains firm in its commitment to prevent disorders linked to the consumption of substances before starting, to expand access to treatment and to strengthen recovery paths to build a healthier future for all Americans.”
But the proposal for the federal budget also includes a recommendation for financing the reduction in the financing of the abuse and Mental Health Services Administration, or Samhsa.
“This administration is committed to fighting the scourge of deadly drugs that have ravaged American communities. Unfortunately, within the framework of the previous administration, Samhsa subsidies were used to finance dangerous activities presented as “reduction of harms”, which included the financing of “smoking kits and secure supplies” and the “syringes” for drug consumers “, according to the budget document.
Hundreds of researchers and health care providers sent a letter to the congress on Monday warning “disastrous consequences of dismantling rescue work” through budget cuts that would affect the consumption of substances and mental health programs. The proposed cuts “would certainly undermine the harshly disputed progress that we have made, in particular in the prevention of overdose”.
Protection of access to treatment for naloxone and drug addiction via Medicaid is among the main priorities among people in the field.
“The supply side of the equation did not work. Even if we say that a fetanyl supply shock caused this drop in death by overdose, we cannot count on creating it again,” said Ciccarone. “The reduction of misdeeds maintains people engaged, and if we do not keep this cohort engaged, they will do worse.”
