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Federal data shows that overdose deaths in the United States are the lowest they have been in three years, and new Analysis Some of the downward trends suggest “unprecedented” progress in fighting the drug epidemic.
Overdose deaths have increased during the Covid-19 pandemic. a 30% jump between 2019 and 2020 and another 16% by the end of 2021; Data From the US Centers for Disease Control and Prevention. But the latest interim data shows that overdose deaths took a sharp turn at the end of last year and have been declining for months.
At the end of April, there were about 101,000 overdose deaths, the CDC estimates. Even more people are disappearing than before the pandemic – There were almost 72,000 overdoses in 2019 – but the latest figures show that deaths have fallen by 10% in a year and are the lowest since the spring. of 2021.
A key factor in the overall decline is the reduction in mortality with fentanyl.
Overdose deaths from fentanyl and other synthetic opioids are down 20% year over year, according to CDC data. These drugs are involved in two-thirds of the overdose deaths, more than three-quarters of which occurred a year ago.
“After so many years of watching the death toll rise and rise, the prospect of hopelessness is staggering,” said Dr. Sarah Wakeman, senior medical director of substance use disorders at Mass General Brigham. Given that overdose deaths still exist before the pandemic, and preventable deaths, we are higher than we could have been.
Delving deeper into the trends, street drug scientist Nabarun Dasgupta and his colleagues at the University of North Carolina found that non-fatal drug overdoses also fell sharply and trends were relatively consistent at the state level — a sign that all experts felt the overall trend was strong.
Data compiled by the CDC on the rate of overdose emergency room visits showed a 24 percent year-over-year decline in April and a 13 percent year-over-year decline through June. And data from 911 calls and other emergency medical service responses show that non-fatal opioid overdoses were 17 percent lower this month than in September of last year.
“A 15-20% reduction in nonfatal overdoses and a 10% reduction in fatal overdoses is a large effect. No other public health intervention has reliably achieved this rate of reduction,” Dasgupta and colleagues wrote. Analysis It was published Wednesday at the University of North Carolina at Chapel Hill's Street Drug Analysis Laboratory.
“Our conclusion is that the overdose rate is real, and not an artifact of the data. It remains to be seen how long it will last. If it persists, whatever the cause, it is one of the strongest 'interventions' in this area of public health,” they wrote. A 15% to -20% reduction in overdoses is unprecedented. To our knowledge, no other public health intervention in the United States has met this criterion.
Nothing can explain the rapid decline or the timing, experts say. Rather, it is likely the result of a broad, sustained effort as they begin to make an impact.
“If this is true – and I hope it is true and continues to be – because there are many different multi-level interventions that are ongoing efforts,” Wakeman said, referring to the interventions. Access to naloxone has been expanded To reverse overdose, change with medications, and promote opioid use disorder Test strips of fentanyl. “Finally, after many years of effort and attention, looking at this as a public health situation may start to pay off.”
John Pamplin, an assistant professor of epidemiology at Columbia University who studies the effects of structural racism on substance use outcomes, says there is a cyclical nature to the US drug crisis: changes in drug availability and new patterns of drug use are needed. Adapting to knowledge and intervention, all this takes time.
In fact, the CDC has divided the opioid epidemic into Three wavesIt began in the 1990s with an increase in prescription opioids, an increase in heroin overdose deaths in 2010, and a more recent increase in synthetic opioids in 2013.
“We're riding a better than 20-year high in terms of drug overdoses,” Pamplin said. “Generally speaking, you have to rise and fall like that. It may be time for these to become real failures.
Although the 10% drop in overdose deaths may be unprecedented, Pamplin's level of support for change and intervention has also reached new heights.
I think that's why it's important to give time to deal with harm reduction approaches, not only to have these potential outcomes, but also to have enough time to properly evaluate the policies. He said.
In any case, the rate of change indicates a “very strong driving force,” Dasgupta and colleagues wrote. “Something has changed. And the fact that this happens without central coordination is a big deal. It had a big impact on the way you think about preventing overdose.
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Still, now is not the time to be complacent, experts warn. While national data show promising trends, they may blur the distinction between drug overdose epidemics and the burden of populations in need of special attention.
“Unfortunately, for the most affected groups, namely Native Americans and black American men, the death rate is not decreasing and is at the highest level recorded,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. Health.
“Understanding the causes of the different trends in overdose mortality is needed to implement and support evidence-based strategies to prevent and reduce deaths, prevent drug use, treat addiction, make lifesaving disability-reduction services accessible and equitable and accessible to all who benefit from them.” We must continue to prioritize efforts.