Falling number of overdoses give reason for hope

When Nabarun Dasgupta, a leading drug expert at the University of North Carolina, discovered the figures from the Centers for Disease Control and Prevention (CDC) in May, he was “skeptical.” For the first time since 2018, they announced a 3% drop in the number of overdose deaths in the US in 2023, compared with the previous year. As the months went by, he had to admit it: the trend continued and even intensified. According to the latest CDC data published in November, the decline is now expected to be 14.5% nationwide between June 2023 and June 2024, with 96,801 overdose deaths, compared with 113,154 a year earlier.

For over 20 years, the opioid crisis has been wreaking havoc in America. It was first fueled by the explosion of prescription painkillers such as oxycodone, then by the rise of heroin and finally by that of synthetic opioids such as fentanyl, which is a hundred times more powerful than morphine. Death from fentanyl overdose is now the leading cause of death among Americans aged 18 to 45.

The Covid-19 pandemic only made matters worse. In 2021, the number of overdose deaths exceeded 100,000 nationwide for the first time, then a new record of 110,000 in 2022. “When we see a double-digit drop like this, it shows that it’s not just a statistical aberration,” confirmed Allison Arwady, director of the National Center for Injury Prevention and Control, a branch of the CDC.

This decline is more pronounced in the east part of the country – North Carolina recorded a decrease of around 30% – while the situation is more contrasted in the west, with five states recording rising numbers. Arwady said this can be explained by the fact that the East Coast was the first to be affected by fentanyl and therefore the first to have to react before the trend moved westwards.

A life-saving nasal spray

Why this recent and marked downtrend? Has access to treatment for opioid addiction improved? Is the fight against cartels more effective? Is funding more massive? Yes, answered the White Housefor whom this decline is the result of the policies pursued by outgoing president Joe Biden over the past four years. In a lengthy blog post published in SeptemberNabarun Dasgupta reviewed the various arguments suggested by the scientific community, which itself is struggling to explain this decline. “There is no single obvious answer,” he wrote, before acknowledging that “we may never know what caused this dip, and if it will last.” “It’s hard to see what’s working at the national policy level, but on the ground, it’s clear that each community [administrations, associations, social workers, doctors working together] has a different path to success and that it’s the collective effort that works,” he said.

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