Chattanooga Times Free Press

Overdose deaths trending down

- BY MIKE STOBBE

NEW YORK — U.S. overdose deaths last year likely fell for the first time in nearly three decades, preliminar­y statistics suggest.

The Centers for Disease Control and Prevention on Wednesday posted the provisiona­l numbers showing nearly 68,000 drug overdose deaths were reported last year. The number may go up as more investigat­ions are completed, but the agency expects the tally will end up below 69,000.

Overdose deaths had been climbing each year since 1990, topping 70,000 in 2017.

The numbers were celebrated by the U.S. secretary of health and human services. “Lives are being saved, and we’re beginning to win the fight against this crisis,” Alex Azar wrote in a tweet.

But the overdose death rate is still about seven times higher than it was a generation ago.

“We’re still in a pretty sad situation that we need to address,” said Rebecca Haffajee, a University of Michigan researcher.

Researcher­s do not believe this is the start of a dramatic decline. Data from the first months of this year likely will show the decrease lessen a bit rather than accelerate, said Farida Ahmad of the CDC’s National Center for Health Statistics.

The improvemen­t was driven by a drop in deaths from heroin and prescripti­on painkiller­s. Those falls were offset somewhat by continuing growth in deaths involving fentanyl, cocaine and psychostim­ulants like methamphet­amines. Overdose deaths often involve more than one drug.

It can take months for authoritie­s to complete toxicology tests and other elements of a death investigat­ion involving drugs. And some states report faster than others. The CDC is expected to report more complete data later this year.

The current overdose epidemic has killed more people than any other in U.S. history, and it had been on a soaring

trajectory. From 2014 to 2017, overdose deaths jumped by 5,000 or more each year.

Experts trace the epidemic’s origins to 1995 and the marketing of the prescripti­on painkiller OxyContin. It was meant to be safer and more effective than other prescripti­on opioids, but some patients found themselves hooked and drug abusers found they could crush the tablets and snort or inject them to get high.

Gradually, more addicts turned to cheaper street drugs such as heroin and fentanyl. In 2015, heroin began causing more deaths than prescripti­on painkiller­s or other drugs. In 2016, fentanyl and its close cousins became the biggest drug killer, and in 2018 they were involved in about 46% of the reported overdose deaths, according to the preliminar­y CDC data.

Strategies to reduce drug overdose deaths have included tougher policing, treatment program expansions, policies to limit opioid painkiller prescripti­ons and wider distributi­on of the overdosere­versing drug naloxone.

Haffajee and other researcher­s are trying to figure out what measures are most responsibl­e for the slight improvemen­t.

“It’s complicate­d because there are so many policies going on, and as an evaluator it’s very hard to separate them out and determine which is working,” she said.

Valerie Hardcastle, a Northern Kentucky University administra­tor who oversees research and other work on local health issues, has seen the overdose epidemic play out in her region, near Cincinnati. She believes a major factor is Narcan, a nasal spray version of naloxone, that has been widely distribute­d through the efforts of philanthro­pists and local, state, and federal officials.

“It’s fantastic that we have fewer deaths, don’t get me wrong,” she said. “But I’m not sure it’s an indication that the opioid problem per se is diminishin­g. It’s just that we have greater availabili­ty of the drugs that will keep us alive.”

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