Opioid overdose deaths on the decline says CDC but the real picture may still be grim

By Dr. Ananya Mandal, MDJul 17 2019

The opioid epidemic began in the 1990s with hundreds of deaths occurring each year due to overdose of these drugs of abuse. According to the Centre for Disease Prevention and Control (CDC), for the first time in two decades, there has been a drop of 5 percent in the opioid overdose deaths in 2018.

Experts add that this 5.1 percent may seem small but translates to hundreds or thousands of lives saved annually. The CDC adds that in 2018 there have been 68,000 drug overdose deaths. This is a drop from the 72,000 deaths due to drug overdose in 2017. The CDC says that there may be a plateauing of the opioid crisis.

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Health and Human Services Secretary Alex Azar said in a statement, “The latest provisional data on overdose deaths show that America’s united efforts to curb opioid use disorder and addiction are working. Lives are being saved, and we’re beginning to win the fight against this crisis.” Stanford University professor Keith Humphreys, a former senior policy adviser at the White House Office of National Drug Control Policy, in a statement said, “Since the epidemic started, we’ve had a few years where deaths were flat or barely grew year on year, but this is the first time they’ve actually declined. Losing nearly 70,000 people a year of course still means we’re in the midst of a public health disaster, but this is the first real sign of hope we’ve had that we might be turning the corner.”

While these data appear encouraging, several experts including the CDC have warned that there may be cause for concerns yet and all may not be well. The CDC says that this data is a preliminary one and may not reflect the actual picture yet. The final figures regarding opioid related deaths would be revealed this December says the CDC.

The CDC adds that there is always a margin of error when the number of deaths attributed to overdose of opioids is concerned. In 2017 for example the actual numbers of deaths could be 2,000 less than what was announced. They also add that in 2011 and 2012 there had been a similar pleateauing off of the overdose deaths at 41500. This was before a synthetic street version of Fentanyl came back and the number of opioid overdose related deaths shot up by 70,000 to 72,000 in 2017 driven by Fentanyl alone. Even now there is an epidemic of Fentanyl use in the Northeast and Midwest parts of the nation.

Based on early data from CDC, there is a rising trend of Fentanyl related deaths that remains a threat, say experts. The CDC says that 2018, the deaths related to synthetic opioids were nearly 32,000 and this was around 29,000 in 2017. The drop recorded here in this report came from the opioid painkiller deaths rather than synthetic opioids of abuse, cocaine or meth, say the CDC officials. The lethal overdose from opioid pain killers were 12,757 in 2018 compared to 14,495 in 2017, the CDC report adds. The CDC report points out that even at 68,000 overdose related deaths, the number is too high and surpasses deaths due to fire arms, car accidents and HIV/AIDS. Azar noted that there were “concerning trends in cocaine and methamphetamine overdoses” and said that “this crisis developed over two decades and it will not be solved overnight.”

The report provides the only hopeful addition that there has been a reduction in the number of deaths associated with opioid pain killers and those in need for their pain relievers have been provided with necessary pain relief. According to Humphreys the doctors prescribing opioid painkillers with caution has been an ongoing process. He added, “That actually started about five years ago, which is about how long many of us thought it would take to show up in reduced overdoses. If you don’t start millions of opioid-naive people on opioids they don’t need, it translates over the short term into few of them developing opioid problems, and in the longer term into fewer overdoses.” The CDC added that in counties where opioid pain killer prescriptions were high also reported a higher overdose related deaths.

Humphreys added that there has been a drop in heroin over doses. He said, “One thing that may be making a difference is markedly increased availability of naloxone. If you look at the data, we see that despite a lot of advocacy and laws, big spikes in naloxone availability didn’t occur until 2016.” Naloxone is used successfully in opioid overdoses to prevent deaths.

Rebecca Haffajee, a behavioral health researcher at the University of Michigan who studies policies aimed at curbing opioid addiction, said in a statement, “We’re still in a pretty sad situation that we need to address.” Humphreys said, “The supply of drugs matters enormously no matter what else we try to do. When there’s a flood of addictive drugs, lots of people end up being harmed.”