12 months ending August 2024: | 89,740 |
12 months ending August 2023: | 111,464 |
Full-year 2023 | 110,037 |
Full-year 2022 | 112,582 |
WHAT THEY MEAN:
From the Drug Enforcement Administration last Saturday, a report from Tucson:
“The United States Attorney’s Office for the District of Arizona announced today that extensive bilateral cooperation between the United States and Mexico resulted in Mexico’s Attorney General’s Office, Fiscalía General de la República (FGR), conducting a significant enforcement operation last week in Nogales, Sonora, to dismantle a prolific transnational drug trafficking organization operating along the U.S. Mexico border. The operation resulted in the arrest of two individuals in Mexico including the leader of the organization, Heriberto Jacobo Perez, and another member of the organization, Jesus Bernardo Rodriguez. Mexican authorities also seized four vehicles, two buildings, two firearms currency, a large number of fentanyl pills, and other controlled substances.”
Some background and then a wide-view look:
Deaths to drug overdoses in the United States rose fast and steadily for two decades. The Centers for Disease Control estimated 17,400 deaths in 2000, 41,500 in 2012, 43,697 in 2016, 92,500 in 2020, and peaks above 110,000 in 2022 and 2023. For context, the 112,582 deaths in 2022 is 50% above that year’s combined 42,514 deaths to car accidents (itself the highest traffic fatality figure in a decade) and 24,849 homicides. Synthetic opioids, in particular fentanyl, are the main cause, accounting for 87,155 or 78% of all American drug overdose deaths in 2023.
CDC’s most recent numbers show a startling change: drug overdose deaths turned down in mid-2023 and have been falling ever since. The CDC’s latest estimates cover August 2024. These report 89,740 overdose deaths over the 12 months since September 2023: a drop of 22,000, or 21.7%, from the 111,464 estimated from September 2022 to August 2023. Some states show even steeper drops, with North Carolina deaths down 51%, Virginia 32%, New Jersey and Ohio 30%, and Pennsylvania 27%. The decline is almost entirely in “synthetic opioids” such as fentanyl, for which the CDC estimates 79,815 deaths between September 2022 and August 2023, and 57,997 from September 2023 to August 2024. Extrapolating carefully from this 12-month number to individual months, and assuming no sharp change last autumn, the full-year 2024 toll would be somewhere between 70,000 and 80,000. This would be the largest one-year drop in deaths on record.
What explains this? Probably not any single factor, but complementary developments in three broad areas:
Source reduction abroad and at home: Last week’s Tucson event illustrates the value of U.S.-Mexican law enforcement cooperation. The Drug Enforcement Administration reports continuous pressure on the two large narcotics “cartels” responsible for most fentanyl trafficking, and notes that the 55.5 million fentanyl pills seized in 2024 test are somewhat less powerful — half contain potentially lethal doses, as opposed to 70% in earlier years — and so somewhat less likely to kill their users. (Administrator Milgram: “[F]ive out of ten pills being lethal is awful and we should not accept that. But it is significant progress in our fight to save lives, because it means that for every ten pills on the street, two fewer are deadly today.”) Nor are foreign countries the only sources: the fentanyl epidemic began with domestic prescriptions, and legal U.S.-based uses of opioids are declining, with prescriptions down from 154 million in 2019 to 125 million in 2023.
Treatment: Over the past four years, with harm-reduction support flowing from Congress to clinics and hospitals, testing and emergency treatment have become easier to find. The CDC, for example, notes that doses of Naloxone, chemically an “opioid antagonist” used to restore normal breathing during fentanyl overdoses via injection or nasal spray, doubled from 1.00 million in 2020 to 2.13 million in 2023.
Education: With schools, police offices, health services, and state governments informing the public about the particularly severe risk fentanyl carries — two milligrams in a single pill is a lethal dose — users are likely more aware of the danger and may be turning away from opioids.
In this larger view, DEA’s Saturday report from Tucson is another bit of encouraging news. Echoing Administrator Milgram, a year in which 70,000 or 80,000 people die of drug overdoses is a bad year. But it’s better than we’ve had in a while, with a drop large enough, and sustained long enough, to suggest that we might have turned a corner.
The CDC’s overdose data and mortality estimates through August 2024.
And via CDC’s data, deaths by drug overdose from 2000 to 2023, with a tentative estimate for 2024 based on the data available through August:
2024 | 75,000? |
2023 | 110,037 |
2022 | 112,582 |
2021 | 107,500 |
2020 | 92,500 |
2019 | 71,100 |
2016 | 63,600 |
2012 | 41,500 |
2000 | 17,400 |
Perspectives:
From Congress, Rep. Brittany Pettersen (D-CO) on a painful family experience and current work to raise community treatment and recovery capacity in last year’s “SUPPORT” Act.
From the Drug Enforcement Administration, a report from Tucson.
… background on fentanyl and its effects.
.. and DEA’s status report to the National Family Summit on Fentanyl last November from Administrator Anne Milgram, covering indictments, diplomatic and law-enforcement engagements with China and Mexico.
From the National Institutes of Health, an introduction to Naloxone.
And back to the CDC for data on Naloxone doses from 2019 to 2023 nationally and by state, along with domestic opioid prescriptions and Buprenorphine delivery.
And some international context:
UN’s Office on Drugs and Crime’s World Drug Report 2024 reviews drug production, transport, health, and other policy matters around the world. They estimate 60 million opioid and opiate users worldwide, including 9 million in North America, in a global drug-user population of 292 million.
Ed Gresser is Vice President and Director for Trade and Global Markets at PPI.
Ed returns to PPI after working for the think tank from 2001-2011. He most recently served as the Assistant U.S. Trade Representative for Trade Policy and Economics at the Office of the United States Trade Representative (USTR). In this position, he led USTR’s economic research unit from 2015-2021, and chaired the 21-agency Trade Policy Staff Committee.
Ed began his career on Capitol Hill before serving USTR as Policy Advisor to USTR Charlene Barshefsky from 1998 to 2001. He then led PPI’s Trade and Global Markets Project from 2001 to 2011. After PPI, he co-founded and directed the independent think tank ProgressiveEconomy until rejoining USTR in 2015. In 2013, the Washington International Trade Association presented him with its Lighthouse Award, awarded annually to an individual or group for significant contributions to trade policy.
Ed is the author of Freedom from Want: American Liberalism and the Global Economy (2007). He has published in a variety of journals and newspapers, and his research has been cited by leading academics and international organizations including the WTO, World Bank, and International Monetary Fund. He is a graduate of Stanford University and holds a Master’s Degree in International Affairs from Columbia Universities and a certificate from the Averell Harriman Institute for Advanced Study of the Soviet Union.