Overall overdose death rates decreased by 4.1 percent from 2017 to 2018 in the United States. New CDC data show death rates involving heroin decreased by 4 percent, and prescription opioid-involved overdose death rates decreased by 13.5 percent.
“Decreases in overdose deaths involving prescription opioids and heroin reflect the effectiveness of public health efforts to protect Americans and their families,” said CDC Director Robert R. Redfield, MD. “While we continue work to improve those outcomes, we are also addressing the increase in overdose deaths involving synthetic opioids. We must bring this epidemic to an end.”
While progress has been made to combat overdose deaths, death rates involving synthetic opioids (excluding methadone) increased by 10 percent from 2017 to 2018.
The findings come from an in-depth Centers for Disease Control and Prevention (CDC) analysis of the latest available drug overdose death data. The report, published in CDC’s Morbidity and Mortality Weekly Report (MMWR), analyzes changes in age-adjusted overdose death rates from 2017 to 2018 by demographic characteristics, county urbanization levels, U.S. census region and state. More than 750,000 Americans died from drug overdoses from 1999 to 2018.
“To sustain decreases and continue to prevent and respond to drug overdoses, specifically those involving synthetic opioids, it is critical to have a coordinated response,” said Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control. “Medical personnel, emergency departments, public health and public safety officials, substance abuse treatment providers, community-based organizations and members of the community all play a role in addressing this complex and fast-moving epidemic.”
Opioids were involved in more than 46,000 drug overdose deaths in 2018. Of the 39 jurisdictions included in the analyses, 11 states and the District of Columbia saw decreased rates of death involving opioids overall.
Synthetic opioids were involved in 31,335 overdose deaths — nearly half of all drug overdose deaths in 2018. Illicitly manufactured fentanyl (IMF) likely drove the increase in deaths involving synthetic opioids (excluding methadone) from 2017 to 2018.
Synthetic opioid overdose-involved death rates increased from 2017 to 2018 among males and females, people age 25 years and older, non-Hispanic whites, non-Hispanic blacks, Hispanics and non-Hispanic Asian/Pacific Islanders.
Death rates from synthetic opioids also increased in large central metro, large fringe metro, medium metro and small metro counties. The latest available data show synthetic opioid-involved overdose death rates increased in 10 states. The four states with the highest increases were Arizona, California, Washington and Missouri. The rates increased in the Northeast, South and West but remained stable in the Midwest.
“Opioid overdoses decreased from 2017 to 2018 but still remain high. Efforts must be strengthened to maintain and accelerate decreases in deaths involving prescription opioids and heroin and to prevent continued increases in overdose deaths involving synthetic opioids,” said Nana Wilson, Ph.D., epidemiologist at CDC and lead author of the MMWR study.
Preliminary successes in addressing the drug overdose crisis occurred during 2018. From 2017 to 2018, decreases occurred in all drug overdose deaths and in deaths involving all opioids, prescription opioids and heroin. Efforts to improve opioid prescribing practices have increased and may have contributed to decreases in prescription opioid-involved overdose deaths.
The findings suggest that factors that may be contributing to the decrease in heroin-involved deaths include reductions in the number of people initiating heroin use; shifts from a heroin-based market to a fentanyl-based market; increased treatment provision for people using heroin; and expansion of naloxone access.
Prescription opioid-involved overdose death rates decreased by 13.5 percent from 2017 to 2018. Rates decreased:
· Among males and females
· Among people age 15–64 years
· Among non-Hispanic whites, Hispanics and non-Hispanic American Indian/Alaska Natives
· Across all urbanization levels
· In 17 states, prescription opioid-involved overdose death rates declined
· In the Midwest, South and West, but remained stable in the Northeast
Heroin-involved overdose death rates decreased by 4.1 percent from 2017 to 2018. Reductions occurred among males and females, persons aged 15–34 years and non-Hispanic whites, and in large central metro and large fringe metro areas. Among the findings:
· Rates remained stable in the Northeast and South, decreased in the Midwest and increased in the West.
· Rates decreased in seven states and Washington, D.C., and increased in three states.
Opioid-involved overdose death rates decreased among females, persons aged 15-34 years, 45-54 years, and non-Hispanic whites and in small metro and nonmetropolitan areas. Findings note:
· Rates increased among persons aged ≥65 years, non-Hispanic blacks and Hispanics.
· Rates increased in the Northeast and the West and decreased in the Midwest and the South.
· Rates decreased in 11 states and Washington, D.C., and increased in three states.
