US Drug Overdose Deaths Declined in 2023

The overall number of reported drug overdose deaths in the United States declined by 3.1% in 2023, the first decrease in 5 years, provisional data from the Centers for Disease Control and Prevention (CDC) suggest.

An estimated 107,543 people died from an overdose, down from 111,029 in December 2022. 

Deaths from synthetic opioids and heroin declined, whereas deaths from psychostimulants, such as methamphetamine, and cocaine increased. This matches a report on drug-seizure trends released last week from the Drug Enforcement Agency (DEA). 

Despite the drop in overall national overdose mortality, the death toll remains over 100,000 nationwide and increased in 15 states and Washington, DC. 

“Today’s data showing a decrease in drug overdoses over the 12-month period through December 2023 is heartening news for our nation and demonstrates we are making progress to prevent deaths from drug overdoses,” said CDC Chief Medical Officer Deb Houry, MD, in a statement. 

“However, this does not mean we have accomplished our mission,” she said, adding that with more than 100,000 deaths, “there are still families and friends losing their loved ones to drug overdoses at staggering numbers.”

Overdose deaths declined the most in Nebraska (25%), followed by Indiana (18%), Kansas and Maine (16% each), North Carolina (14%), and Arkansas (13%). 

Most states in the Northeast, Southeast, and Midwest saw declines with the exception of West Virginia (+1%) and Alabama (+8%). California, Texas, Colorado, Idaho, Oklahoma, South Dakota, and Wyoming had small increases. Hawaii and Utah had an 8% increase, and Washington, DC, had a 9% increase. 

Nevada experienced a 29% rise, and deaths increased in Washington state and Oregon by 30% and 28%, respectively. Deaths rose by 44% in Alaska, which is the highest increase in the country.

The largest number of deaths were due to an opioid. Synthetic opioids, which include fentanyl and tramadol, accounted for the largest number of those opioid-related deaths (74,702), with the rest of the deaths in the opioid class (8198), coming from heroin, methadone, morphine, codeine, and semisynthetic opioids such as oxycodone and oxymorphone.

Overdoses with psychostimulants with abuse potential, including methamphetamine, caused almost 36,000 deaths. Heroin deaths have greatly declined, from some 16,000 in 2017 to 4065 in 2023. 

The provisional data does not include cases where a death is still pending investigation, although the CDC said that overall, about 99% of the overdose deaths in the United States were accounted for.

The data reported by the CDC matches what the DEA is seeing from its seizures.

“The shift from plant-based drugs, like heroin and cocaine, to synthetic, chemical-based drugs, like fentanyl and methamphetamine, has resulted in the most dangerous and deadly drug crisis the United States has ever faced,” said DEA Administrator Anne Milgram, in a statement accompanying the release of the agency’s annual National Drug Threat Assessment. Milgram blamed the Sinaloa and Jalisco drug cartels for the increase in fentanyl and other synthetic drug trafficking.

The DEA reported that from 2021 to 2023, seizures of fentanyl powder almost doubled to 13,176 kg (29,048 lb), with 30% of the powder containing the animal sedative xylazine. Seizures of fentanyl pills tripled to 79 million in 2023. Almost all methamphetamines sold in the United States is manufactured in Mexico, and it is purer and more potent than ever, according to the DEA.

Alicia Ault is a Saint Petersburg, Florida–based freelance journalist whose work has appeared in publications including JAMA and Smithsonian.com. 

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