07/21/2024

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US Drug Overdose Deaths Are Dropping, and Here’s Why

US Drug Overdose Deaths Are Dropping, and Here’s Why

US Drug Overdose Deaths Are Dropping, and Here’s Why

When Dennis Cauchon started to notice a sharp drop in drug overdose deaths in the fall of 2023 in the US state of Ohio, he was convinced there was something wrong with the data.

Ohio was one of the first places to be hit hard by the US fentanyl crisis, starting around 2015. Between 2016 and 2023, the state averaged about 4,500 drug overdose deaths each year, driven largely by the synthetic opioid.

But during the last quarter of 2023, overdose deaths across the state dropped by 25% and continued to fall through the first three months of 2024, according to official data Couchon had analyzed.

SEE ALSO: Mexico Fentanyl Production Migrates North as Chapitos Death Threats Loom

The drop in overdose deaths in Ohio may be part of a broader nationwide trend. In 2023, there were 107,543 drug overdose deaths in the United States, representing a 3% drop from the 111,029 deaths estimated in 2022, according to preliminary data released in May by the Centers for Disease Control and Prevention (CDC). While only accounting for a difference of just under 3,500 deaths, it was the first annual decrease since 2018.

A Fentanyl Ban

For Cauchon, who is president of a human rights group called Harm Reduction Ohio, only one thing could explain the sudden and extraordinary drop in drug overdose deaths in Ohio: a criminal ban on fentanyl production in a key manufacturing hotspot in Mexico.

“I thought, what causes a 25% decline at the snap of a finger?” he told InSight Crime. “Something distinct had to have happened for there to be such an unprecedented, sudden, large shift in overdose deaths in Ohio.”

Around June 2023, the Chapitos faction of the Sinaloa Cartel ordered all fentanyl producers in their base of Sinaloa to halt production. The move came after months of increased pressure on the group. In January 2023, Mexican authorities arrested one of the faction’s key leaders, Ovidio Guzmán López, one of several sons of Joaquín Guzmán Loera, alias “El Chapo,” the now-jailed former Sinaloa Cartel boss. And in April 2023, US federal prosecutors unveiled new drug trafficking charges against Ovidio and his brothers.

However, data to accurately analyze how the ban might be impacting the US market is seriously lacking. Independent drug producers told InSight Crime in early 2024 that the ban was still firmly in place in Sinaloa. But fentanyl is still mass-produced in Mexico, and the producers said the ban simply pushed production towards the US-Mexico border.

The Chapitos are not the only criminal faction involved in producing and trafficking the synthetic drug. US customs officials seized more than 12 tons of fentanyl in various forms along the southwest border in the 2023 fiscal year, according to official data, almost double the amount seized in 2022. The purity of that seized fentanyl also varies considerably, suggesting numerous producers with wide-ranging production capabilities.

“If there was a real reduction in supply, we would see this in the purity adjusted price, so that’s what I would want to look at to try to really figure out whether this was a change in supply or something else,” said Beau Kilmer, co-director of RAND’s Drug Policy Research Center.

Exhausted User Base

Overdose deaths due to fentanyl have been so high in recent years that it is possible that there are simply fewer opioid users around now.

“Fentanyl has now reached throughout the country and has had such a large death toll that maybe you are now exhausting or shrinking the pool of those susceptible to dying,” said Peter Reuter, a drug policy expert and professor at the School of Public Policy and the Department of Criminology at the University of Maryland.

But drug dealers are seeking to expand the market by increasingly mixing fentanyl with stimulants like cocaine and methamphetamine. A recent study carried out by researchers at the University of California, Los Angeles (UCLA) found that a third of all US fentanyl overdose deaths in 2021 involved fentanyl mixed with a stimulant, predominantly cocaine and methamphetamine, compared to about half of one percent in 2010. 

SEE ALSO: How Precursor Chemicals Sustain Mexico’s Synthetic Drug Trade

Researchers say it has become harder to accurately understand drug markets in the United States since the federal government cut funding for monitoring programs roughly a decade ago, just as illicit fentanyl began to appear in the United States.

“Having information on the number of people who are using, how much they’re using, and prices, that’s all really useful information that could help us get a better sense of what’s happening in these markets and why we’re seeing reductions in some places and increases in others,” said Kilmer.

Increased Tolerance

Whereas illicit fentanyl originally deceived drug users who used it unwittingly, many users now realize that they are consuming fentanyl and seek it out directly, which may in turn be increasing tolerance for the drug.

“There’s increasing evidence that people who regularly use fentanyl are now using much more than they did before,” said Reuter.

The amount of fentanyl authorities are submitting for testing today has also increased, which may point to greater use. Between 2014 and 2022, the number of fentanyl samples sent to the Drug Enforcement Administration’s (DEA) National Forensic Laboratory Information System (NFLIS) skyrocketed from just 4,642 to 163,201.

SEE ALSO: Fentanyl Seizures on US-Mexico Border at Record High Amid Production Ban

Wider availability also means lower prices. The wholesale price of a kilogram of fentanyl is a fraction of what it was when the market took off years ago, according to synthetic drug producers InSight Crime spoke with recently in Sinaloa. In the United States, users can now purchase a counterfeit M30 oxycodone pill laced with illicit fentanyl for less than one dollar in many cities across the country.

“It’s so pure and it’s so cheap, the sense is that for a lot of frequent users, it may raise their tolerance levels,” Kilmer told InSight Crime.

Treatment and Harm Reduction Services Grow

Harm reduction services and life-saving overdose treatments like naloxone have become more widely available in recent years, which may also be a contributing factor to the slight drop in drug overdose deaths nationwide.

While drug overdose deaths may have dropped slightly nationwide, not all US states saw a decrease. Drug-induced deaths went up more than 20% between 2022 and 2023 in western states like Nevada, Oregon, and Washington, but there was a nearly 25% decrease in Nebraska during that time and overdose deaths fell by about 15% in Maine.

“There definitely has been an increase in access to treatment in some places, especially with respect to medications for opioid use disorder,” Kilmer told InSight Crime. “But there’s a lot of variation there. Some places are better about providing access than others.”

These variations, coupled with a lack of data, force experts to speculate on how better treatment and harm reduction systems may be impacting overdose deaths. To get an accurate picture of drug use trends and the state of drug markets in the United States, Kilmer said it is essential to fund monitoring programs and capitalize on existing efforts to test wastewater.

“We have a whole COVID-19 network that’s testing wastewater to look for different variants. It would not be difficult to take an additional sample and test it for various drugs,” he said. “This can be really useful information for early warning systems.”

Featured image: A Narcan vending machine on the campus of a university in California. Credit: Josie Lepe.

The post US Drug Overdose Deaths Are Dropping, and Here’s Why appeared first on InSight Crime.