Preliminary data from the Ohio Department of Health’s Mortality Database shows overdose deaths in Licking County have fallen for the third year in a row, a trend that’s reflected in communities nationwide.
Provisional data from the Centers for Disease Control and Prevention’s National Vital Statistics System indicated a nearly 24% decline in drug overdose deaths in the United States for the 12 months ending in September 2024, compared to the previous year. If this holds, this would be the fewest overdose deaths in any 12-month period since June 2020.
In a news release, Allison Arwady, director of the CDC’s National Center for Injury Prevention and Control, cited the CDC’s public health work, improved data collection and public safety partnerships for improved overdose responses around the country.
But that may be just part of the reason overdose deaths have fallen nationwide.
The Drug Enforcement Administration has said the decline is because they targeted cartels.
And certainly, the drug supply has shifted. One theory is that there’s less fentanyl because the Sinaloa cartel stopped producing it.
Dennis Cauchon, founder of Harm Reduction Ohio and a former journalist, has been studying Ohio overdose data since 2018. It’s clear to him that overdoses are down because of the change in the drug supply.
“Fentanyl comes, people die,” Cauchon said. “Fentanyl goes away, people don’t die.”
From his own recent analyses of the Ohio Department of Health’s Mortality Database, he said the reduction in overdose deaths in Ohio has been dramatic.
In a social media post, Cauchon noted, “Overdose deaths fell from 4,452 in 2023 to an estimated 2,927 in 2024. That is a 34.3% overdose death decline, year-over-year, and the first time since 2014 that fewer than 3,000 Ohio residents died from drug overdoses.”
And in Licking County, reported overdose deaths in 2024 were significantly lower than previous years, according to the ODH Mortality Database. Preliminary numbers from the ODH database indicate 28 people died due to an overdose in 2024 – down significantly from 2021, when overdose deaths peaked at 63. That number may be adjusted based on updated reports from the Licking County Coroner.
In a brief, Drug Policy Alliance (DPA) said that DEA supply-side crackdowns have only led to more potent drugs.
In fact, new research shows that law-enforcement drug seizures actually lead to localized increases in overdoses.
The DPA, a New York-based nonprofit that advocates for health-based drug policies, argued in the brief that the drop in overdoses is due to many factors including changes in use habits, more smoking and less injecting. Moreso, public health interventions like widespread access to naloxone and fentanyl test strips, and easier access to medication-assisted treatment like buprenorphine and methadone may have had a profound effect.
Read more: Reducing harm, finding hope: Overdose, addiction and the health of our community
Nationally, organizations like Remedy Alliance for the People and NEXT Distro have helped lower barriers to naloxone access in all corners of the country.
On one day alone last year, 82,000 doses of naloxone were distributed on Sept. 26, which was Save a Life Day in 35 states, from Mississippi to Maine. The event, launched by West Virginia-based SOAR in 2020, supported people who hit the streets pulling wagons loaded with boxes of naloxone, setting up tables on sidewalks, and talking to community groups.
Naloxone is available in schools and public libraries, in rest-stop bathrooms and vending machines and over the counter at pharmacies.
Read more: Newark residents remember lives lost amid ongoing overdose crisis
But the overdose death rate in the United States remains higher than in any other country.
Overdose remains the leading cause of death for all Americans aged 18-44, and overdose rates are still high or increased for Black, Latino, and Native American populations, according to the DPA.
Between July 2023 and July 2024, 93,000 people died of drug overdoses, DPA wrote in its policy fact sheet – “more than the number of people who died from vehicle-caused accidents or firearms combined. This remains an urgent public health issue that requires evidence-based solutions.”
Why the decline?
According to Nabarun Dasgupta, senior scientist at University of North Carolina at Chapel Hill, the decline in overdoses was not sudden.
Dasgupta is a street-drug scientist and activist at the University of North Carolina with two decades of experience in overdose prevention. He is also the co-founder of Remedy Alliance for the People.
“Overdoses started declining in 2022 at a state level, and accelerated through 2023,” Dasgupta said. “By early 2024, every state was declining in overdose deaths. … That’s a really different narrative than we have come to appreciate. The conventional wisdom is things have been getting worse and worse and worse for 30+ years, and nothing has been working. But it turns out that things have been working and we haven’t been paying attention.”
But Dasgupta said no one is totally sure why overdose deaths have decreased.
“We have like 20 possibilities that we are thinking about. Whatever is happening isn’t linear, and it’s probably not just one thing,” he explained. “The only people who I hear consistently saying they know what caused the decline is the DEA.”
Dasgupta said part of the challenge is lack of concrete data – though that may be changing, too.
As more people get involved in fighting the overdose crisis on the ground, there is much to be learned from their stories – often left out of the narrative.
“What is happening at a local level is so woven into the fabric of those communities that they are not independently quantified, and so they get left out of the explanations,” he explained. “If you’re in a small enough community, you know who is alive and you know their histories and you know when they got some help and they made some change and things stuck.”
In a report for the Opioid Data Lab, Dasgupta pointed to places like Lake Charles Memorial Hospital in Louisiana and communities in St. Louis, Missouri.
In Louisiana, emergency responders and doctors saw an increase in non-fatal overdose visits. Doctors began prescribing buprenorphine in the emergency department, and began widespread naloxone distribution in the community.
In St. Louis, the community benefited from a statewide naloxone distribution plan that prioritized making sure the drug gets into the hands of people who use drugs.
Both communities, Dasgupta said, saw a noticeable decline in overdose deaths.
“We’ll miss seeing these stories if we obsess over a single cause for the OD decline,” Dasgupta writes. “Our minds crave a tidy explanation, but the unstated cost of simplicity is the implication that all these things folks are doing aren’t effective.”
Community and peer-based harm reduction education efforts have shifted drug culture in the United States.
And the supply may be weaker because of the introduction of the sedative Xylazine and other adulterants.
Fewer people are injecting and more are smoking fentanyl. This leads to slower consumption.
Andi McGrew, a harm-reduction outreach worker with the Newark Homeless Outreach in Newark, Ohio, said she has seen evidence of these changes.
In addition to distributing naloxone and fentanyl testing strips, McGrew teaches people who use drugs about behaviors and resources that can keep them safe, telling people when there is a bad batch in the area and teaching people how to administer naloxone and how to use fentanyl testing strips.
“If they know that it has fentanyl, they’ll make sure that someone is around them and that they have naloxone,” she said. “You can’t narcan yourself.”
Jack Shuler writes for TheReportingProject.org, the nonprofit news organization of Denison University’s Journalism program, which is supported by generous donations from readers. Sign up for The Reporting Project newsletter here.