The Real Reason for 2018 Drop in Fatal U.S. Drug Overdoses

FRIDAY, Sept. 18, 2020 (HealthDay News) -- A slight decline in U.S. drug overdose deaths in 2018 was due to a drop in supply of a dangerous opioid from China rather than federal government efforts, and was only temporary, a new study shows.

"The U.S. has not bent the curve on the drug overdose epidemic," said lead author Dr. Hawre Jalal, an assistant professor of health policy and management at the University of Pittsburgh.

"We are concerned that policymakers may have interpreted the one-year downturn in 2018 as evidence for an especially effective national response or the start of a long-term trend," he said in a university news release. "Unfortunately, that isn't supported by the data."

Since at least 1979, U.S. overdose deaths have doubled every 10.7 years. In 2016 and 2017, death rates exceeded that projection by 22% and 11%, respectively. But the rate declined by 4.1% in 2018, the first drop since 1990.

To find out why, Jalal and his colleagues analyzed data on types of drugs seized and submitted to state crime labs.

They found that carfentanil -- an opioid 10,000 times stronger than morphine that has no known medical use in humans -- was rarely detected by these labs before 2016. It peaked in 2017, with a sudden decline in 2018.

The 2017 spike was concentrated in five states: Ohio, Florida, Pennsylvania, Kentucky and Michigan.

In 2017, China added carfentanil to its list of controlled substances. Soon, the U.S. supply of the drug dried up and there was a drop in overdose deaths in 2018, the researchers reported.

Since then, however, there's been a 5.6% increase in overdose deaths, according to findings, published Sept. 16 in the journal Addiction.

"We all celebrated when the overdose death rate dropped, but it was premature," said study co-author Dr. Donald Burke, a professor of health science and policy at the University of Pittsburgh.

He said history has shown that funding gets channeled to other efforts when policymakers believe a problem is solved.

"The drug overdose epidemic is not solved," Burke added. "It continues to track along an ever-rising curve, with deaths doubling nearly every decade. We must address the root causes of this epidemic."

Jalal said this is a critical time for the drug overdose epidemic, given the diversion of health care resources and the focus on COVID-19.

"The epidemic has continued brewing under the COVID-19 pandemic for half a year now," he said. "There is no indication that it's slowing."

More information

The U.S. National Institute on Drug Abuse has more on the opioid overdose crisis.