As Drug Overdose Deaths Decline, Experts Worry About Future

Drug overdose deaths declined by almost 27% in 2024, new provisional data from the US Centers for Disease Control and Prevention (CDC) showed.

The decline continues a downward trend that began in 2023, with a 3% decline that year, followed by steady drops each month of 2024.

Overall, there were 80,391 predicted provisional deaths at the end of 2024, down from 110,037 in December 2023. Some 111,029 individuals died from overdose at the epidemic’s peak in 2022.

Decreases in overdose deaths last year were reported in almost every state, with only Nevada and South Dakota reporting slight increases.

In a statement, the CDC said the decline reflects “a strong sign that public health interventions are making a difference and having a meaningful impact” but noted that “overdose remains the leading cause of death for Americans aged 18-44, underscoring the need for ongoing efforts to maintain this progress.”

Some experts are concerned that the progress may be affected by the Trump administration’s staffing and budget cuts to various health agencies and steep funding cuts to Medicaid proposed by the White House and congressional Republicans.

The CDC’s National Center for Injury Prevention and Control — the group responsible for collecting and monitoring overdose data — was among the agencies that saw workforce layoffs and firings earlier this year.

In addition, as reported by Medscape Medical News, the Substance Abuse and Mental Health Services Administration (SAMHSA) was also hit hard by staff and program cuts. US Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., has proposed a reorganization of the department which would include folding SAMHSA into a new Administration for a Healthy America.

At a May 14 congressional hearing, Rep. Madeleine Dean (D-Pennsylvania) asked Kennedy how that move would help combat the opioid epidemic. “You’re eliminating training,” said Dean, referring to reports that proposed cuts would eliminate both grants to states and communities for naloxone distribution and training in how to administer the overdose medication.

HHS has proposed “shifting [SAMHSA] to a subdivision where we can operate it more efficiently,” Kennedy said.

“We want to provide naloxone. We want to make sure that addicts have every option,” he said.

As reported by Medscape Medical News, the Trump administration’s drug policy priorities — outlined in an Office of National Drug Control Policy document — include encouraging state and local authorities to “increase the availability of drug test strips and naloxone.”

SAMHSA has largely funded the distribution of the more expensive nasal form of naloxone, said Nabarun Dasgupta, MD, senior scientist at the Injury Prevention Research Center at The University of North Carolina at Chapel Hill. “I’m optimistic that the administration will understand that this is a life-saving medication and will hopefully find ways to keep it going,” he told Medscape Medical News.

He said SAMHSA-funded outreach programs “are already shutting down.” That means “laying off these highly skilled people that we need on the front lines to actually reach the populations at greatest risk,” said Dasgupta.

Potential Medicaid reforms and cuts are also worrying, said Dasgupta. “Medicaid provides a huge amount of drug treatment in this country, and anything that makes that more difficult or cuts funding is going to have a direct impact on overdose numbers,” he said.

That was echoed in a statement by Stephen M. Taylor, MD, MPH, president of the American Society of Addiction Medicine (ASAM).

ASAM said that some proposals to impose cost-sharing requirements on certain Medicaid enrollees could make addiction-related treatment services even more expensive than some tobacco products, alcohol, and illicit drugs. If that proposal became law, “we risk losing valuable ground in our addiction and recovery efforts,” Taylor said.

Dasgupta reported being the co-founder of the nonprofit Remedy Alliance / For The People.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X: @aliciaault and on Bluesky @aliciaault.bsky.social.