An estimated 107,543 people in the US died from drug overdoses in 2023, a shocking figure that dims a glimmer of hope – marking the first annual decline in drug overdose deaths since 2018.
The grim toll represents Americans’ struggle with powerful synthetic drugs, especially the synthetic opioid fentanyl, known to be up to 100 times more potent than morphine. More than 1 million people have died from drug overdoses since 2001according to the Centers for Disease Control and Prevention.
The National Center for Health Statistics (NCHS), which tracks overdose deaths, attributed more than 74,000 deaths to fentanyl alone, followed by more than 36,000 deaths from methamphetamine. Overdose deaths often involve more than one drug. Drug overdoses decreased by 3% in 2023.
The West was particularly hard hit by drug overdoses, according to NCHS data. Alaska, Oregon and Washington all saw increases in drug overdose deaths of more than 27%. The increases may reflect the way illicit drugs have spread across the U.S. after emerging mainly in states east of the Mississippi in the early 2010s. Other states saw notable declines: Nebraska, Kansas, Indiana and Maine all saw declines of 15% or more.
Recent reports from the Drug Enforcement Agency (DEA) and a study supported by the National Institutes of Health, both released this week, paint an increasingly complex picture of the illicit drug supply in the US, with fentanyl-laced pills appearing to account for an increasing share. part of the illegal drug market.
“Pills are flooding the market,” said Joseph J Palamar, an associate professor in the Department of Population Health at New York University, and the lead author of the NIH-supported study published this week in the International Journal of Drug Policy.
According to Palamar’s research, police seized more than 115 million fentanyl pills in 2023, up from about 49,000 in 2017, a 2,300% increase, while new synthetic drugs such as xylazine have created new threats.
Palamar also said he believes the arc of drug use has changed over time. In the early 2000s, a person may have developed a substance use disorder by starting with a prescription opioid, such as Oxycontin, and then moving on to heroin. In the early 2010s, it was common for heroin to be mixed with fentanyl.
Today, fentanyl may be preferred by some people, and it also appears as an adulterant in many different types of illegal drugs. There is also a push to resemble prescription benzodiazepines or opioids, making it more likely that people will think they are taking prescription drugs or taking them with fentanyl.
“The most serious thing is you get these young people who think they’re going to take a Xanax, an Adderall or an Oxycontin and then find out it has fentanyl in it,” Palamar said. “You have a kid who thinks he’s going to get an Adderall from Snapchat or whatever — that kid could overdose and die.”
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According to the DEA, the illegal drug supply is mainly controlled by Mexican cartels National Drug Threat Assessment. Cartels ship fentanyl, methamphetamine and synthetic drugs to the US through extensive networks, often with the support of illicit Chinese chemical suppliers, pill presses and bankers.
The toll also reflects the broader struggle within American society. An approximate 2.5 million people suffer from opioid use disorder, but only one in five are receiving treatment, even as the disease has increasingly come into the public eye due to a housing affordability crisis.
Experts credit the low number of Americans in treatment systemic barriersincluding a focus on abstinence, insurance company policies and laws that are inconsistent with science and that of comparable Western countries.
At the same time, addiction and the overdose crisis have become a new front in the culture war. Republicans have criticized President Biden for not focusing on it ban on illegal fentanyl at the border, even as many Republican policies make access to treatment more difficult.