Data Shows First Dip in Overdose Deaths Since Pandemic Highs

Provisional counts show overdose deaths down 7.2% but some death investigations are still incomplete

According to provisional counts of death certificates logged in the CDC’s National Vital Statistics System, more than 100,500 people died of drug overdoses in the U.S. in the 12 months to September 2022.^[1] That’s down 7.2% from the peak reached in February 2022, when more than 110,000 people died in 12 months amid a mid-pandemic upswing in drug use and fentanyl lacing and the closure of treatment facilities.

However, the actual decline may not be so pronounced. The CDC cautioned that some drug overdose deaths require prolonged investigations, and death certificates may be initially filed with a preliminary or unknown cause of death. 

The agency also published an adjusted value to account for this early underreporting. Its predicted deaths showed a more modest decline: down 3.2% to 106,800 deaths in the year ending in September.

Regional variations in overdose trends

Additionally, a closer look at the data shows that the reprieve from overdose deaths isn’t being felt everywhere.

The flood of overdose deaths in Appalachia seems to have somewhat receded. According to CDC estimates, overdose deaths fell by 10% in West Virginia, by 8% in Virginia, around 7% in both Ohio and Pennsylvania, and nearly 6% in Kentucky—all states bordering the mountainous region perhaps hit hardest by the opioid crisis.

However, overdose deaths were still climbing elsewhere: up 19% in Maine and up 15% and 8% in neighboring New Hampshire and Vermont, respectively. The Southeast has also been hit hard recently, with predicted overdose deaths up by double digits in both Georgia (12.8%) and Alabama (10.8%). 

Some states also bucked regional downward trends. Delaware (25% increase), Oklahoma (18.5%), Wyoming (17.8%), and Washington (15.8%) all saw deaths surge while they fell or rose more modestly in neighboring states.

Celebration might be premature, experts have cautioned

Experts have previously tempered enthusiasm about recent dips in drug overdose deaths, warning that earlier plateaus in the opioid crisis haven’t lasted. 

Late last year, after data revealed that overdose deaths also dropped modestly between July 2021 and June 2022 compared to the previous February, analysts cautioned that the trend analysts may not last.

“You can't celebrate every time you see a slight downturn,” Dr. Donald Burke, former dean of Pitt's school of public health, told USA Today in November. He pointed out that the long-term trend has been toward rising overdose deaths.^[2]

The recent declines may also just be overdose deaths returning to normal after the disruption of the pandemic when social distancing restrictions drove drug use and limited the availability of treatment for people struggling with addiction.

“We may just be returning to a pre-COVID level. I think we’ll need at least a year more of data to confirm that,” Erin Winstanley, a researcher at West Virginia University, said. 

Indeed, overdose deaths have not yet reached pre-pandemic levels. Nationally, the estimated 106,840 overdose deaths recorded in the 12 months leading up to September 2022 were still 55% higher than the deaths in the year before September 2019 and 18% higher than those recorded in the 12 months before September 2020.