By Taylor Hughes

 

The United States continues to experience a drug overdose crisis, but evidence suggests a change is happening. Provisional data from the Centers for Disease Control and Prevention (CDC) estimated about 107,000 drug overdose deaths nationwide in 2023, a 3% decrease from 2022 and the first annual decrease since 2018. The majority of drug overdose deaths involve opioids, a class of addictive natural, semi-synthetic, and synthetic drugs. Some opioids, such as morphine or oxycodone, can be legally prescribed to manage pain, while others, such as heroin, are illicitly created and distributed.

The types of opioids fueling the overdose crisis have changed over time. According to the National Institute on Drug Abuse, the first wave of the opioid crisis in the 1990s was due to the misuse of prescription medications. The second wave, beginning in 2010, resulted from more heroin use. The third and current wave started in 2013 and has been driven by illegally produced fentanyl, a powerful synthetic opioid. Fentanyl is used in medicine but, in the past decade, has been a major contributor to drug overdose deaths in the United States. Oftentimes, illegal fentanyl is laced with other drugs, so users of other drugs can overdose without realizing its presence.

The federal government has taken steps to address the opioid epidemic in recent years. In 2018, Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. The SUPPORT Act provided funding for community-based treatment and recovery programming. It also created a new requirement for federal-state Medicaid programs to cover FDA-approved medications for opioid use disorder (MOUD). Strategic efforts from the federal government, particularly from the U.S. Department of Health and Human Services (HHS) also include preventative health education and harm reduction measures. One of them is the increased availability of drug test strips and naloxone (NARCAN), an emergency medicine that reverses an opioid overdose.

New Jersey has expanded upon federal action to combat the opioid epidemic. As reported by NJ Spotlight News, New Jersey is mirroring the new federal trend—a decline in the number of suspected drug overdose deaths. Deaths have dropped from 2,900 in 2022, to 2,600 in 2023, to 1,100 by mid-June 2024. Public health experts attribute the decline to harm reduction measures conducted in the state. We have seven Harm Reduction Centers, which act as stigma-free treatment facilities. These centers connect people to resources and medication for opioid use disorder, and importantly, abstinence is not required before someone can get support. Harm Reduction Centers and participating pharmacies also provide naloxone to the public for free.

While the changing trends in opioid overdose deaths statewide and nationwide are promising, more needs to be done to address this issue. Notably, the 118th Congress did not reauthorize the SUPPORT Act of 2018. Both the House and Senate drafted reauthorization bills, but the latest action recorded on February 1, 2024 notes, “Placed on Senate Legislative Calendar under General Orders. Calendar No. 319.”

Federal support could help the new trends continue. Crucially, NJ Spotlight News highlights that disparities exist within the overall downward trend in the state. Suspected drug overdose deaths are trending down for white New Jerseyans but continue to rise for people of color. New Jersey’s next steps need to consider the impact of policies on the entire spectrum of our citizenry struggling with addiction.

 

Provisional Data from the CDC for the United States:

 

Provisional Data from the CDC for New Jersey:

 

Taylor Hughes is a graduate student pursuing a Master of Public Policy degree at the Edward J. Bloustein School of Planning and Public Policy. She serves as a research assistant with the New Jersey State Policy Lab.