Falling Overdose Rates (Bonus Aced It Episode!)

In this very exciting bonus episode, we talk you through the recent headlines about declining U.S. overdose rates by detailing the seven major hypothesis people use to explain the rate drop. While the evidence supporting each of these hypotheses varies, it’s important to know what the current thinking is and why there is both cause to celebrate and to keep focusing on finding ways to continue the downward trend… until there are none.

Download the one-pager (PDF).


Balawajder, E. F., Ducharme, L., Taylor, B. G., Lamuda, P. A., Kolak, M., Friedmann, P. D., … & Schneider, J. A. (2024). Factors associated with the availability of medications for opioid use disorder in US jails. JAMA Network Open,7(9), e2434704-e2434704. doi:10.1001/jamanetworkopen.2024.34704

Binswanger, I. A., Stern, M. F., Deyo, R. A., Heagerty, P. J., Cheadle, A., Elmore, J. G., & Koepsell, T. D. (2007). Release from prison—a high risk of death for former inmates. New England Journal of Medicine,356(2), 157-165. https://doi.org/10.1056/nejmsa064115

Center for Disease Control and Prevention. (2024, May 15). U.S. overdose deaths decrease in 2023, first time since 2018. National Center for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm

Dasgupta, N. (2024, Sept 18). Are overdoses down and why? Opioid Data Lab. https://opioiddatalab.ghost.io/are-overdoses-down-and-why/

Drug Enforcement Agency. (2022, October). The growing threat of xylazine and its mixture with illicit drugs. Drug Enforcement Agency. https://www.dea.gov/sites/default/files/2022-12/The%20Growing%20Threat%20of%20Xylazine%20and%20its%20Mixture%20with%20Illicit%20Drugs.pdf

Dyer, O. (2024). Opioid crisis: Fall in US overdose deaths leaves experts scrambling for an explanation. The British Medical Journal. https://doi.org/10.1136/bmj.q2091
Ghose, R., Forati, A. M., & Mantsch, J. R. (2022). Impact of the COVID-19 pandemic on opioid overdose deaths: a spatiotemporal analysis.Journal of Urban Health,99(2), 316-327. https://doi.org/10.1007/s11524-022-00610-0

Klemperer, E. M., Wreschnig, L., Crocker, A., King-Mohr, J., Ramniceanu, A., Brooklyn, J. R., … & Evans, E. A. (2023). The impact of the implementation of medication for opioid use disorder and COVID-19 in a statewide correctional system on treatment engagement, post release continuation of care, and overdose. Journal of Substance Use and Addiction Treatment,152, 209103. https://doi.org/10.1016/j.josat.2023.209103

Massachusetts Department of Public Health. (2024, June 6). Massachusetts opioid-related overdose deaths decreased 10 percent in 2023. Massachusetts Department of Public Health. https://www.mass.gov/news/dph-report-massachusetts-opioid-related-overdose-deaths-decreased-10-percent-in-2023

Moghtaderi, A., Zocchi, M. S., Pines, J. M., Venkat, A., & Black, B. (2023). Estimating the uncertain effect of the COVID pandemic on drug overdoses. PloS one,18(8), e0281227. https://doi.org/10.1371/journal.pone.0281227

National Public Radio (NPR). (2024, Sept 18). U.S. overdose deaths plumet, saving thousands of lives. National Public Radio. https://www.npr.org/2024/09/18/nx-s1-5107417/overdose-fatal-fentanyl-death-opioid

NBC News. (2024, March 11). Where’s the Narcan? At pharmacies across the U.S., the OTC antidote can be hard to find. NBC News. https://www.nbcnews.com/health/health-news/narcan-opioid-overdose-drug-otc-access-varies-us-stores-rcna135324?ref=opioiddatalab.ghost.io

New York Times (NYT). (2024, September 2024). Drug overdose deaths are dropping: The reasons are not perfectly clear. The New York Times. https://www.nytimes.com/2024/09/21/us/politics/drug-overdose-deaths-decrease.html

Sugarman, O. K., Hulsey, E. G., & Heller, D. (2023, October). Achieving the Potential of Naloxone Saturation by Measuring Distribution. In JAMA Health Forum (Vol. 4, No. 10, pp. e233338-e233338). American Medical Association. doi:10.1001/jamahealthforum.2023.3338

The White House (2024, June). Fentanyl adulterated or associated with xylazine implementation report. Office of Drug Control Policy. https://www.whitehouse.gov/wp-content/uploads/2024/08/ONDCP-2024-FAAX-Implementation-Report.pdf?ref=opioiddatalab.ghost.io

University of Michigan School of Public Health. (2024, April 30). It’s easier now to treat opioid addiction with medication – but little has changed. University of Michigan School of Public Health. https://shorturl.at/BPJN8.


This project was supported by Grant [5PBJA-22-AG-00031-MUMU] awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. Points of view or opinions in this podcast are those of the host and the research team and do not necessarily represent the official position or policies of the U.S. Department of Justice.