What’s behind the drop in US overdose deaths?
New research challenges a leading explanation for the decline in overdose deaths in the United States.
Researchers at Brown University, Virginia Commonwealth University, and the University of Pittsburgh have found that increased use of the overdose-reversing drug naloxone may not be a significant factor in the sharp decline in opioid overdose deaths across the US since 2023. Coauthor Michael Barnett, a researcher at Brown University and physician at Brigham and Women’s Hospital, stated that "there are big questions about why opioid overdose mortality rates are falling nationally since 2023."
The study, published in JAMA, analyzed 2.5 million nonfatal overdoses over a period of five years and found no increase in naloxone use relative to the number of overdoses. In fact, naloxone administrations were 21.3% below projected levels, and the medication was used at nearly the same rate as before the decline. The researchers suggest that fewer overall overdoses—potentially due to changes in the illicit drug supply or opioid usage patterns—may be contributing to the decline in deaths, rather than an increase in people being revived with naloxone.
More research is needed to understand the factors driving the decline and how public health efforts can sustain it.
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