Decline in opioid prescriptions translates to drop in drug overdose deaths for the first time in decades

A decline in prescriptions for opioids is a major factor for the drop in drug overdose deaths—the first time the number of deaths has dropped in the U.S. since 1990.

Drug overdose deaths in the U.S. fell slightly in 2018, declining by 5.1% from 2017, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention’s (CDC's) National Center for Health Statistics.

Based on provisional counts, the center estimates there were an estimated 68,000 drug overdose deaths in 2018, compared to about 72,000 the year before.

The CDC is still tallying fatal drug overdoses for 2018, so the numbers released are considered preliminary. While the CDC anticipates the number of overdose deaths has declined, the rate remains high.

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The current drop is due to fewer deaths from heroin and prescription painkillers, but deaths from fentanyl, cocaine and stimulants such as methamphetamines are still increasing.  

Department of Health and Human Services Secretary Alex Azar said the data show “that America’s united efforts to curb opioid use disorder and addiction are working.”

“Lives are being saved, and we’re beginning to win the fight against this crisis,” Azar said in a statement, noting that the number of  patients receiving medication-assisted treatment has increased, distribution of overdose-reversing drugs is up and nationwide opioid prescriptions are down.

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“While the declining trend of overdose deaths is an encouraging sign, by no means have we declared victory against the epidemic or addiction in general,” he said. “This crisis developed over two decades and it will not be solved overnight.”

The center also released a state-by-state breakdown of drug deaths that showed a wide variation in how states are doing in the battle to rein in the opioid crisis. While some states saw a decrease in deaths, 16 states saw their numbers increase.

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For instance, Missouri, a state with one of the biggest drug use problems, saw a 16.3% increase in overdose deaths. On the other hand, New Hampshire, another state with a large drug problem, saw a 7.1% decrease.

More cautious prescribing of opioid painkillers has played a role in the decline of fatalities.

Faced with a growing opioid epidemic, the CDC three years ago issued federal guidelines for prescribing opioids.

Under pressure from healthcare experts, the federal agency earlier this clarified that the guidelines were not intended to deny chronic pain patients relief from opioids and encouraged physicians to use their “clinical judgment” in prescribing the medications, which can be addictive. 

A 2018 survey found many doctors reduced the number of opioid prescriptions they write or stopped prescribing opioids at all.