Opioid drug overdose deaths are down in US, study finds, but COVID-19 could change that

More than 151,000 Americans died from drug overdoses, alcohol and suicide combined in 2018, slightly lower than the overall numbers in 2017, and leveling off for the first time in two decades, according to a new study.

But the report also found that deaths of despair increased in some minority communities during the same time period. And separately alcohol-related deaths were up 4% and suicides were up 2%, the analysis by the non-profit health policy groups Trust for America's Health and the Well Being Trust, reported Thursday.

While the numbers were mostly level with 2017, they show a 51% increase over the past decade, the report found.

Coronavirus could cause a spike in deaths of despair

Even more problematic, though, the groups warned, these numbers could change when the coronavirus pandemic is factored in. A report released earlier this month by the Well Being Trust predicted as many as 75,000 Americans could die because of drug or alcohol misuse and suicide as a result of the coronavirus pandemic.

"We've seen unemployment rates go higher than what we were anticipating, which means that some of the estimates on those deaths could actually increase substantially," Ben Miller, a psychologist and the chief strategy officer for the Well Being Trust, told CNN.

"But what makes it all different and why I think that people do need to be paying attention to this is that the social issues, the sheltering in place, the isolation, the loneliness -- those are major, major risk factors for people not doing well psychologically, as well as potential premature mortality due to suicide or overdose," Miller said.

Some opioid deaths down, other drug overdoses up

The big difference in overall deaths of despair in 2018 compared to the year before, the researchers said, was the lower numbers of overdose deaths involving prescription opioids, such as oxycodone and hydrocodone, and to a lesser extent heroin, which were down by 2%.

"I think the bright spot in the report is that we can see that some strategies that our nation has pursued around opioids might actually be working for some communities," Miller said.

The study, which analyzed numbers from the US Center for Disease Control and Prevention since 1999, also found that while some drug-related deaths declined for the first time in a decade, including for whites and those between 18 and 54 years old, deaths from other drugs increased.

Drilling down into the report reveals some troubling trends. The death rate overall for synthetic opioids, such as fentanyl and carfentanil, for example, was up by 10% in 2018 to 14 deaths per 100,000 compared to 3.5 deaths per 100,000 in 2013. Deaths involving cocaine, methamphetamine, ecstasy and other prescription stimulants were also higher.

Minority deaths of despair on the rise

Also troubling, whites were the only racial group that saw a decrease in overall deaths from drug overdoses in 2018 -- by 6% or 23.3 per 100,000. The numbers were worse than the year before for Native Americans, African Americans, Asians and Latinos, who all experienced increases in drug overdose deaths, the report found, with blacks and native Americans experiencing the largest rise.

"Blacks now have higher synthetic opioid overdose rates (10.7 per 100,000), cocaine overdose rates (8.8 per 100,000) and nearly the same overall drug-induced death rate (21.8 per 100,000) as whites, after decades of having substantially lower rates," the report read.

"The ongoing structural inequalities in this country are so profound that I think that this report also does call out those disparities that have been here for a long time, and they're not getting any better. And, so, we have to think beyond one size fits all for providing meaningful solutions for communities that really are having major problems around this," Miller said.

The report also revealed that overall drug-related deaths increased at the highest rate among Asian Americans from 2017 to 2018, increasing by 6% to 4.2 deaths per 100,000, and among Native Americans these deaths were up 5% in 2018. Suicide rates also increased the most among Native Americans and Latinos.

"These data are a clarion call to action," John Auerbach, president and CEO of Trust for America's Health, said in a statement. "We know what works to address deaths of despair, but progress has been uneven and death rates continue to climb, with communities of color experiencing higher rates of increases in drug-induced and alcohol deaths."

Still too many preventable deaths

Miller said the US responded to the broader opioid epidemic that has been gripping parts of the country for the past decade and it's reflected in this report, but the broader addiction crisis has not been addressed in the same way.

"It was only about opioids because a lot of those strategies have worked but they have not necessarily done as much as they could have done to address issues across the broader community," he said.

"Arguably any death due to a preventable cause is a death that we should have done something about," he added. "I think that the most important findings from this study is that 150,000, while it wasn't substantially more than the previous year, it is still too many.

The report makes recommendations for combating deaths of despair, including promoting racial equality, reducing risk factors, such as violence, unstable housing and discrimination, and increasing access to health care.