Is the opioid crisis peaking?

It’s all very preliminary, but there is a glimmer of hope that the epidemic of drug-overdose-related deaths is beginning to decline. A fresh report from CDC, “Vital Statistics Rapid Release,” indicates that the 12-month running estimate of overdose deaths peaked last September, at 73,133, and has steadily declined, to 71,073, in March, the latest reporting period. (These are “predicted” numbers; CDC goes through a process of comparing past patterns of initial reports from public authorities with final reports once a medical determination has been made to provide the predicted value.)

There’s no reason to be relieved at the announcement; it could bump upward again; and there’s little understanding of why it’s declining. CDC hypothesizes that the decline could be attributed to wider use of emergency naloxone (to resuscitate an overdose victim), to greater care being taken by drug addicts. Heroin and fentanyl—the main causes of overdose deaths—are still present among victims, and abuse of prescription opioids is still a factor, even though opioid prescribing has been on a downward slope for several years now. Plus, it’s worth keeping in mind that a mortality count relates only indirectly to the underlying drug abuse itself; the US still has a massive drug-addiction problem.

Commentators on the overdose crisis also cite a recent report in Science magazine, where biostatisticians looked back on decades of CDC data to find that the current opioid crisis might simply be the latest peak in a wave of drug abuse that began in the 1970s. Different drugs of abuse, and different affected populations, may have masked the extent and duration of the wave.