While the overall number of drug overdose deaths in the United States decreased slightly in 2018, deaths linked to fentanyl and related substances continued to climb, according to newly released data from the Centers for Disease Control and Prevention (CDC). The findings paint a complex picture of the opioid crisis—one in which progress is being made in certain areas, but deadly threats like fentanyl remain stubborn and persistent.
At the same time, suicide death rates also ticked upward, highlighting the continued importance of mental health initiatives alongside substance use prevention efforts.
Fentanyl Continues to Drive Overdose Deaths
The CDC’s latest analysis reveals that fentanyl and similar synthetic opioids continue to fuel overdose deaths nationwide. In 2018, deaths involving fentanyl, its analogs, and tramadol rose from 9 per 100,000 people in 2017 to 9.9 per 100,000—a 10% increase in just one year.
This upward trend is alarming, particularly as deaths related to other opioids and drugs declined during the same timeframe. Fentanyl, a synthetic opioid 50 to 100 times more potent than morphine, remains the deadliest substance in the ongoing opioid epidemic.
Part of the reason fentanyl is so dangerous lies in its potency and its increasing presence in the illicit drug market. It is often mixed with other substances, including heroin, cocaine, and counterfeit prescription pills, frequently without the buyer’s knowledge. Even minuscule amounts can be fatal, making accidental overdoses all too common.
Other Opioid Deaths Decline
While fentanyl-related deaths surged, the CDC reported modest declines in overdose deaths linked to other opioids:
- Heroin: Deaths decreased from 4.9 per 100,000 people in both 2016 and 2017 to 4.7 per 100,000 in 2018.
- Natural and Semi-Synthetic Opioids: Overdoses from drugs such as hydrocodone and oxycodone fell from 4.4 per 100,000 people to 3.8 per 100,000.
- Methadone: Deaths also dropped slightly, from 1.0 per 100,000 in 2016 and 2017 to 0.9 per 100,000 in 2018.
These figures suggest that efforts to curb the misuse of prescription opioids and heroin are showing some success. Many states have implemented tighter prescribing guidelines, launched medication take-back programs, and expanded access to naloxone, a life-saving opioid overdose reversal medication.
However, fentanyl’s dominance presents a unique challenge that requires different solutions, as it is often manufactured illicitly and trafficked across borders, making traditional prescription monitoring less effective.
Overall Overdose Deaths Show a Modest Decline
Despite the troubling rise in fentanyl-related deaths, the CDC reported an overall decline in drug overdose fatalities. In total, 67,367 people died from drug overdoses in 2018, down from 70,327 in 2017—a decrease of just over 4%.
This decline, while modest, marks the first time in decades that the nation’s overdose death toll has fallen year-over-year. Public health officials have attributed this progress to several factors, including:
- Expanded access to medication-assisted treatment (MAT) for opioid use disorder
- Greater distribution of naloxone
- Public awareness campaigns around opioid risks
- Law enforcement efforts targeting drug trafficking networks
However, experts caution that the overall decrease doesn’t tell the full story—especially with fentanyl still driving large numbers of deaths.
Suicide Deaths Also Increase
In addition to tracking drug overdose fatalities, the CDC also reported a continued rise in suicide deaths. In 2018, the suicide rate increased by 1.4% compared to the previous year, continuing a troubling trend of rising suicide rates over the past decade.
The data serves as a reminder that mental health challenges are deeply intertwined with the opioid crisis and broader public health concerns. Individuals struggling with substance use disorders often face co-occurring mental health conditions such as depression or anxiety, putting them at greater risk for suicide.
Public health experts emphasize the need for integrated approaches that address both mental health and substance use, including:
- Expanding access to mental health care and crisis intervention services
- Reducing stigma around mental illness and substance use disorders
- Enhancing suicide prevention programs in schools, workplaces, and communities
Federal Officials Highlight Progress
Despite the mixed results in the CDC’s data, officials from the Trump administration at the time hailed the overall decrease in drug overdose deaths as a positive sign.
“This news is a real victory, and it should be a source of encouragement for all Americans who have been committed to connecting people struggling with substance abuse to treatment and recovery,” U.S. Department of Health and Human Services (HHS) Secretary Alex Azar said in a press release.
Azar credited the administration’s focus on combating the opioid epidemic—through investments in treatment programs, community partnerships, and law enforcement—with helping to drive the overall decline.
However, he also acknowledged that significant work remains to be done.
“The drop in overdose deaths shows that the President’s new level of focus on the opioid crisis, and the administration’s science- and community-based efforts to combat it, are beginning to make a significant difference,” Azar said. “But we know this crisis is far from over.”
The Road Ahead: Cautious Optimism
While any decrease in overdose deaths is welcome news, public health experts stress that the fight against the opioid epidemic is still ongoing. The rise in fentanyl-related deaths, in particular, signals the need for more targeted interventions, such as:
- Enhanced Fentanyl Detection: Equipping law enforcement and first responders with better tools to detect fentanyl in the drug supply.
- Broader Distribution of Naloxone: Making naloxone widely available in communities heavily affected by fentanyl.
- Harm Reduction Strategies: Supporting programs like supervised consumption sites, syringe exchange services, and fentanyl test strip distribution.
- Expanded Treatment Access: Increasing the availability of MAT, including buprenorphine, methadone, and naltrexone, especially in underserved areas.
- Public Education: Raising awareness about the risks of fentanyl and how to recognize and respond to overdoses.
Additionally, addressing the growing suicide crisis requires a national focus on mental health care access, prevention programs, and early intervention.
Conclusion
The CDC’s latest data offers a nuanced view of the nation’s struggles with drug overdose and suicide deaths. While the overall decline in drug overdose fatalities is a hopeful sign, the continued rise in deaths from fentanyl and the increase in suicide rates make it clear that America’s public health crisis is far from resolved.
Moving forward, policymakers, health care providers, and communities must work together to combat the dual challenges of synthetic opioids and mental health crises. Only through sustained investment, innovation, and compassion can the nation continue to make meaningful progress toward saving lives and supporting recovery.
