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Experts want to capitalize on declining fatal overdose rates

JUANA SUMMERS, HOST:

Thousands fewer people in the U.S. are dying from drug overdoses. Public health data from around the country shows the first big sustained drop in fatal overdoses since the opioid crisis began decades ago. Researchers and public health officials are racing to understand why this hopeful trend is happening so they can keep it going and save more lives. NPR addiction correspondent Brian Mann broke the story, and he joins us now. And Brian, you have been digging into these numbers along with some of the country's top addiction researchers. How big is the shift?

BRIAN MANN, BYLINE: Yeah, this is really unprecedented, Juana. Deaths from opioids, methamphetamines and other drugs are dropping fast, down 11% nationwide, down 15- to 20-, even 30%, in some hard-hit places like Ohio and Vermont. If this trend holds up, researchers say we could see 20,000 fewer deaths per year from drugs. I spoke about this with Dr. Nora Volkow. She's head of the National Institute on Drug Abuse.

NORA VOLKOW: This looks real. It looks very, very real. It is predominantly driven by significant reductions in mortality from opioids.

MANN: And in some places, deaths from fentanyl in particular have dropped dramatically just a year ago. That seemed like an unachievable goal.

SUMMERS: And Brian, this seems pretty remarkable. Is this improvement something that health officials believe that they can really build on?

MANN: Some government officials and frontline health workers, including Volkow, say the answer is to keep doubling down on public health programs, better medical treatment for people with addiction, especially the wider use of naloxone, also known as Narcan. That's the medication that reverses opioid overdoses.

VOLKOW: There are interventions that have been prioritized to address the crisis, which are expansion of naloxone to expansion of access to medications for opioid use disorder. And these two strategies work.

MANN: A lot of public health officials say the fentanyl overdose crisis isn't over, but they say these big gains validate their efforts and may show a way forward.

SUMMERS: Well, Brian, I mean, does everyone agree that the U.S. should just - I don't know - just keep doing what we're doing?

MANN: Well, this is interesting. No. In fact, a lot of drug policy experts say these gains and improvements are so big and so sudden that they may not be explainable by those public health strategies alone. I spoke about this with Dr. Dan Ciccarone. He's a researcher at the University of California San Francisco.

DAN CICCARONE: What makes this fascinating is the speed at which it's happening. Everyone's going to come out now and claim that what they did is what caused the decline.

MANN: So Ciccarone and others I spoke to, Juana - they say there's a mystery here, some factor that's driving this positive trend. And this matters because if we don't know why the change is happening, it's going to be harder to sustain.

SUMMERS: Brian, are you hearing other theories out there about other factors that could perhaps be reducing drug deaths?

MANN: Yeah, there are a ton of these theories. For sure, things like Narcan are helping. Everybody agrees about that. The U.S. is also hitting the Mexican drug cartels really hard, making big arrests and drug seizures. Some researchers say fentanyl is now harder to get and less pure in some areas.

Another possibility is that this trend finally reflects the end of the COVID pandemic. More people are getting out. They're less isolated. That could mean they're using fewer drugs, finding ways into treatment and health care programs.

SUMMERS: I mean, Brian, this sounds like really good news, but I wonder, do people think that this positive trend is going to continue?

MANN: You know, I'm hearing a lot of hope. We know more resources are reaching people in addiction. Experts say the U.S. is slowly getting better at helping people caught up in this drug epidemic. For now, these improvements actually seem to be accelerating. No one thinks this overdose crisis is over. A lot of people are still dying. But, Juana, after decades of super grim statistics, researchers think this pivot is real, and they think it's going to offer clues about how to save even more lives.

SUMMERS: That's NPR addiction correspondent Brian Mann. Brian, thank you.

MANN: Thanks so much. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.