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Overdose Rates Are on the Decline: Prevention and Response Efforts Must Not Be

By Abigail Winiker

On March 17, the Johns Hopkins Bloomberg School of Public Health Center for Mental Health and Addiction Policy hosted a panel of experts for a discussion on Developing a Better System of Care for Nonfatal Overdose. The panelists came from several states and disciplines to discuss their communities’ approaches to overdose prevention and post overdose care.

The panelists were: 

  • Valencia Lyle, MPH, a health policy expert who serves as the Opioid Crisis Response Program Manager in the City of Detroit Mayor’s office; 
  • Stephen Murray, MPH, NRP, the Director of the SafeSpot Overdose Hotline at Boston Medical Center in Massachusetts; 
  • Divad Sanders, the Program Director for the Newark Community Street Team’s Overdose Response Team and Harm Reduction Center in New Jersey; and 
  • Dr. Jean R. Moise, the Deputy Director of Adult Services within the District of Columbia’s Department of Behavioral Health.

The event comes at a time when the US has seen the first significant declines in fatal overdose rates since the start of the overdose crisis: the Centers for Disease Control and Prevention reported a nearly 24% decrease in drug overdose deaths between September 2023 and September 2024.1 The drivers of the decrease are likely multifactorial, including primary prevention and improved access to treatment, recovery supports and harm reduction programs. 

While overdose deaths did drop by over 27,000 individuals, the country still lost 87,000 people to fatal overdose between October 2023 and September 2024 and overdoses remain the number one cause of death for Americans between the ages of 18-44. Additionally, many disparities persist; although rates have decreased among white individuals, overdose mortality remains on the rise among some racial groups including Black, LatinX, and Native American populations.

Panel members at the event shared their continued commitment to investing in overdose response and prevention efforts.

  • Sanders described providing targeted naloxone distribution and training to those who may be likely to witness an overdose, such as peers of people who use drugs and sellers
  • Dr. Moise described D.C.’s efforts to get creative in reaching populations with limited access to services, including strategic placement of naloxone vending machines
  • Lyle shared Detroit’s successful multidisciplinary collaborations between street outreach teams, case workers, and clinicians to offer behavioral health and primary care along with post overdose response efforts to rough sleepers in the community
  • Murray presented SafeSpot, a 24/7 hotline providing safety and overdose response services to people using drugs alone, which fielded 5,000 calls and led to 21 overdose reversal events in the past year

Some considerations stressed by panelists that are essential to any overdose response work: 

  • Sanders warned against adopting a “cookie cutter” mentality, stressing the importance of individualized care for everyone with an opioid use disorder  
  • Murray emphasized giving people with lived experience a “seat at the table” in all planning and implementation efforts, highlighting that 65% of his team members at SafeSpot have lived experience with substance use disorders
  • Murray also identified the need to use data to evaluate program impacts and respond accordingly, including being willing to abandon efforts that aren’t working 
  • Lyle shared Detroit’s efforts to embed stigma reduction interventions into their programming, including among nursing home and medical staff

Panelists also emphasized the need to enhance the capacity of ongoing work. In particular, opioid settlement fund dollars were seen as an opportunity to expand the reach of ongoing efforts and help those who continue to face a disproportionate burden of harms from the opioid crisis. To achieve this, they stated, communities must critically examine both who has access to their services and more importantly, who is being left out. In particular, the following groups can face challenges in accessing needed services:

  • LGBTQ people,
  • Various racial and ethnic groups,
  • Youth and adolescents,
  • Pregnant and parenting individuals, 
  • Older adults,
  • People who sell sex,
  • People with a current or past history of carceral involvement, and
  • People in early stages of recovery.

Overdose deaths remain one of the most significant public health challenges of our time despite the recent decrease in the number of overdose deaths. Growing disparities provide an opportunity for public health leaders to critically examine current overdose prevention and response efforts, identify what’s working, and expand their efforts to reach all communities affected by the epidemic.

Interested in hearing more? Watch the public panel here!

About the author:

Abigail Winiker, PhD, MSPH, is an Assistant Scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and the new Program Director for the Bloomberg Overdose Prevention Initiative. Her many years of work and training in harm reduction and health education inform her public health practice. She strives to conduct research with direct translational implications to improve outcomes among at-risk populations.