Fentanyl overdose deaths suffer a considerable drop: What is behind this trend?

The fentanyl crisis remains a serious problem in the United States. According to the latest data from the Centers for Disease Control and Prevention (CDC), an estimated 112,323 people lost their lives to drug overdoses between June 2022 and June 2023, 70% of whom died from fentanyl overdoses. However, although the picture is not very encouraging, in recent months, the situation has taken a different turn, one that could be the harbinger of a change in trend with respect to this problem.

Indeed, fentanyl deaths fell by 14.5% in the last seven months. Although 97,000 deaths are estimated for this last period, the figure shows a drop compared to the previous measurement.

Fentanyl has become scarce and expensive

As for the causes of this decline in overdoses, experts point to a few. For example, one variable is the decline in the "quality" of fentanyl pills. The aggressive approach by authorities to affect the traffickers' supply chain has meant that pure, and of course, more lethal, fentanyl has become scarce and expensive.

Anne Milgram, director of the Drug Enforcement Administration (DEA), said the agency is seeing a decline in the potency of fentanyl pills for the first time since 2021.

"Decreases in drug related deaths and the lethality of pills equals lives saved. The 14.5% decrease in poisonings and overdose deaths translates to more than 14,000 American lives saved. The cartels have reduced the amount of fentanyl they put into pills because of the pressure we are putting on them," she explained.

"Last year, seven out of 10 counterfeit pills tested in D.E.A. labs contained a life-threatening amount of fentanyl, she said, but that number has dropped to five out of 10," the New York Times reported.

Traci Green, who runs a drug control program in Massachusetts, reinforced this explanation. "We have been seeing for a while fentanyl changing: how much fentanyl is in the supply, the kinds and the form," she told the NYT.

Another factor noted is the widespread use of Narcan, a drug designed to prevent overdoses.

A joint investigation among several institutions and published in the National Library of Medicine found that the form of fentanyl consumption has also changed. As they explained, fentanyl is often diluted with xylazine, an animal tranquilizer.

For Colin Miller, a researcher at the University of North Carolina at Chapel Hill, if someone consumes fentanyl mixed with xylazine, "they may not inject another bag of fentanyl, because they become unconscious." Indeed, the cited research showed that patients admitted to emergency departments for fentanyl overdoses had less severe outcomes when xylazine was also detected.

Drop in overdoses

This is what the data collected from the CDC suggest. Because fentanyl lozenges now contain lower doses of this opioid, it is more difficult to reach overdose. The figures showed a year-over-year decrease of 24% in April and 13% from June. In turn, calls to 911 and other answering services were 17% lower in September than a year earlier.

However, experts also warned that the number of deaths per year remains above pre-pandemic data.

Dr. Sarah Wakeman, senior medical director for substance use disorders at Mass General Brigham, told CNN that "having the opportunity to feel hope after so many years" was wonderful. She clarified that "there are still more people dying from overdoses than before the pandemic." "We’re still stratospherically higher than we should be in terms of people dying from a preventable cause of death," she added.

What is fentanyl?

According to the Mayo Clinic website, it is "a broad group of analgesic drugs that interact with opioid receptors on cells," which "are distributed through the blood and bind to opioid receptors on brain neurons," releasing "signals that dampen your perception of pain and increase the sensation of pleasure."

Within the synthetic opioids, i.e., laboratory-made ones, appears fentanyl, which happens to be up to 50 times stronger than heroin and 100 times stronger than morphine.

There are two types of fentanyl: pharmaceutical and illegally manufactured. While the former is medically prescribed to relieve pain related to surgeries or illnesses, the latter circulates on the black market and proves to be much more dangerous. Why is this? Because of its extreme potency, traffickers mix it with other substances to make it cheaper and more harmful to the body. It is available in both liquid and powder versions.

The lethal dose for adults is estimated to be two milligrams, which happens to be less than the average weight of an ant.